In this article, I’m going to teach you about how the scapula affects shoulder injuries and also share some exercises that stabilize your scapulae, strengthen your shoulders, improve function and posture, as well as relieve pain.
The scapula is a triangular-shaped bone that rest on either side of your upper back, near your shoulders. The shoulder itself is a ball and socket joint, where the ball is the top of the arm bone (or head of the humerus) and the socket is part of the scapula.
This is, in part, why the scapula is such an integral part of shoulder rehabilitation. Nearly all patients complaining of shoulder pain benefit from assessment and treatment of scapular positioning and motor control.
There are 17 different muscles that attach to this one bone. These muscles will run from the scapula to the skull, neck, shoulder, ribs, or the thoracic spine.
Here they are in case you’re taking notes.
They will all pull in different directions when they contract or a are tight, causing the scapula to move or rotate with them.
Normally, these muscles will work in concert to deliver smooth fluid movement as well as provide stability.
Researchers, Kibler et al., in 2012 described in The Journal of the American Academy of Orthopaedic Surgeons:
“The scapula has relatively limited bony attachment; thus, it is dependent mostly on muscle activation for mobility and stability. This anatomic construct allows a great degree of mobility and accommodates many demands in different arm positions, but it also requires considerable eccentric muscle activation to withstand high distraction loads in activities involving forward motion of and loading on the arm.”
If there is weakness or injury causing inhibition to any of these muscles, they will fail to adequately resist the pull of an opposing muscle.
This, in turn, will cause a shift in posture and alter the mechanics of optimal scapular movement leading to dysfunction and pain. This is called “scapular dyskinesis“.
In the picture above, you’ll note the significant “scapular winging” on the right side indicating poor stabilization with dynamic movements.
Scapular winging may also be seen with other movements such as reaching your hand behind your back to scratch your opposite scapula or flexing your shoulder forwards to perform an overhead reach.
Rehabilitation for this area will often include scapular stability exercises. It may be helpful to work with a trained physical therapist to help determine the specific impairment and which muscle imbalances need to be addressed.
As always, you should consult with your health care practitioner before starting rehabilitation exercises to treat pain or dysfunction.
The following videos will demonstrate exercises that will strengthen your scapular stabilizers:
3 Scapular Exercises that will Improve Your Shoulder Function.
Serratus Push-Up Plus
“I’s”,”T’s”, and “Y’s”
In addition to scapular stability exercises, rehabilitation may include rotator cuff strengthening, stretching, manual therapy, therapeutic taping (kinesiotape), postural training, ergonomics, as well as pain modalities including (TENS, Acupuncture, Ultrasound, Heat or Ice).