Starting position: Stand with your arms in front of your body, elbows flexed 90° and a piece of elastic band or tubing placed across the hands in the palm-up position. Shoulders are in neutral rotation such that the hands are directly in front of you.
Exercise action: With light tension in the band, externally rotate both shoulders by moving the hands apart about 3 to 6 inches (8 to 15 cm) against the resistance of the band. While holding this position, maximally retract and depress (squeeze shoulder blades together and downward), holding this end position for 1 to 2 seconds. Return to the starting position by relaxing the shoulder blades and moving the hands back toward each other.
Primary muscle groups: Scapular stabilizers, rotator cuff
Indications: Excellent exercise to recruit the lower trapezius with little activation of the upper trapezius
Contraindications: Shoulder pain
Pearls of performance: Ensuring that the patient maximally retracts the scapulae is an important guide in this exercise. Giving feedback by palpating the scapular medial border is recommended during skill acquisition of this exercise.