As a physiotherapist I get to see a ton of patients that come in with shoulder problems. The number one profile I see with this; a late 30s, early 40s desk jockey who hits the gym and trains but is otherwise sedentary, overweight and living a happy suburban life. They come in, take of their jacket and immediately their shoulders are not level, not even close; one is always down and forward.

The typical story I get when taking their history goes along the lines of; “I was reaching up to the top shelf at work to get a package of computer paper, I turned to see who came into the room and ‘pop’ something happened to my shoulder. The next day I went to the ER cause it hurt like a ***** but the x-ray said no fracture. The doctor gave me muscle relaxants and told me to take a day or 2 off work. It’s been 2 weeks and it hasn’t gotten better.” I do a few quick tests and then begin moving the shoulder back into alignment.


What happened?

The shoulder is inherently unstable compared to most joints. Think about how limited a knee is and how much muscle crosses it. There are a ton of things holding a knee in place. A shoulder, in order to maximize mobility—part of our primate inheritance for climbing—must be loose in the socket. 4 small muscles which make up the rotator cuff stabilize the gleno-humeral head and the scapula (shoulder blade). They are the supraspinatus, infraspinatus, teres minor and subscapularis. There won’t be a test, don’t worry. Since we don’t spend our time climbing, hanging from rings or ropes, getting into forest canopies, etcetera, the function of these stabilizer muscles isn’t fulfilled. Combine that with a lifetime of forward pushing (bench press guys), crappy desk jockey posture, crappy watching the game on the couch posture and what do you think is going to happen to those 4 small muscles when you break alignment?

The Solution

We can avoid 90% of shoulder issues with a simple prehab program. 3 days a week at 2×15/day complete the following exercises:

1. scapular retraction with depression

Scapular Retraction With Depression

Scapular Retraction With Depression


2. side-lying external rotation

side-lying external rotation


3. side-lying horizontal abduction

side-lying horizontal abduction


4. I-Y-W-T-M

Illustrated: Y, T, H special thanks to

Illustrated: M by Al-Jahara hospital, W by

The overwhelming majority of shoulder problems can be solved with direct muscle work and minor postural corrections. Rather than waiting till you have a problem, you can add this to your routine as part of warm up or cool down. It’s a bit tedious but so boredom from injury is worse.

Train Smart



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Guy Razy holds a B.Sc. degree in Kinesiology, and an M.Sc. in Physiotherapy from McGill University. He is also one of the original and longest serving Agatsu kettlebell coaches in Canada. His experience in high performance sports started as a competitive fencer in Quebec where he competed at provincial tournaments. As a kinesiologist, he was a successful full-time fitness professional in Montreal before moving into full-time physiotherapy in 2008. Since that time, his approach to strength and conditioning has been informed by an intricate knowledge of the musculo-skeletal system and both orthodox and unorthodox training methods. His approach is highly skilled, but extremely practical and effective.