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Exercises for Preventing Shoulder Pain | Jeff Cavaliere & Dr. Andrew Huberman

Huberman Lab Clips12:36Added Aug 31, 2026

Jeff Cavaliere and Dr. Andrew Huberman discuss the mechanics of shoulder health and the importance of external rotation, explaining how strengthening the rotator cuff prevents joint impingement by keeping the humerus centered and providing practical strategies for improving joint stability and mobility.

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Contributed by 刘嘉琪

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  1. Shoulder Health Introduction

  2. 00:00the shoulders. Um, I'm gonna knock on
  3. 00:02wood in a second because I I've been
  4. 00:04fortunate that my shoulders haven't
  5. 00:05given me issues, but that means it's
  6. 00:07probably just next. But perhaps that's
  7. 00:09also the consequence of having once
  8. 00:11again listened to your content and
  9. 00:14whenever possible, I've tried to get
  10. 00:16into external rotation, which is uh if I
  11. 00:19reference the fs, will anyone know what
  12. 00:20I'm talking about? So, thumbs out and uh
  13. 00:23you know, giving the thumbs up, but
  14. 00:24thumbs rotated away from the belly
  15. 00:25button, away from the midline. Could you
  16. 00:27explain where the shoulder tends to be
  17. 00:30most vulnerable and this business of
  18. 00:32internal thumbs pointing toward the
  19. 00:33belly button versus external rotation
  20. 00:35during all sorts of movements and also
  21. 00:37just daily life? Good point here too is
  22. 00:40on top of the thumbs is, you know, not
  23. 00:42just the flipping of the hand itself
  24. 00:45through supernation and pronation of the
  25. 00:48forearm, but literally letting the elbow
  26. 00:50kind of travel with that, right? So,
  27. 00:52you're letting everything move together
  28. 00:53cuz it's the it's the rotation that's
  29. 00:55happening in this joint, this ball and
  30. 00:57socket up top.
  31. 00:58Shoulders got to rotate out, right? So,
  32. 01:00we're not just we're not just talking
  33. 01:02about moving your thumbs away from your
  34. 01:04belly button out for those just
  35. 01:05listening. We're talking about getting
  36. 01:07the elbows in in a bit more. As those
  37. 01:10thumbs go out, the shoulders externally
  38. 01:12rotating as well.
  39. 01:13Yeah. Which is key. And and
  40. 01:16the the issue with internal rotation,
  41. 01:18external rotation is that it's in
  42. 01:20they're both motions of the shoulder,
  43. 01:21right? We're need we need both of them.

  44. Controlling Internal Rotation

  45. 01:23We need to be able if you go back to the
  46. 01:25pitcher, he needs to be able to
  47. 01:26externally rotate and then of course
  48. 01:28internally rotate to throw the ball. I'm
  49. 01:30not saying that internal rotation is is
  50. 01:32is the devil. What we need though is the
  51. 01:36ability to control internal rotation. We
  52. 01:39need to be able the ability to have
  53. 01:40enough external rotation strength to
  54. 01:42hold that position for longer or to or
  55. 01:45to be able to control right the ex the
  56. 01:47eccentric control from the external
  57. 01:50rotators is what actually controls the
  58. 01:51internal rotation. the eccentric control
  59. 01:54from the internal rotator external
  60. 01:55rotators from the external rotators
  61. 01:56which controls internal rotation because
  62. 01:58as we're lengthening the external
  63. 02:00rotators we're controlling if we have
  64. 02:02good control the eentric control of that
  65. 02:04then we're slowing down the internal
  66. 02:06rotation or at least controlling it at a
  67. 02:08certain pace that's extremely important
  68. 02:10when it comes to pitching. we have this
  69. 02:13rapid internal rotation going on which
  70. 02:16is essentially the thumb is moving
  71. 02:18toward the midline to throw and so is
  72. 02:20the
  73. 02:21so is the elbow so is your shoulder.
  74. 02:23So if the external rotators are
  75. 02:25eccentrically strong they can control
  76. 02:27that and control the the pace of that
  77. 02:29and make sure that it's not outpacing
  78. 02:31what your your shoulder itself can can
  79. 02:33structurally protect. So it's important
  80. 02:36to have that too. But internal rotation
  81. 02:40in the world of the of of the
  82. 02:42non-athlete is particularly problematic
  83. 02:46if a you're posturally holding that
  84. 02:48position for way too long throughout the
  85. 02:50day and which is what we all chronically
  86. 02:53are suffering from whether we're
  87. 02:54texting, typing, not focusing ever on
  88. 02:58the external rotators of our, you know,
  89. 03:00in our training. You're just getting
  90. 03:02chronically tight and internally
  91. 03:04rotated. And then when you go to do even

  92. Risks Of Shoulder Impingement

  93. 03:07basic things like lift your arm up over
  94. 03:09your head, you're creating an internal
  95. 03:11shoulder environment that's more prone
  96. 03:14to
  97. 03:16creating less space in inflaming tissues
  98. 03:19that wind up getting pinched in that
  99. 03:20position. That basically when you're
  100. 03:22tight internally, you get changes to the
  101. 03:26shoulder capsule itself, which is all
  102. 03:27the ligamentous structures that surround
  103. 03:29it that make you more internally rotated
  104. 03:31and tight. You can't get out of that
  105. 03:33position. And so now when I go to raise
  106. 03:35my arm up, there's just less room in
  107. 03:37here. For instance, I think I we might
  108. 03:39have done this before you and I, but if
  109. 03:40I were to have you just lean forward
  110. 03:42like this or slump your shoulder and
  111. 03:44then raise your arm as high as you could
  112. 03:45in front of you, you're going to that's
  113. 03:47as far as you get, right? And you're
  114. 03:48limited not because of anything that's
  115. 03:51necessarily tight right there, but
  116. 03:53structurally there's a little bony bump
  117. 03:56on the top of your humorris that's
  118. 03:58actually getting stuck on the upper
  119. 04:01portion of your shoulder joint there. So
  120. 04:02now Bring your arm down. Open up your
  121. 04:05chest as much as you can. Turn your arm
  122. 04:07out a little bit. Now raise it up
  123. 04:08overhead and it goes higher. Why?
  124. 04:10Because you just created external
  125. 04:12rotation inside the joint that allows it
  126. 04:14now to go up in a higher position. Well,
  127. 04:16what happens if you're chronically in
  128. 04:18this position of internal rotation and
  129. 04:21you go to raise your arm, you go to wash
  130. 04:23your hair, you go to get stuff out of
  131. 04:24the cabinet, you go to do all the things
  132. 04:26you do every day. Every time with there
  133. 04:28being less space in there, there's more
  134. 04:30likelihood to pinch on a super spinus
  135. 04:33tendon. There's more likelihood to be
  136. 04:34pinched on a bersa. There's more any and
  137. 04:36every time we pinch, we potentially
  138. 04:38inflame and cause more swelling inside
  139. 04:41that joint, which causes less joint
  140. 04:43space, right? So, you're inflaming those
  141. 04:46tissues, more more uh compression in
  142. 04:48that joint, and then more pain
  143. 04:50ultimately. And then that winds up
  144. 04:51causing down the road things like
  145. 04:54partial thickness tears and tears of the
  146. 04:56of the rotator cuff that we don't want.

  147. Function Of Rotator Cuffs

  148. 04:58So internal rotation in this elevated
  149. 05:01position is not good. having external
  150. 05:06rotation abilities or strength that can
  151. 05:09help to centralize what it what it
  152. 05:11really does when people talk about
  153. 05:12rotator cuff training is yes you're
  154. 05:15working the external rotators but really
  155. 05:16what its main job is to actually keep
  156. 05:20that ball centered in the middle of the
  157. 05:22socket.
  158. 05:23I see.
  159. 05:23So as you go and you raise your arm up
  160. 05:26in an internally rotated dominated
  161. 05:29dominant shoulder, it will migrate up.
  162. 05:32Why? Because the deltoid pulls up. So as
  163. 05:35you're raising your shoulder up, the
  164. 05:37deltoid is pulling that humorous up and
  165. 05:40the internal rotation of the other
  166. 05:42muscles are already too tight,
  167. 05:43chronically tight or just keeping it in
  168. 05:45the front side anyway. So you're lifting
  169. 05:46your arm up and you're getting very
  170. 05:48little space. What the external rotators
  171. 05:50will do is they'll keep it centered so
  172. 05:52that as you raise instead of it
  173. 05:54migrating up, it's countering the force
  174. 05:57of the deltoid. So it's staying in the
  175. 05:59middle and it basically can rotate and
  176. 06:01stay right in the middle where it has to
  177. 06:02be. You're not getting this migration or
  178. 06:04pinching going on. So that's the real
  179. 06:06function of the rotator cuff is to
  180. 06:08maintain a more centralized position
  181. 06:10with less of this pinching. So you
  182. 06:12really have to focus on when we're
  183. 06:14talking about avoiding shoulder issues.
  184. 06:17The biggest thing you can do is start
  185. 06:19training the rotator cuff,
  186. 06:22not stop training the rotator cuff. And
  187. 06:24if you're doing a lot of heavy pressing
  188. 06:26or a lot of work with exercises that
  189. 06:28tend to internally rotate your shoulders
  190. 06:31now, then you have to do even more work
  191. 06:33for the rotator cuff to try to maintain
  192. 06:35that balance. If you're doing all kinds
  193. 06:36of delt work, you're never doing it
  194. 06:38rotator cuff work, you're just creating
  195. 06:39more and more of that imbalance. So I
  196. 06:42think the biggest thing you can do is
  197. 06:43maintain mobility of the shoulder,
  198. 06:45mobility of the shoulder girdle itself.
  199. 06:47So the the the scapula being able to
  200. 06:49rotate and then having strength of the
  201. 06:52muscles of that shoulder girdle which
  202. 06:53are the rotator cuff. Those are the
  203. 06:54three main things you can do to keep
  204. 06:56that shoulder functioning well and
  205. 06:58staying out of this domination of
  206. 07:00internal rotation with elevation. What's

  207. Banded External Rotation Exercise

  208. 07:02your favorite uh external rotator
  209. 07:05exercise?
  210. 07:06My favorite is just simply attaching a
  211. 07:09band to a stable. could be a stair uh
  212. 07:13like a a stair post or it could be in
  213. 07:16the gym just a rack, right? And you you
  214. 07:18step away. You you put the band in your
  215. 07:21hand from the anchor point. You're going
  216. 07:23to step out until there's good tension
  217. 07:25on the band. If you were to let it
  218. 07:27relax, you would pull your your hand
  219. 07:29towards your chest, towards your belly.
  220. 07:31You externally rotate to about back to
  221. 07:34neutral or a little bit beyond if you
  222. 07:35can.
  223. 07:36A little bit beyond your torso.
  224. 07:37Yep. Yeah. A little beyond your torso if
  225. 07:39you can. That's even better if you have
  226. 07:40that range of motion. Sometimes people
  227. 07:41don't. And when you get it there, you
  228. 07:43again hold it, right? You hold it for a
  229. 07:45second just so you know that you
  230. 07:46actually muscled it out there. You
  231. 07:47didn't just swing it out there. The
  232. 07:49number one thing people do here to
  233. 07:51cheat, and we talk about this, we talked
  234. 07:53about it in the gym quite a bit. Your
  235. 07:55body knows how to compensate. Like, if
  236. 07:58you ever want to know what you're doing
  237. 07:59wrong, just look at yourself in the
  238. 08:00mirror and then look and see what your
  239. 08:01body's trying to do. You'll realize the
  240. 08:03compensation is the direct opposite of
  241. 08:05what it's not doing, what the job is is
  242. 08:07is avoiding. So when the rotator cuff is
  243. 08:10trying to externally rotate the
  244. 08:11shoulder,
  245. 08:12the way I can avoid that is just lift my
  246. 08:15elbow away from my side. I can get my
  247. 08:17hand from here to here if I raise my arm
  248. 08:21out to the side. But now I'm using my
  249. 08:23delt to do it and not the rotator cuff.
  250. 08:24Keep that elbow pin.
  251. 08:25You got to keep the elbow pinned to the
  252. 08:26torso. So the easiest thing you can do
  253. 08:28is just put something underneath your
  254. 08:29arm, a little towel. Fold the towel, put
  255. 08:31it underneath there, and then do the
  256. 08:33exercise. And if you find that your
  257. 08:34towel is dropping to the floor, it's
  258. 08:36obviously that because you're lifting
  259. 08:38your shoulder, your elbow away from your
  260. 08:40body and you're using the wrong muscle.
  261. 08:42Do this as a warm-up. Do it at the end
  262. 08:44of the workout. How many sets, how many
  263. 08:46reps, how many times a week?

  264. Warmups & Training Frequency

  265. 08:47There's different applications of it.
  266. 08:48You can do it before a workout. So, if
  267. 08:50I'm going to press, like, let's say
  268. 08:52bench press, I could use this as a good
  269. 08:54warm-up before I go press almost as a
  270. 08:57neuroactivation technique to make sure
  271. 08:59those muscles are alert and firing so I
  272. 09:01can make sure that they're working when
  273. 09:02I go to press to keep my shoulders back
  274. 09:04in in a better position. And especially
  275. 09:06as I raise my arms up in an overhead
  276. 09:08press, I can make sure that they're
  277. 09:10alert, they're fired up, they're they're
  278. 09:12willing to contribute to keep that head
  279. 09:14centered when the arm's going up
  280. 09:15overhead. So, I like to do them on
  281. 09:17pressing days as a neuroactivator before
  282. 09:20I train. And it's serving as a warm-up,
  283. 09:22too, or on other days. Again, treating
  284. 09:24it as my special program, which is what
  285. 09:26I have to do because of all the issues
  286. 09:28that I've had with my shoulders. Again,
  287. 09:30not from this one didn't come
  288. 09:31necessarily from bad training, but just
  289. 09:33dumb decisions trying to throw a
  290. 09:34baseball back with the Mets. Um, I lost
  291. 09:37a bet. It's kind of famous at this at
  292. 09:39this point, but like a player bet me
  293. 09:41that I couldn't throw the ball from
  294. 09:43Well, let's rephrase that. I bet that I
  295. 09:45could throw the ball from right field to
  296. 09:47third base on the fly because it just
  297. 09:49looked rather short from where I was,
  298. 09:51but it's actually a lot longer and only
  299. 09:54the better arms in baseball can actually
  300. 09:56do that really easily. So, I have no
  301. 09:57idea why I thought I could, but I did.
  302. 10:00And literally the the moment I let that
  303. 10:02ball go, I feel like my lab went with it
  304. 10:05and maybe landed somewhere near second
  305. 10:07base because it just felt like a burning
  306. 10:10zipper pain in my shoulder and I've had
  307. 10:13to deal with it ever since. Did the ball
  308. 10:14get to the third base?
  309. 10:15Oh, no. No way. No. I think it landed
  310. 10:17with the labor bat at like second base,
  311. 10:19you know, like no way. So,
  312. 10:22you know, I learned my lesson, but the
  313. 10:24fact is it's something that you can
  314. 10:28you can adopt pretty easily as a special
  315. 10:31programming type thing. Um, there's
  316. 10:34things you could do too to make it a

  317. Advanced Shoulder Stability Variations

  318. 10:35little bit more interesting. Like once
  319. 10:36you get into position where you could do
  320. 10:38the actual repetition, you can then hold
  321. 10:40it in a neutral position. The neutral
  322. 10:43for this exercise would be not in, not
  323. 10:46out. So where your fist is pointing
  324. 10:47straight ahead.
  325. 10:48And then then take a big giant step away
  326. 10:50from the band.
  327. 10:51So you're increasing the resistance of
  328. 10:53the band dynamically, but still having
  329. 10:55to keep yourself in that same position.
  330. 10:58So elbow still locked to the side, fist
  331. 10:59out in front of you. You're holding the
  332. 11:00band. There's tension. Step away from
  333. 11:02the bar that the band is fixed to. So
  334. 11:04there's additional tension.
  335. 11:05Yeah. And it's going to want to pull
  336. 11:06your hand back, but you keep it right
  337. 11:07where it is. And then the fun part of it
  338. 11:08is that I could then take it even
  339. 11:11further. I could jump out there. So now
  340. 11:13it becomes a little bit more ballistic
  341. 11:14and dynamic. [clears throat] So I can be
  342. 11:16in this position and then jump. And if I
  343. 11:18jump quickly, now it really wants to
  344. 11:21pull me in, but I have to still keep
  345. 11:22that same position here. So it's
  346. 11:24mimicking a little bit more of a of a
  347. 11:26ballistically dynamic force. So I could
  348. 11:29do that. I could start to change the
  349. 11:30angle. I could be here in this position
  350. 11:32now facing facing the the the anchor
  351. 11:36point and it still wants to pull me into
  352. 11:37internal rotation.
  353. 11:38So band in front of you, not to the
  354. 11:39side, right? Okay.
  355. 11:40And I could jump back and see if it
  356. 11:42pulls me down this direction. Internal
  357. 11:44external rotation is is is
  358. 11:47is is done so many different ways.
  359. 11:49Again, I could be in this position here.
  360. 11:51I'm just reaching my arm out in front of
  361. 11:53me and turning my my my arm all the way,
  362. 11:56thumbs down to the floor, all the way
  363. 11:58back past the sky, and then thumbs out
  364. 12:01towards my side. Right? That's internal
  365. 12:03external rotation. I don't even have a
  366. 12:04bent elbow, right? Because we're talking
  367. 12:06about a shoulder movement, not an elbow
  368. 12:08movement. But when we when we do it, we
  369. 12:10could do it down low is going to be
  370. 12:11easier for people to start. And the more
  371. 12:13things you start to do with external
  372. 12:15rotation, internal rotation with the arm
  373. 12:16elevated, the more challenging it starts
  374. 12:18to become. So you progressively move
  375. 12:21towards movements where you're internal
  376. 12:23or externally rotating against
  377. 12:24resistance in a higher and higher arm
  378. 12:27position. [music]