Therapeutic exercise
Side-Lying Eccentric External Rotation
Eccentric variant of side-lying external rotation with a dumbbell. The focus is on the controlled lowering phase — essential in rotator-cuff tendinopathy rehabilitation, when the patient already tolerates dynamic load but needs to remodel the tendon with prolonged loading.
How to perform
- Starting position. Lie on your side, with the affected side up, head resting on a pillow and knees bent.
- Step 2. Hold a light dumbbell (1–3 kg) in the hand on the affected side, keeping the elbow flexed at 90° and tucked against the trunk.
- Step 3. Start with the forearm in maximum external rotation (dumbbell pointing toward the ceiling).
- Step 4. Lower the dumbbell slowly over 4–5 seconds until the forearm crosses the line of the trunk into internal rotation — this is the eccentric phase.
- Return. Use the other hand to return the dumbbell to the starting position (skip the concentric phase) and repeat only the lowering movement.
When not to perform
- Tendinopathy in an acute reactive phase (start with isometrics first)
- Complete rotator-cuff rupture
- Recent post-operative tendon repair
- Glenohumeral instability
- Recent dislocation
- Pain that does not reduce within 24 hours after the exercise (sign of overload)
Medical disclaimer. These exercises are presented for informational purposes only. Always consult your physician before starting any exercise program, especially in case of acute pain, recent injury, or underlying clinical condition.
Related Exercises
Side-Lying Shoulder Wiper
A wide windshield-wiper-like sweeping motion of the shoulder in side-lying, covering the range of internal and external rotation in a controlled manner. Isolates the subscapularis and the posterior cuff simultaneously — useful for recovering range and coordination after immobilization.
Isometric Shoulder External Rotation
Isometric contraction of the shoulder external rotators (infraspinatus and teres minor) without joint movement. The first stage of rehabilitation in reactive rotator-cuff tendinopathy — reduces pain through central analgesic mechanisms without loading the inflamed tendon.
Banded External Rotation
A functional variant of external rotation, performed standing with elastic resistance. Excellent for progression and maintenance in chronic rotator-cuff tendinopathy.