Upward rotation of the scapular is a key movement required when training in overhead movements, and without it, we increase our chances of becoming injured. This movement, upward rotation, will allow us to train pain-free so let’s go ahead and fix it! The big question is… How do we fix a scapular that doesn’t want to upwardly rotate?
Our main focus is around coupling force motion of the Upper Trapezius, Lower Trapezius and the Serratus Anterior (Paine et al., 2013). Therefore, we must fire these muscles, known as the upward rotators, and not allow the downward rotators (Pectoral Minor, Rhomboids, Levator Scapulae) to take over and disrupt the movement.
Upper trapezius activation
A common misconception when assessing scapular upward rotation is that the Upper trapezius is working overtime, however, looking more closely it is more likely that this muscle is lengthened and weakened meaning that this upward rotation is not happening as efficiently, and efficiently as it should be (Meakins, 2013).
Therefore, a large proportion of our rehab will be focused on strengthening the Upper trapezius, resulting in improved upward scapular rotation. However, as previously mentioned, the Upper Trapezius isn’t the only component of this upward rotation, so improving the activation of the entire complex (Upper Trapezius, Lower Trapezius and the Serratus Anterior) is necessary.
Rehab for upward scapular rotation
Pizzari, Wickham, Balster, Ganderton & Watson (2014) states the importance of exercises to increase Upper Trapezius activation in the aid of helping to fix the upward scapular rotation. Exercises that have been shown to increase the activation of the Upper Trapezius and effectively help us fix our upward scapular rotation are the following:
- Overhead shrugs
- Monkey Shrugs
Both monkey shrugs and overhead shrugs can be performed with kettlebells or dumbbells. Both are great exercises and, yes with the monkey exercise you may look like a monkey, but it will be worth it. Both have been shown to have higher activation of your Upper Trapezius and decrease your Levator Scapulae activation (downward rotators). Therefore, making them two great exercises to help promote your upward scapular rotation.
Monkey shrugs is a shrug of the shoulders whilst the elbows are bent and the overhead shrug is performed with the arms above the head.
Why are we not shrugging by our sides?
These shrugs are preferred over the use of normal shrugs due to a study by Pizzari (2014) showing that a modified shrug with at least 30 degrees of shoulder abduction creates a more efficient activation and coupled motion activation of both upper and lower trapezius, therefore, enabling a higher activation rate of the two upward scapular rotators.
Shrugs performed by our sides have actually been shown to cause a higher Levator Scapulae activation over what we used to believe was an upper trapezius activation exercise (Choi et al., 2015).
Overhead shrugs hurting? Then move to shrugs at 90 degrees. These have been shown to be great with athletes suffering from shoulder impingement (above 90 degrees of shoulder movement = painful) as this exercise is still allowing for high activation of Upper Trapezius recruitment but not putting the athlete at risk of pain, which is likely to be reproduced in movements above 90 degrees (Choi et al., 2015).
Although it is crucial to rehab and strengthen the upward rotation, balance between these and the downward rotators is just as important when aiming for overall scapular health and efficiency. The overhead shrug is believed to form a balance between the Levator scapulae (downward rotator) and the upper trapezius. In an overhead position, the Levator Scapulae is less active, therefore, allowing the upper trapezius to be effectively strengthened for upward rotation (Sayce, 2011).
Serratus Anterior
The serratus anterior also plays a role in upward rotation; Cressey (2006) states that Wall slides are important to enhance upward rotation. This muscle is usually one of the first muscles to become inhibited with scapular humeral dysfunction (decreased upward scapular rotation) therefore, should be implemented into rehabilitation programmes for people who need to fix their upward scapular rotation. All upward rotators should be strengthened, not just the upper trapezius. Additionally, the serratus punch exercise improves the engagement and strength of the Serratus Anterior.
These two exercises, coupled with the previous shrug exercises, are a great way to encourage upward rotation, especially when working overhead.
Remember… There needs to be a balance between upward and downward scapular rotator exercises to ensure we are free from abnormal scapular movement and therefore, forever promote optimal shoulder performance when training (Choi et al., 2015).
Don’t forget, it is important to get your shoulders assessed to fully understand what may be causing your pain and discomfort, and to know which element isn’t functioning optimally.
If you have any questions or feel you’re suffering from a shoulder injury, please get in touch or book an appointment online!
References
Meakins, A. (2013). Upper Traps: over assessed, over blamed, and misunderstood! The Sports Physio.
Paine, R; Voight, M.L. (2013). The role of the scapular. Int J Sports Phys Ther. 8 (5), pp.617-628.
Pizzari, T., Wickham, J., Balster, S., Ganderton, C., & Watson, L. (2014). Modifying a shrug exercise can facilitate the upward rotator muscles of the scapula. Clinical Biomechanics, 29(2), 201-205.
Cressey.E. (2006). Shoulder savers: Part 1. T-NATION.
Choi, W-J; Cynn, H-S; Lee, C.H; Jeon, H-S; Lee, J-H; Jeong, H.J; Yoon, T-L. (2015). Shrug exercise combined with shoulder abduction improves scapular upward rotation and scapular alignment in subjects with scapular downward impairment. Journal of electromyography and kinesiology. 25, pp.363-370.
Sayce, T. (2011). The shoulder: what every swim coach/athlete should know-scapular rotation. Shoulder care, Sayco performance athletics.
