Swing Your Wing
Published October 21, 2009 10:14
For efficient movement of the shoulder blade, called scapula, plays an important role in facilitating optimal function. Anatomy and biomechanics of the scapula create a highly functional upper extremity but when it fails to perform its stabilization role, the shoulder function will be inefficient and can result in significant shoulder injuries.
For normal range of motion and stabilization the scapula is highly dependent on its surrounding musculature. The main stabilizers are the levator scapula, rhomboids major and minor, serratus anterior and trapezii. To protect the arm, the "Rotator Cuff" muscles work with the scapular muscles for stabilization. The rotator cuff muscles are paired to allow co-contractions for good control of shoulder movement and positioning
The primary role of the scapula is the maintenance of dynamic stability with controlled mobility to allow a normal positional relationship with the arm. Muscle weakness is a common finding around the shoulder girdle, and decreased support of the shoulder due to weakness in any shoulder muscle could lead to an injury.
When the stabilizing muscles are weak or fatigued, shoulder motion becomes abnormal, which can cause injuries to the muscles, capsule and ligaments of the shoulder complex. A common abnormal mechanism called impingement, (a narrowing of the shoulder joint causing a pinching of the structures within the subacromial space), may be painful and often leads to more serious damage in the shoulder.
How stable is your shoulder? Try this self-test (by Dr. Ben Kibler) to see:
Pull both shoulder blades together toward your spine and down to your low back. Hold it for 15 to 20 seconds. A scapular muscle weakness often results in a burning pain in less than 15 seconds!
Once an injury or weakness is diagnosed, proper motion must be restored and scapular control emphasized. Proper control can be restored with appropriate exercises completed in ranges of motion that are not impinging any structures and avoiding fatigue to the point that proper scapula positioning and control cannot be maintained. As larger, pain-free range of motion is restored, strengthening should be incorporated to the program. Finally, as the full range of motion is restored and strengthening progressed the athlete can return to sport specific activities.
Every exercise progression must begin with stretching exercises. Weak scapular muscles cannot be strengthened if the counterparts are not flexible--for example, a tight chest, the pectoralis muscles, will inhibit the scapular stabilizer, the lower trapezius. With proper stretching, good posture can be facilitated thus should be the foundation for all exercises.
To improve your scapular stabilization, try the following exercises on a daily basis. Start with a 20 minute warm up such as running or biking, followed by at least 5 minutes of stretching.
Place the hand of your injured or weak shoulder on a ball or table. Keep your posture nice and tall with tightened abdominal muscles during the entire exercise. Roll the ball by moving your shoulder blade forward and backward, toward and away from your trunk.
Use an elastic exercise band to complete this exercise. Keep your posture nice and tall with tightened abdominal muscles. Hold one end of the taut band in each hand at shoulder height in front of you, elbows bent. Pull your hands toward you as you pinch both shoulder blades toward your spine, keeping both hands up at shoulder height. Make sure that you move just the shoulder blades forward and backward and not the shoulder joints. Repeat this exercise 10 times before you rest one minute and continue with another 2 series.
Continue with the elastic band by securing one end under your left foot and holding the other end with you right hand at hip height in front of you. Move your right hand slightly outward toward the ceiling. Maintain good posture and tight abdominals as in the exercises above. Slowly release to return your hand to the start position. Repeat 5 to 10 times depending if you are able to maintain the posture. Take a one minute break and switch sides. Repeat both sides with 3 series.
Continue with the elastic band and good posture with tight abdominal muscles. Secure one end of the band in your left hand at the back of your hip, have the band pass under your right foot and then grasp the other end in your right hand. Step forward with your left foot and keeping your shoulder blade close to your spine, raise your right hand to shoulder height. From this position, punch your right hand forward while maintaining keeping your shoulder blade back. After 3 repetitions of punching, take a one minute break and then repeat on the other side. Try 3 series on each side and see if you are strong enough to keep your shoulder blade close to the spine.
Exercise 5, Stretching:
Sit next to a table with your right arm, palm down, on the table slightly in front of you. Tighten your abdominal muscles while you move your right shoulder blade towards your spine. Keep your shoulder blade back as you bend your trunk forward while sliding your hand forward. Continue moving forward as far as you can while maintaining your shoulder blade position. When you feel a stretch around your armpit, hold this position for 30 seconds. Return to your start position and rest. Now try your left shoulder and compare the stretching feeling and the range of motion. Repeat each side 3 times.
These exercises may not be beneficial for every athlete, so avoid using this information as a "cookbook". Consult with your physiotherapist or athletic trainer to individualize your treatment and exercises based on your injury or weakness and to make it fun and exciting!
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