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Scapular Dysfunction

Michelle Fritz, PT, DPT


The scapula, or shoulder blade, is a large triangular-shaped bone that lies in the upper back. The bone is surrounded and supported by a complex system of muscles that work together to help you move your arm. Some of the muscles that attach to the scapula include all 4 rotator cuff muscles as well as the deltoid, rhomboids, tricep, pec minor, lats and trapezius. In fact, 17 muscles in total attach to the scapula. If an injury or condition causes any of these muscles to become weak or imbalanced, it can alter the position of the scapula at rest or in motion and result in injury to the shoulder, mid back, chest or neck.


The scapula is connected to the arm bone (humerus), and the joint where they meet is known as the glenohumeral joint, which is considered a “ball and socket” joint because the head of the humerus sits in the “socket” of the scapula. As you move your arm around your body, your scapula must also move to maintain the ball and socket of your shoulder joint in normal alignment. The scapula accounts for ⅓ of the total shoulder motion. This means that the scapula is essential for not only shoulder stability but also shoulder mobility. If the muscles that attach to the scapula are weak/injured or if the scapula is not moving optimally, shoulder pain or injury is likely to occur.


My favorite exercises to recommend for improving scapular stability include the Y, T and I exercises. These exercises can be performed in a variety of positions, but prone (lying on stomach) tends to allow for better isolation of the muscles. You want to ensure that your neck is either supported or in a neutral position to avoid any undue stress on the neck during these exercises. The video below shows Bob Mallory completing these exercises with the proper form.


To focus on proper scapular mobility, you want to raise your arm at a 45 degree angle as that is referred to as the “plane of the scapula.” Because the scapula sits on an angle, performing flexion/extension exercises or abduction/adduction exercises of the shoulder do not necessarily improve the mobility of the scapula. To improve scapular mobility, stand against a wall and focus on proper activation and movement of the shoulder blade through the range of motion. The last video below is of Bob Mallory performing proper scapular mobility exercise.

Of course, many of the other accessory muscles/exercises we perform will improve scapular function. Some other great scapular exercises include face pulls, band pull aparts and any rotator cuff strengthening exercises. As always, you can reach out to me directly if you have any questions at mfritz1773@gmail.com


** Disclaimer: This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.


Reference:

Paine, R., & Voight, M. L. (2013). The role of the scapula. International journal of

sports physical therapy, 8(5), 617–629.

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katwin323
katwin323
Jan 22, 2022
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