Question:

  • Do you train individuals that experience pain and impingement with overhead motion?
  • Do you train clients that have poor scapular control during their pushing and pulling patterns? How about the client who has ‘clicking’ as they lower their arm from an overhead position?
  • Do you use the cues of ‘pull your shoulder blades down and back’ when working with any of these clients I just asked you about?

If you answered ‘yes’ to any of these questions then this edition of Fitness Insider is for you! I am going to once again challenge your knowledge about shoulder stabilization and give you a strategy for improving scapular stabilization so you can develop your knowledge and skill-set and become a booked solid industry expert.

And I have included a video link below to show you two of the most effective exercises we use to improve scapular stabilization and train the rotator cuff as part of the corrective exercise component of the Integrative Movement SystemTM.

What is the problem with most of our clients’ shoulders that create impingement issues in the first place?

  1. 1. Downward rotation syndrome: Most clients with scapular instability have some component of downward rotation. This is most common when the downward rotators - pectoralis minor, levator scapula, and rhomboids - become the dominant scapular stabilizers in relation to the upward rotators - serratus anterior, upper and lower trapezius. This increases the likelihood of impingement syndromes both as the arm is going overhead and as the arm returns from an overhead position.

  1. 2. Posterior rotation of scapula: The lack of posterior rotation of the shoulder complex - both at the clavicle (by the subclavius) and at the scapulo-thoracic articulation (by the serratus anterior and lower trapezius) - increases the likelihood of impingement syndromes. Again, with dominance of the downward rotators - which also tend to contribute to anterior scapular tilting - there is a lack of posterior scapular tilting which is necessary for stabilizing the scapula against the thorax and decreasing the potential for shoulder impingement. Inhibition of the posterior rotators by the scapula depressors and anterior tilters increases the likelihood for impingement syndromes.
  1. 3. Improper cuing: Common cuing to improve poor scapular control such as ‘squeeze your shoulder blades down and back’ directly contribute the very problem they are trying to solve. The client with inhibition of the upward rotators and posterior tilters of the scapula generally have poor scapulo-thoracic awareness and therefore tend to pull their shoulder blades further into a depressed and downward rotated position. What should happen to optimally stabilize the scapulo-thoracic is that the scapula should wrap down (depress slightly) and around (upwardly rotate and posteriorly tilt) the thorax during functional patterns.

If you have not watch the video of the two patterns you may use to help improve function of the upward rotators and posterior tilters while simultaneously improving scapular depression.

CONCLUSION

  • To improve scapular stability and decrease the likelihood for impingement, you must put the client into positions that activate the upward rotators and posterior tilters.
  • To properly cue your clients with scapular dysfunction and or impingement issues, use cues such as ‘get long’ through your shoulders and ‘wrap your scapula down and around your thorax’ rather than ‘squeeze your shoulder blades down and back.’
  • If you want to make a dramatic difference in the lives of your clients, if you want to book yourself solid, if you want to become part of the solution to the health care crisis, let us help. Make plans to join us in 2012 for the Integrative Movement SpecialistTM program and let us help you develop your expertise and confidence in becoming a movement specialist.

Coming Next Edition of FITNESS INSIDER: How to improve posture for improved core function

Helping You Think Bigger About Your Role as a Fitness Professional,

Evan Osar