Patrick has shoulder impingement syndrome. He has been referred to you by a physical therapist for strengthening of his shoulder complex and to begin first with a closed chain exercise. Which progression is MOST appropriate

The available options are:

a) Push-up plus off a wall → shoulder IR/ER → seated DB press

b) Shoulder IR/ER → push-up plus → seated DB press

c) Shoulder IR/ER → seated DB press → push-up plus

d) High-rep bench press → shoulder IR/ER → abdominal crunch

A. Push-up plus off a wall -> shoulder IR/ER -> seated DB press

Explanation:

A push-up plus off a wall is an example of a closed chain exercise as the arm is fixated to a stationary surface.

It also make your shoulder blades to move freely, making serratus anterior stronger, a vital muscle that keeps scapula stable and helps it rotate upward. This in turn reduces shoulder impingement when push-ups plus off a wall is done.

Shoulder IR/ER also helps to correct the imbalance in the rotator muscles of the shoulder.

Also, seated DB press strengthens all muscles of the shoulder in a functional way.