Great Article!..I have been having a chronic pain in my right shoulder due to an injury from lifting weight,maybe i should try these out!
The Best Scapular Muscle Exercises to Prevent & Treat Shoulder Pain
July 17 2010
There are number of exercises to optimize scapular muscles to prevent and treat shoulder pain. But which are the best scapular muscle exercises?
What are scapular muscles?
Scapular muscles are muscles that connect to the scapula and give both stability and mobility to the scapula, which is unique among other joints . The major scapular muscles are shown in the below picture.
Why scapular muscles are important in shoulder pain?
Scapulothoracic Rythm: The scapula has to move in a well-coordinated manner as shown to bring about arm movements. Any change in the function of scapula muscles can affect the normal functioning of the shoulders.
Correlation: Very recently, number of studies have shown abnormalities in scapular position and motion to be correlated with shoulder pain caused by impingement symptoms, rotator cuff dysfunction, and instability.
Shoulder Rehab protocols: All shoulder rehab protocols now emphasize the importance of scapular muscle training as a component of shoulder rehabilitation.
Which scapular muscles are important ?
Most researchers attribute scapular dysfunction to scapular muscular imbalance rather than absolute strength deficits of the scapular muscles.
In particular,excess activation of the upper trapezius (UT), combined with lower activation of the lower trapezius (LT) and the serratus anterior (SA), has been proposed as contributing to abnormal scapular motion (muscles shown in pic).
Hence the best scapular exercises are those which have high activity of LT & MT and low activity of LT.
So which are the best scapular muscle exercises?
- The study looked at 12 different trapezius strengthening exercises and they found the below exercises to have the highest activity of LT & MT and lowest activity of UT.
- None of the exercises met the criteria for optimal intermuscular balance restoration of serratus anterior (SA) and LT. Push up and push with aplus are normally prescibed exercises for SA.
- The results of this study suggest that the exercises: A, B, and C are optimal for restoration of UT/LT muscle imbalances. A, B, and D are optimal for restoration of UT/MT muscle imbalances.
If you have any questions about these scapular exercises, just ask in the comment section.
Anoop | Sat July 24, 2010
Yes L-Flyes are the most common exercise for shoulder rehab. But I would do it lying on your side as shown. When you are standing due to gravitational forces, the upper trapezius muscle are more activated. Hence the reason all the exercises are done lying down. As the study shows, the best scapular exercises are those which has the highest activty for LT and lowest for UT. So the side lying one will be the best one for both rotator cuff and scapular muscles.
I would recommend doing these exercise 2-3 times/ week.
Anoop | Sat July 24, 2010
Thanks. Yes, these exercises done 3 times/week should help.
Chris Melton | Sat July 31, 2010
I think many people are unaware of the importance of scapular strength and mobility. These are great exercises and should be part of our overall fitness program.
I Liiiike it!
Anoop | Sat July 31, 2010
Thanks for the comment. The whole subject of scapular dyskinesis is still emerging and we will see a lot more studies on this subject int he future.
Hi, I would love to try these exercises, however I find it difficult to tell the direction of movement from the photos. Could you explain please, or perhaps put arrows on the photos?
Anoop | Sun August 15, 2010
I will get some arrows and post a new pic in a few days. which one do you have doubts about?
Anoop | Mon August 16, 2010
Glad I could help. Do register int he forums when you get a chance.
This is great, what sort of weight should be used, is it relative to individual strength?
Anoop | Thu September 23, 2010
Thanks. Pick a weight which you do 12-15 reps with good form.
Great presentation and article! What if the range of motion for Exercise B is impossible to achieve by the client? As their shoulder is internally rotated due to scapular imbalance. What would you suggest to get them to the point of being able to accomplish this movement and range? Considering they can only rotate externally their forearm until it is horizontal (parallel with the ground) and no higher.
Anoop | Sun December 05, 2010
Thanks for the comment.
I do think they need stretching to regain their ROM since the ER is really bad, and maybe start with no weights.
And if he or she is in that shape, better to refer it out to a PT.
Anoop | Sat January 01, 2011
Thanks for the comment. Just go with red arrows.Can you see those?
Hello Mr Anoop,
Yes but I don’t understand, for example in A you arent supposed to go lower than that (relative to your body)?
hi i am being treated for chronic pain in my scapular and neck and am currently doing a gym course the massage therapist has told me my scapular attachments are strained i currently only do light weight excersises but find my scapular area is a sore and stiff after the gym is this ok or am i causing further damage
Anoop | Thu September 01, 2011
If you are in chronic pain, please read this article: http://www.exercisebiology.com/index.php/site/articles/a_revolution_in_the_understanding_of_pain_and_treatment_of_pain/
I have been treating for scapular pain with PT, massage and chiropractic for nearly a year and am told that my problem is that my muscles are just too tight…both between my shoulder blades and across my chest. My PT does very few weight bearing exercises…but I am wondering whether these might be helpful to me? Would love to know your thoughts. Also, for those of us who aren’t exercise biologists, it would be great to include written descriptions of each exercise. For example: In Exercise B, is the idea to raise the arm from a 90 degree angle from ones waist and then fully extend the arm straight in line with the shoulder, or should the movement be smaller.
Again, very helpful
Anoop | Tue September 06, 2011
Thanks for the comment and sorry that I haven’t been clear. I just assume too much.
About exercise B here is a video:
And these exercise will definitely help. And please also read this article about pain: http://www.exercisebiology.com/index.php/site/articles/a_revolution_in_the_understanding_of_pain_and_treatment_of_pain/
Hope it helps!
Excellent. Thank you Anoop. I’ve had a client doing rehab with 3 of these exercises (altho D was done standing using theraband.) I like A. Haven’t seen that one before!
I think you made a mistake with “Hence the best scapular exercises are those which have high activity of LT & MT and low activity of LT.”
Please double check if its, LOW activity of UT (upper trap).
Hi Is there help for me?Im not in pain,just upset everytime I see my bad posture,(head and shoulders forward of my body)caused from 30 years of hairdessing!Is there help for my posture please?
Are there YouTube videos of the other three exercises? The one for B was very helpful.
Anoop | Sun March 25, 2012
I am not sure, David. But those are pretty easy right? does the arrows make sense?
I have two articles for your posture and pain:
A,B, and D make sense, especially with video for B. I am not sure what C means. Below the table? I do most of my practice on the floor.
Anoop | Fri April 27, 2012
It might. Most shoulder injuries will carry over some scapular dysfucntions. Atleast that’s the theory.
Hey I don’t have health insurance so I’m doing the best I can to diagnos myself. I had surgery on my right shoulder and it’s great now, but my left feels so much more tighter and rolls forward. My right is broader, dominant and flexible. I dont feel square. I do my best to maintain good posture. I do pull ups, serradus push ups and light weights. I think I am going to stop bench pressing and continue to stretch my chest more. Any other advice would be great.
Anoop, Do you prefer the free weight or a stretch band for these exercises?
Anoop | Thu May 09, 2013
No video JJ. Isn’t it clear from the picture? The BC & D can be found in you tube. A is not really popular.
Daniel Brady | Sat December 14, 2013
When I did exercise B, I didn’t have good range of motion at the top of the movement. So I did a stretch with the same movement but lying on my back, then did the exercises, and my pain was immediately decreased. Maybe my pain is due to shoulder inflexibility (around the humeral joint) due to my computer mouse position.
I have had 2 surgeries on my shoulder joint . the second was successful. Yet my shoulder blade does not move. I see an acupuncturist, chiropractor and spine specialist, who diagnosed the problem as l scapula immobilization. The massage therapist recommended is not available for 2 weeks. Also myofascia release is not covered by insurance.
The medical industrial complex is so uncooperative at times. I do have a pt. coming on board who is supposed to be good. What is the best route? Seems scapular dyskinesia is rather new and very painful.
Amazed!! I can’t believe there are so many people with the same problem/pain I have! I have been through PT, x-rays, and MRI and the final diagnosis was that my posture was bad! Even the PT said I had one of the worst he had seen and that was 2 years ago. I look down when I walk and apparently lean forward and the pain in my scapula’s during housework or sitting at the computer is horrible. I take NSAIDs daily for plantar facistis and the ortho doctor said his suggestion was to take NSAIDs too for this pain. It helps a little, but not enough.
I a going to try these exercises! Massage is the only thing that has helped in the past and I am a LMT so I know the value, I purchased a massage chair and mostly sit in it to watch tv sometimes for hours.
This pain is horrific and it has been getting worse for the past 5-6 years. I have extremely tight rhomboid muscles and my scapula’s seem to be pinned down so I use the massage chair to loosen as much as possible.
Thank you for posting this!
It appears that MT is a typo and should be replaced by SA (serratus anterior). If not, what does MT stand for?
Anoop | Mon December 08, 2014
MT stands for middle trapezius.Thank you for the comment.
Anoop, can you suggest any way to stretch myself out? For instance, I am unable to go a full 90 deg on the l flyes up to the vertical…..and I am assuming i should be able to.
I am interested in the joint articulations for exercises.
Could you explain the scapular movements for exercising for these motions Elevation, Depression, Protraction (abduction) Retraction (adduction) Upward (lateral) rotation, Downward (medial) rotation, Anterior Tipping, and Posterior Tipping.
It is difficult to find definitive explanations on the internet. the most complete explanations I found were from exrx.net/Lists/Articulations.html
This site seems to have limitations. It shows clapping push ups for scapular protraction. I have also seen wide arm pull ups used as an example.
My understanding is straight arm push ups are a better representative where the shoulder is pushed forward.
Do you know of any better site where joint articulations for exercise are shown and or explained.