Scapular strength and stability in shoulder pain.

winging it

What’s in a shoulder?

To take a step back your shoulder is the joint that is formed by your upper arm bone, (humerus) and a triangular shaped bone sitting on your rib cage which we call the shoulder blade or scapula to get all Latin about it.

What’s the role of the scapula?

Well glad you asked ,this complex of the two bones and the muscles working off it allow the shoulder to be the most mobile joint in the body.

There are muscles working from the scapula to the rib cage, scapula to humerus and scapula to the neck.

muscles of shoulder | Arana Hills Physiotherapy

This dynamic complex allows us to move our arm and hand in space in a wide arc and acts as a force transmitter for the upper limb. It also provides part of the platform for our neck to move on and is therefore really important in successful neck rehab.

How do the scapular muscles influence your shoulder ?

Here in lies an issue that has to be dealt with. There is no doubt that shoulder pain can be caused or at least affected by the movement of the scapula or starting position of the scapula .

Weakness or tightness in the muscles working at the scapula.

These 2 factors then lead to changes in how the shoulder moves that can result in irritation in the soft tissue structures in the shoulder such as tendons or bursa.

However if you have changes in scapular strength, posture or movement that DOESN’T
mean you will have or get shoulder pain. The science tell us it’s not that clear
cut.

What is a winging scapula ?

Is scapular stability causing your shoulder pain ?

I think this is relatively simple to assess but does need a bit of detective work . The fairly straight forward thinking is that if you can change how the scapula moves or change it’s start position and that improves your shoulder pain then it’s odds on favourite the scapula is villain in the story.

If there is no change to the pain is made then I’d be hunting for another culprit to sort out before addressing that joker, ( see what I did there ? ).

how do I strengthen the  scapular muscles ?

 Am I wasting my time squeezing my shoulders down to my opposite hip ?

Yes, yes and probably yes would be my answer to that.

Activating the lower fibres of trapezius is one of the go to exercises for lovers of all things scapula, or more likely those that blindly prescribe the same exercises to everyone regardless of what is going on .

This is one of those bits of research from (quite) a few years ago that has been taken out of context and inappropriately applied to countless shoulder pain sufferers. It may have a role in very acute or post surgical shoulders in the very early days.

So If it’s not taking the pain away I suggest it’s pointless and there are more effective things to do.

The best approach to scapular strengthening

The most important factor is to Identify what activities are aggravating your shoulder and remove them or find a better way to do it. Are there any techniques we can use to put the “the fire” out so to speak.

Next on the list is to observe how the shoulder blade moves in relation to the humerus to determine what the issue is.

  • Is it more to do with the strength of  shoulder muscles rather than how it moves.
  • Can we change your pain by increasing the strength of the shoulder.
  • Can we change your pain  by assisting the scapula in shoulder movement.
  • Are the muscles working around the scapula too tight or weak.

The answers to these questions will let us know where we should start and where we should be looking to go with your shoulder.

So in a nutshell

By looking at these points we can devise the best , most effective long lasting solution for you and your shoulder.

Some shoulders need the scapula addressed and some don’t . It’s just got to be relevant to you and your problem , not a one size fits all approach .

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Thanks for reading, if you have any shoulder issues feel free to contact us at the clinic for help.

 

 

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