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Better I’s, Y’s, and T’s

If you’ve ever been to physical therapy for your shoulder or have been a throwing athlete at some point in your life, you’ve likely been shown exercises like the I’s, Y’s, and T’s (see picture below). They are named this because the shape you create with your arms during the resistance exercises resembles those letters. These exercises are typically prescribed to activate certain muscles for scapular strengthening or stability purposes. Though they have their place in the field of rehabilitation at certain times, I think we can improve upon them. Here are some thoughts and an updated approach to training the shoulder blade.

I’s, Y’s, and T’s
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Case Study: Femoral Acetabular Impingement

Mike is a 32-year-old male law enforcement officer presenting with chief complaint of left hip pain upon transition in and out of his work vehicle and exercises involving hip flexion like squatting (loaded and unloaded). Patient was diagnosed with left Femoral Acetabular Impingement (FAI) with bony growths and a torn hip labrum. Mike was recommended to have surgery to fix his abnormal orthopedic findings after failed attempts at out-patient physical therapy. Patient’s goals are to return to a consistent and non-painful training program for health as well as preparation for occupational demands and selection testing for a specialized law enforcement team next year.

Examination Findings

  • Toe Touch = 2 inches from toes
  • Functional Squat (feet shoulder width, knees tracking over toes) = exacerbated painful symptoms one quarter of the way into decent
  • Hip Internal Rotation = 0° bilaterally – bony end feel – exacerbated painful symptoms
  • Adduction Drop Test = (+) bilaterally – bony end feel – 2 inches from table
  • Hip Flexion = 100° bilaterally exacerbates painful symptoms

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