Addressing Our Scapular Stabilizers
Developing Our Scapular Stabilizers to Prevent Shoulder Injury.
What constitutes a shoulder joint that is prone to injury? Could it be weak rotator cuff musculature? Maybe it is joint laxity and instability? What about capsular restrictions or the work we do on a regular basis? Or, is it possible that weak scapular stabilizers could play a role in shoulder injury?
The answer is, all of the above reasons could contribute as the cause of a shoulder injury. Although shoulder injuries are often complex, many do happen to be related to one common problem: weak muscles that support the shoulder blades, otherwise known as scapular stabilizers.
The scapula (shoulder blade) is a very involved structure of the body. Not only does this bone articulate with the humerus (upper arm bone) and clavicle (collar bone), it is also the attachment site for many muscles in the shoulder itself, as well as the back, the chest, the arm, and even the neck. It is therefore easy to comprehend how a weakness in this area could affect many others in the body.
The muscles that attach on the medial (inside) aspect of the scapula are the key muscles for scapular stabilization. These include the middle trapezius and lower trapezius, rhomboid major, and rhomboid minor, and serratus anterior. The middle trapezius and rhomboid muscles function to retract the scapula. Scapular retraction is the action of squeezing your shoulder blades together. The lower trapezius takes care of scapular depression which is drawing the scapula down the thorax. The task of serratus anterior is to hold the scapula’s medial border tight to the thorax.
Many of these weaknesses are actually observable. When the lower trapezius muscle is weak, a flaring of the lower scapula exists. When the serratus anterior is weak, the medial border of the scapula flares. Weakness of the middle trapezius and rhomboid muscles contributes to a separation of the scapulae, also known as protraction.
It is therefore the job of these muscles to hold the scapulae tight to the thorax. If the scapulae are not held firmly by strong muscles, they are left free to flare and flop with arm movements. Without stability at the scapula, how is it possible for the glenohumeral joint (shoulder joint) to remain stable? It isn’t.
Scapular instability leaves the glenohumeral joint (GH joint) at risk of injury as the GH joint requires both strength and endurance of scapular stabilizers for it to be protected. The stability of the GH joint cannot come from the humerus since the arm does not have anything to stabilize from; it has no anchors. However, the scapula attaches to the axial skeleton of the body (a fantastic anchor) and therefore can generate stability from the thorax. Strong scapular stabilizers have been proven to defend the GH joint from injury.
Once these weaknesses are identified via observation of functional movements and muscle testing, exercises must be incorporated into one’s daily schedule in order to prevent or rehabilitate shoulder injuries. Many of the exercises used to target such muscles are very intricate in their movement patterns and look fairly easy. Often, the first time patients see these exercises performed, they expect them to feel simple. However, as soon as they attempt one repetition themselves, they recognize how weak their stabilizers actually are and appreciate the need for such training.
Typical yoga posture focuses heavily on scapular retraction and depression. Yoga brings these movements into everyday life. If you meet a yogi, their scapulae will be retracted and depressed. Their shoulders will not be around their ears like the rest of the population who carry their tension in their upper trapezius muscles and levator scapulae. Simply applying these two movements to your daily activities will prove beneficial. However, to truly protect the GH joint from injury, more intensive exercise is required.
Yoga, single-handedly, can not target each of the scapular stabilizers appropriately, unless modifications are made to poses or practices. For example, by the addition of scapular protraction to plank pose, the serratus anterior muscle could be optimally targeted. Many of the movements designed to pursue the scapular stabilizers are very specific. Feedback from a health care professional or yoga instructor is ideal when attempting to understand these movements.
Bring attention to these muscles in your back. The benefits you will gain from strengthening these muscles are plentiful. Whether you are a parent who is constantly picking up children, a housewife who places the dishes in the top cupboard, or an athlete who is involved in sports with overhead movements such as tennis, volleyball, or climbing, scapular stabilization is essential in preventing shoulder injuries.
About the Author
Protecting Wrists in Downward Facing Dog and Yoga Poses
I teach Hatha Yoga classes at a variety of Yoga studios, some with carpet and some with hardwood flooring. Regardless of the flooring type, I often see common hand-placement errors in wrist-loading Yoga poses like Downward Facing Dog that can chronically lead to compression injuries in the wrists.
Having the proper placement and understanding of how to manipulate the surface area of the hands can significantly reduce the incidence of wrist injuries in your Yoga practice. The first issue to address is the floor type that we practice Yoga on. Most people find practicing on hardwood floors hard for the knees and other pressure points on the body. To create cushioning, many people practice in studios on two Yoga mats. This doubling of mats creates a similar problem to practicing with a Yoga mat on a carpet. The thickness of two mats or of a mat on carpet causes the hands to sink into the soft support. When hand positions are even slightly off-balance, body weight is shifted even more into those sinking points. The wrists are next to fall into this compression and take this uneven energy. What causes this uneven compression?
Notice what happens to the connection points in the hands the next time you do Downward Facing Dog, Cat pose, Plank pose, Cobra pose or any other pose that positions your hands forward of the shoulders and applies pressure. As you move away from your hands in Downward Facing Dog or in the exhaled phase of Cat pose, do the inner regions of the hands (proximal index finger and knuckle) lift off the ground? Is there space flowing from the inner hand into the palm?
When the inner hand lifts in these loaded poses and when we practice on thick surfaces, body weight transfers heavily to the outer wrist joints. These outer joints become easily compressed and, for some, result in acute or prolonged pain. Considering how static pressure increases when we decrease the surface area that the pressure is being applied to, we can easily decrease this damaging pressure by bringing attention to how we apply energy into the hands. Before loading the hands in Yoga poses, align the wrists so the middle and index fingers roughly point forward or parallel with your mat. Send a gentle spread across the fingers without tension going into the wrists and arms. Allow a pause to lightly ground the proximal end of the index fingers and the index knuckles. Feel that you are already distributing your body forward out of the wrists and more evenly over the hands. Rather than the weight going into a small portion of the hands (high pressure), the weight is fanned out over a greater area (less pressure). As you set up the rest of the pose, keep applying this gentle, inner grounding of the index region. You may feel as though you are slightly spiraling the forearm inwards.
In Downward Facing Dog and Plank poses, this inwards spiral of the forearms, may draw the upper arm bones and shoulder blades forward. Therefore, a countering motion is required. A slight outwards spiral of the upper arms should be applied along with a light hugging of the shoulder blades back and down into the upper ribs. There are various Yoga equipment products that can aid in reducing wrist compression as well. But I first recommend exploring how you can change hand placement and energy applications. If possible, practice with only one mat and thinner cushioning under the hands.
Be more aware of the surfaces you practice on and add additional care to protecting the wrists in loading Yoga poses. As our practice is life-long, we need to perform Yoga poses mindfully to sustain the vitality of joints.
