What is Scapular Control?
Almost every individual that comes to see us, both athletes and adults, have some sort of back or shoulder problem. Most often, these issues are centered around a specific region, the scapulo thoracic region of the upper back. Specifically, these individuals lack the ability to control the movements of their scapulas (shoulder blades). This inability to control and stabilize the scapula, especially during overhead movements, can create unwanted stress at the shoulder joint as well as the thoracic spine. The glenohumeral joint (shoulder joint) and the scapulo thoracic are two of the most mobile joints in the human body. Therefore it’s especially important to maintain stability throughout their entire range of motion. Any deficiency in stability creates an increased risk for injury, in particular for the muscles of the rotator cuff.
What Causes a Loss in Scapular Control?
One major cause for loss of scapular control is the deficiencies in strength that we see regarding the scapulothoracic muscles. Weakness in these muscles leads to abnormal positioning of the scapula, which in turn creates biomechanical dysfunction. The weakness in the scapulothoracic musculature can often be seen in what is called “upper-cross syndrome.” Someone who displays upper-cross syndrome will have their shoulders rounded forward, creating an almost hunchback look. This is a result of overactive (tight) pectoralis, upper trap, and levator scapulae muscles and under active (weak) cervical neck flexors, as well as the rhomboids, lower traps, and serratus anterior, which all function to stabilize the scapula. This syndrome is the result of the modern lifestyle where we sit in a poor posture most of the day and do not utilize these muscles. Over time these muscles can actually become completely inhibited.
Weakness of the scapulothoracic muscles potentially leads to abnormal positioning of the scapula, disturbances in scapulohumeral rhythm, and generalized shoulder biomechanical dysfunction. Shoulder injuries incurred as a result of sport activities can be traced to abnormal biomechanics and these abnormalities can be related to improper functioning of the scapular muscles
What can you do to regain scapular control?
Focusing your training on strengthening the muscles that act as scapular stabilizers will help in regaining control. More importantly, re-learning proper multi-planar movement patterns will reinforce the functional roles of these muscles. Some great basic exercises that can be used are scapular pushups, band pull-aparts, and the I-Y-T series if done properly. Once proper movement patterns have been re-learned, more advanced exercises can be used such as chin-ups, overhead presses and various rowing exercises. These exercises are much more difficult because you now have to stabilize the scapula under a load. If ever this ability is lost you should regress back to the basic exercises listed above.