By Beth Jennings, PT, MPT, CHWC
Putting on a seat belt.
Serving a tennis ball.
Scratching your lower back.
All of these movements require the coordinated effort of shoulder muscles and joints. Although much attention is placed on the rotator cuff muscles, we at FYZICAL – Forest Grove want you to also know why we prescribe scapular stability exercises.
These exercises engage the muscles that attach to the scapula, or shoulder blade, keeping the scapula stable against the ribcage while reaching, scratching, and serving.
Scapular Stabilizers
The humerus, or the upper arm bone, makes a bone-to-bone connection to a flattened area of the scapula.
The clavicle, or collarbone, does the same, with a connection at the sternum at one end and a different area of the scapula at the other.
Shrug your shoulders. Pinch them backward. Circle them around. How does the scapula stay connected to the ribcage yet stay so mobile? It’s the muscles, particularly the scapular stabilizers, that create this dynamic.
These muscles include:
- Trapezius (upper, middle, lower)
- Serratus anterior
- Rhomboid major and minor
- Pectoralis minor
- Levator scapulae
- Latissimus dorsi
The performance of the shoulder, and some will say the elbow and hand as well, begin with coordination and stability of the muscles surrounding the scapulae.
Poor Posture Has Its Effects
Poor posture can put shoulders in an unhealthy position leading to more stress on the joint and rotator cuff muscles. One 2021 study showed that scapular stabilization exercises improve posture with exercises that stretch the chest muscles and strengthen the upper back or scapular stabilization muscles.
Scapular Stability Exercises
The best exercises are the ones that are customized to you, but here are a few exercises we like.
- Scapular sets: While sitting or standing in good posture, pinch your shoulders backward an inch while dropping them away from your ears an inch. This is not a big movement. Don’t arch the back, shrug the shoulders, or move the arms. Hold 5 seconds. Remember this “down and back” position, as it is helpful during other exercises, such as with planks and pushups.
- Prone “I’s” or “T’s”: Lie face down with a towel roll under the forehead, arms along your sides. Hover the arms above the surface at your sides (“I” position) as you pinch the scapulae down (towards your feet) and back. Hold 5 seconds. For added challenge, stretch the arms out like airplane wings (“T” position) and lower and raise them while holding the scapulae down and back.
- Row: Standing or sitting in good posture, pull back against a resistance (weight machine or resistance bands) using both hands. Pinch the scapulae together as the bent elbows slide past the ribcage. Release arms forward, maintaining control of the resistance.
- Pushup+: Can be performed against a wall, a waist-high counter, or on the floor. Hold the scapulae down and back while bending the elbows and lowering the chest to the wall/counter/floor. Straighten the elbows, returning to the starting position, adding a little extra push to separate the scapulae at the end.
Chest Flexibility Is Important too
Maintaining flexibility of the front of your trunk helps the scapulae shift into the position needed for stability.
- Chest/arm stretch: While sitting or standing, reach the hands out to the sides, thumbs up, elbows straight. Next, extend the wrists so that the palms begin to point to the sides. Lift your chest and gently glide the arms backward until a stretch is felt in the arms or chest. Hold or ease in and out of this position.
- Doorway stretch: Stand in a doorway with arms up in a “W” position with hands or forearms on the door frames. Keep good posture while stepping slowly through the doorway until a stretch is felt in the front of the shoulder or chest area. This can be done one arm at a time if needed.
Of course, the physical therapists at FYZICAL - Forest Grove provide customized programs based on the evaluate your scapular stability and shoulder function. Feel free to call us for our next available appointment.
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Beth Jennings, PT, MPT, CHWC is a physical therapist and a health and wellness coach.
Disclaimer This blog is provided for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition.
References:
Cowan PT, Mudreac A, Varacallo M. Anatomy, Back, Scapula. [Updated 2022 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.
Nitayarak H, Charntaraviroj P. Effects of scapular stabilization exercises on posture and muscle imbalances in women with upper crossed syndrome: A randomized controlled trial. Journal of Back & Musculoskeletal Rehabilitation. 2021;34(6):1031-1040. Accessed February 8, 2023.
Heales LJ, Bout N, Dines B, et al. An Investigation of Maximal Strength of the Upper Limb Bilaterally in Individuals With Lateral Elbow Tendinopathy: A Systematic Review With Meta-Analysis. PTJ: Physical Therapy & Rehabilitation Journal. 2021;101(12):1-14.