How do we fix a scapular that doesn’t want to upwardly rotate?
Jessica Woodhouse, Injury Active Clinic
Previously mentioned in the blog “ The importance of upward rotation in the snatch” we outlined the IMPORTANCE of this movement to decrease our chances of becoming injured in overhead movements. This movement, upward rotation, will allow us to train pain free so lets go ahead and fix it!
The big question is… How do we fix a scapular that doesn’t want to upwardly rotate? Thinking back to the last blog we mentioned that we need a coupled force motion of the Upper Trapezius, Lower Trapezius and the Serratus Anterior (Paine et al 2013). Therefore, we must fire these muscles (upward rotators) and not allow the downward rotators (Pectoral Minor, Rhomboids, Levator Scapulae) to over power our upward rotators, ensuring we avoid that destructive downward force in our shoulder that the downward rotators cause.
Upper trapezius activation
This, as already outlined, can become less effective at creating upward rotation due to the downward rotator dominance (Larsen 2014).
There is a common misconception where the Upper Trapezius are blamed for being overactive however, it is likely that this over blamed muscle is actually lengthened and weak which will be causing upward scapular rotation to be less effective (Meakins 2013). Therefore, by rehabbing this upward rotator by actually strengthening it instead of ignoring it, this will allow scapular upward rotation to become more effective. However, like we mentioned rehab needs to have mixed components of scapular strength work of all upward rotators, increasing strength and activation of the Upper Trapezius, Lower Trapezius and the Serratus Anterior.
Rehab for upward scapular rotation
Meakins (2013), states the importance of exercises to increase Upper Trapezius activation in the aid of helping to fix upward scapular rotation. Exercises which have been shown to increase the activation of the Upper Trapezius and effectively help us fix our upward scapular rotation are the following:
1) Over head shrugs
2) Monkey Shrugs
Both monkey shrugs and overhead shrugs can be performed with kettle bells and 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 a higher activation of your Upper Trapezius and decrease your Levator Scapulae activation (downward rotators). Therefore, making them two fab exercises to help promote your upward scapular rotation.
Click below for monkey shrugs and overhead shrugs
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).
Balance. Balance between the upward and downward rotators is important. 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).
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.
Click the link below to learn how to perform Wall Slides
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 promoting optimal shoulder performance when training (Choi et al 2015).
Don’t let you shoulders be depressed. Make them happy and get fixing your upward scapular rotation.
Thank you for reading.
Don’t forget, it is important to get your shoulders assessed to fully understand what is happening/dysfunctional.
Any questions don’t hesitate to get in contact or book an appointment with us below.
BSc Hons Sports Therapy
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.
Cressey.E. (2006). Shoulder savers: Part 1. Available: http://www.ericcressey.com/shoulder-savers-part-1. Last accessed 19/3/15.
Larsen, U. (2014) Olympic weight lifter shoulder injury. A case study in value of an iso-integration technique. Rehab trainer.
Meakins, A. (2013). The upper trapezius, 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; Glanderton, C; Watson, L. (2014). Modifying a shrug exercise can facilitate the upward rotator muscles of the scapula. Clin Biomech. 29 (2), pp.201-205.
Sayce, T. (2011). The shoulder: what every swim coach/athlete should know-scapular rotation. Shoulder care, Sayco performance athletics.