Shoulder pain and scapular dysfunction go hand in hand. I work with a lot of overhead athletes and pitchers. Keep in mind that throwers are expected to have some asymmetries. This exercise is an example of what I term integrated closed kinetic chain upper extremity training and serves as both an assessment tool and effective scapular training exercise.
Begin in a tall plank position with the feet shoulder width apart and the hands beneath the shoulders. Next, slowly extend the left arm out in a diagonal motion ('Y' or 45 degrees). Pause for one second and then return to the start position.

Repeat the same motion on the other side. Continue this alternating sequence for 5-10 repetitions. Focus on maintaining a neutral spine while working to avoid pelvic rotation, keeping the pelvis parallel to the floor. The movement should be slow and deliberate. Bear in mind there will be some small pelvic movement, but the client should strive to be as still as possible in the hips.

While most clients will struggle enough with this exercise, those who do master it can be further challenged by placing the feet together to reduce stability or increasing the cadence resulting in more time under tension.

For those clients unable to do this exercise, modify it by moving through the following...
1. Quadruped diagonal reach with knees shoulder width apart
2. Quadruped diagonal reach with knees together
3. Tall plank diagonal arm lift off (markedly reduced motion)

I utilize this exercise as an assessment tool for clients as well as a training modality to increase shoulder, torso and hip stability while activating the lower trapezius of the moving arm. It can also be used as part of an active warm-up. This is an advanced exercise that requires a pre-requisite level of upper body strength and shoulder stability. Clients will tend to rush through the motion since it is challenging so proper tactile and verbal cues following a precise demonstration will be needed to ensure maximal effectiveness.

Brian Schiff, PT, OCS, CSCS, is a licensed physical therapist, respected author and fitness professional. Currently, he serves as the supervisor for EXOS API at Raleigh Orthopaedic. Brian conducts live continuing education webinars and presents nationally at professional conferences and seminars on injury prevention, rehab and sport-specific training. For more information on his products and services, visit