Prone horizontal abduction trains the muscles that draw your shoulder blades back toward your spine (middle trapezius and rhomboids) and the back of the shoulders. You lie face down with your arms out to the sides at shoulder level, elbows bent to a right angle and hands resting on the mat beside your head. Then you lift your elbows and hands off the mat together, hold briefly and lower them with control.

How to do the prone horizontal abduction

Lie face down on a mat, legs long, with your forehead on the mat. A small folded towel under your forehead gives your nose some room.
Place your arms out to the sides, level with your shoulders, and bend the elbows to a right angle so your forearms point toward the top of the mat and your hands rest palms down beside your head.
Gently draw your shoulder blades back toward each other and let that squeeze lift your elbows and hands off the mat.
Keep your elbows and hands at the same height as they rise, and keep your head down with the back of your neck long.
Pause briefly at the top, then lower both arms slowly to the mat and relax before the next lift.

What you should feel

Work between your shoulder blades and at the back of each shoulder. The front of the shoulder and your neck should stay quiet.

Common mistakes

Lifting only the hands, so the elbows stay on the mat and the forearms tip up.
Shrugging toward your ears, or lifting your head to get more height.
Letting the elbows slide down toward your ribs as you tire.
Dropping the arms back onto the mat instead of lowering them.

How often

Many programs start with 2 to 3 sets of 8 to 12 lifts with a hold of 2 to 5 seconds, once a day or every other day. Your physio will adjust this.

Stop and check with your physio if

A sharp pain, pinch or catch in the shoulder as the arms lift.
Pain, pins and needles or numbness spreading down your arm or into your hand.
Pins and needles in your arm or hand that do not go away after you stop, or part of your arm or hand goes numb. Get medical advice the same day. If one side of your face or body suddenly goes numb or weak, or your speech becomes slurred or muddled, call emergency services, even if it goes away.
Neck or lower back pain that builds as you go.
A feeling that the shoulder is loose or about to slip out of place.
A sudden pop or tearing feeling in the shoulder that brings sharp pain, new weakness or trouble lifting the arm. Stop and contact your surgical team the same day, or get medical advice the same day if you have not had surgery.
The shoulder feels as if it has slipped out of place, looks a different shape or suddenly locks so you cannot move the arm, or your hand turns cold, pale or blue. Go to an emergency department straight away, without driving yourself, and do not try to put the shoulder back in yourself.

From the clinic

The lift does not need to be high. Go only as far as the squeeze between your shoulder blades can take the arms, without your shoulders creeping up toward your ears or your chest leaving the mat. With the elbows bent, the weight of each arm sits closer to the shoulder than in the prone T raise, so this is usually the easier of the two. The prone L lift uses the same arm position with the palms turned to face each other, and the prone W raise tucks the elbows in by your ribs and adds a small chest lift. If you have high blood pressure, breathe steadily through every hold and never hold your breath.

With the elbows out and the hands up by your head, each upper arm is out to the side and turned outward. That is the position most shoulders slip out in, and the lift takes the arms slightly behind you. If a shoulder has ever come out of joint or feels unstable, ask your physio before you try this. After shoulder surgery, including a rotator cuff repair, or after a shoulder fracture or dislocation, follow your surgeon's or physio's plan, and do only the movements and range they have cleared. Many plans allow only passive movement at first, where the arm is moved for you and its muscles stay relaxed.

If you are pregnant, check with your physio before exercising face down, as lying on your front often becomes uncomfortable as a pregnancy goes on. Your physio can show you a version done sitting, or leaning forward with your chest supported on a table.

Written and checked by the PocketPhysio editorial team. Last updated 2026-09-28.

This page is general education, not a diagnosis or a personal treatment plan. If you have pain, an injury or a health condition, see a physiotherapist or doctor before starting new exercises.

Prone horizontal abduction