By Angie Hurley, CSCS, CAT(C)
The shoulder blades AKA scapulae, are the main interaction point for joints and muscles across the neck, shoulder, and torso. These flat bones only have one boney attachment to the rest of the skeleton and 17 muscles influence its resting position and control its six directions of movement.
Sometimes, these 17 muscles don’t work in a coordinated fashion and result in what’s called scapular dyskinesia. In other words, the scapulae can suffer from poor movement quality due to muscle imbalances involving weakness and tightness among the 17 muscles. Scapular dyskinesia can lead to poor shoulder mobility, neck pain or discomfort, altered posture of the upper back and neck, faulty breathing mechanics and reduced mobility of the mid-back.
Preventing and correcting scapular dyskinesia can prevent injury and improve performance during upper body exercises.
Movements of the Scapula
When looking at the picture above, you can see the scapular move through:
- downward rotation
- upward rotation
Let’s now address scapular movement issues in 3 ways:
- Conscious motor control and awareness
- Soft tissue flexibility
(Scapular Rehabilitation Algorithm, Cools et al, 2014)
Build Motor Control and Movement Awareness
We want to bring awareness and focus to the ranges of motion our scapulae are capable of, especially if we haven’t been moving into them for a while.
It helps to feel what correct positioning and proper muscle activation is so you know what to look for in other exercises. Here are 3 movement awareness exercises to help you start to feel your shoulder blades moving on your rib cage.
Prone Scapular Squeeze
Forearm Wall Slide to ‘Y’
Hands Up Scapular Squeeze
Increase Mobility Through Soft Tissue Flexibility
Many things can contribute to the scapula getting ‘locked down’ or altered in its movement pattern. Posture, repetitive movements, and injury compensation can mean some muscles are in a shortened position for a long period of time, thus affecting their flexibility and range. Three common muscles that contribute to the altered, or lack of, movement in the scapula are:
- pectoralis minor
- levator scapula, and
- lastissimus dorsi.
Here are 3 stretches you can do to address these muscles.
Pectoralis Minor Stretch
Levator Scapula Stretch
Latissimus Dorsi Stretch
Strengthen Weak Scapular Muscles
Three stereotypical ‘weak’ muscles of the scapula that contribute to scapular dyskinesis are:
- Lower trapezius
- Middle trapezius, and
- Serratus anterior.
Below are 3 exercises to activate and strengthen the stereotypical “3.” Don’t focus on load here. Focus on little to no weight, muscle activation and movement control.
Isometric Wall Low Row
Prone Shoulder Extension with External Rotation
Y-T-I-Raise with Thumbs Up
Elevated Single Leg Pushup Plus
Single Arm Kettlebell Scapular Punch
Do you suffer from shoulder and/or neck pain? Maybe your scapula muscles need some focused mobility and strength work. We can help!Train With Us
McQuade, K.J., Borstad, J., de Oliveira, A.S. (2016) Critical and theoretical perspective on scapular stabilization: what does it really mean, and are we on the right track? Physical Therapy, 96(8), 1162-1169.
Cools, A. M., Dewitte, V., Lanszweert, F., Notebaert, D., Roets, A., Soetens, B., … & Witvrouw, E. E. (2007). Rehabilitation of scapular muscle balance: which exercises to prescribe? American Journal of Sports Medicine, 35(10), 1744-1751.
Cools, A. M., Struyf, F., De Mey, K., Maenhout, A., Castelein, B., & Cagnie, B. (2014). Rehabilitation of scapular dyskinesis: from the office worker to the elite overhead athlete. British Journal of Sports Medicine, 48, 692-697.
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