The scapular, which is commonly known as the shoulder blade, forms a connection between the shoulder and the cervical spine – it provides mobility and stability to the neck and shoulder region. When the scapular fails to function correctly, it can contribute to neck and or shoulder pain.
It is common for people who perform prolonged sitting tasks to slump and slouch. This increases the curve along their upper spine, and having this affects the position of the scapular, reduces shoulder muscle strength and causes tightness. It is these changes that can then lead to the development of neck or shoulder pain.
The scapular is supported by many muscles which control their many intricate movements. One of the common causes of scapular dyskinesia is having an excess activation of a muscle called the upper trapezius muscle. When this is over-activated, it results in a reduction in the control of other muscles such as the lower trapezius and/or serratus anterior. In this example, your physiotherapist may provide you with soft tissue techniques and stretches to lengthen the upper trapzeius, while prescribing you with exercises to increase the activation and strength of the lower trapzeius and serratus anterior. It is important to note that you should have an assessment conducted by our health professionals at Stay Tuned to identify which muscles are affecting your scapular position.
Below are some exercises demonstrated by our Elwood physio Khoa Pham that may be prescribed by your therapist.
Side-lying external rotation: Enhances middle and lower trapzeius activation
Lying on your side with your forearm parallel to the ground, rotate your arm upwards while keeping your elbow tucked by your side.
Horizontal abduction: Improves lower trapezius activation
Lying on your tummy with your arms out by your side at 90 degrees, lift your arm off the ground while clamping your shoulder blade together. Lower back down slowly
Serratus Punch: Strengthens serratus anterior
Lying on your back, dumbbells at shoulder level, clamp your shoulders upwards while keeping your elbows straight. Once this can be done well, it can be progressed to doing this action in the push up position, commonly known as the push-up plus.
Cools, A.M., Notebaert, D., Cagnie, B. (2007) Rehabilitation of Scapular Muscle Balance – Which Exercise to Choose. The American Journal of Sports Medicine vol. 35, no.10 1744 – 1751.