This device is interesting, as it prevents any cheating when doing external rotator work, which is why I often prescribe this exercise to novices. The shoulder horn is available in four sizes, and it's important to use one that fits the width of your shoulders. There are two possibilities to pair with this device: a dumbbell or a low pulley. A dumbbell provides a good overload in the stretched position (the start) while a pulley permits an overload over a greater range of motion. The pulley version is more appropriate for the athlete who is especially weak in the contracted position.
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The use of dumbbells gives you a much more comprehensive strengthening effect because the workout engages your stabilizer muscles, in addition to the muscle you may be pin-pointing. Without all of the belts and artificial stabilizers of a machine, you also engage your core muscles, which are your body's natural stabilizers.