The Best Shoulder Exercises

There really are no best exercises because the best exercises are the ones that are the most appropriate...

For the athlete, the best exercise he or she needs is the most appropriate one for that given training session, of that given microcycle, of that specific training block, for that...well you get my drift.

And for the patient, as I've mentioned previously, the best exercise is the one that is the most relevant, non-painful, and challenging  exercise that they can perform well...and very often the one that demonstrates within session improvement in mechanical sensitivity.

• Relevant meaning along the continuum of exercise progressions (and regressions) for their specific condition. Remember, relevant doesn't necessarily mean that you are mimicking a particular movement in their activities of daily living. It simply means that it is relevant to their presentation based on your assessment.
• Non-painful because in the presence of pain, it is known that we develop high-threshold strategies that result in neuromuscular compensations...and we don't want to perpetuate compensations, do we?
• Challenging and one they can perform well to maximize the potential of myelination within the brain. This is neuroplasticity. This is motor learning.

Does that mean they only need one exercise? No. But each exercise prescribed should have a purpose. When it comes to "corrective exercise", shouldn't we be "correcting" something?

Having said all that, the majority of my work pertains to the injured population. Athletes and non-athletes, I work with them both and while some may view them as two separate populations, very often the means to which we progress their care (especially in the early stages of rehab) are quite similar.

Take for example a patient who demonstrates poor neuromuscular control of the shoulder. Let's say we've followed the rules of whatever system we subscribe to but for that given presentation, the individual warrants neuromuscular retraining of the shoulder. We have already addressed the other 9 principles of rehabilitation for the shoulder, we have applied our techniques to enhance neural drive to this region, and we have utilized a biospychosocial approach to care to ensure that we are comprehensive in our approach.

In addition, we (may) have performed some manual rhythmic stabilizations with this individual because, as mentioned earlier, this demonstrated positive results with respect to decreasing mechanical sensitivity or improving function.

But if the above manual intervention brought about meaningful change then what type of exercise should we send them home with? Well how about the Bottoms Up Kettlebell Screwdriver and Armbar?

The reason I think these exercises are relevant is because they elicit rhythmic stabilization and proprioception without cognitive input. The glenohumeral rotations and the medial-lateral excursions of the scapula on the thoracic cage are great but the true value of these exercises come from the following:

• Increased neural drive via forceful gripping of the kettlebell (see this post by Carson Boddicker for more information)
• The constant, ever changing, and unpredictable stimulus elicited by the bottoms up kettlebell that warrants dynamic stability. This is neuromuscular control!

You really don't need a heavy weight because if your patient, client or athlete is at the stage where they need rhythmic stabilizations, they probably won't need more that 16kg. I often start with 4-8 kg and once they get it, I move on...on to the next exercise required for that individual.