Shoulder discomfort is a fairly common malady among today’s office workers, and although the scapulae rarely get blamed, they are often the source of the pain. Commonly known as the shoulder blades, the left and right scapulae are the critical links between the spine and the shoulder’s rotator cuffs. Essentially, they and the 17 muscles around them are the foundation of your shoulders and the base of every arm movement, so it pays to keep them positioned properly.
“In almost 100 percent of cases where there is an injury at the shoulder joint, there is also dysfunction at the scapula,” says Mike Robertson, president of Robertson Training Systems in Indianapolis, Ind.
Ordinary lifestyle factors and common exercise patterns can create imbalances in the scapulae that cause them to function improperly. Eventually, this can lead to shoulder problems such as bursitis (sometimes referred to as “swimmer’s shoulder”), arthritis, cartilage damage, rotator-cuff tendonitis (inflammation), tendinosis (degeneration) and rotator-cuff tears.
“But the good news,” Robertson says, “is that if you can get rid of your problems at the scapula, you can get rid of — or prevent — most shoulder injuries.”
The Price of Imbalance
Poor posture, such as the forward rounding of the upper spine common among office workers (see “In a Slump” in the May 2007 archives), inhibits the ability of the scapula to tilt backward and create space for the rotator cuff in the shoulder joint when the arm is lifted overhead. As a result, the rotator cuff gets pinched, causing tissue damage.
Sitting in a hunched position for long periods of time also affects the muscles that move the scapula. “Most commonly, poor scapular positioning causes the lower trapezius, which helps rotate the scapula upward to lift the arm overhead, and the external shoulder rotators to become weak,” says Bill Hartman, PT, CSCS, owner of PR Performance in Carmel, Ind.
These weaknesses reduce the shoulder’s mobility and stability, and certain popular exercises may actually worsen these imbalances — and their consequences. The bench press, for example, strengthens the muscles that rotate the scapula internally and downward, but it leaves the weak external and upward rotators untouched. A good counterbalance to the bench press is the pushup, which activates and strengthens those rotators.
An Ounce of Prevention, a Pound of Cure
Restoring balance and proper function to your scapulae isn’t hard, but it requires some focus and commitment.
“Before anything else, focus on correcting your posture,” says Robertson. Condition yourself to sit with your trunk fully upright and with your deep abdominal muscles engaged. If necessary, reposition your computer screen so you look straight ahead at it instead of downward, and move your keyboard so you can type without reaching forward.
You can further correct a hunched upper back by doing thoracic extension exercises. While sitting in a chair, lace the fingers of both hands together against the back of your head and tilt your head back to look up at the ceiling. Relax and repeat 10 times. Do this exercise at least twice a day.
It’s also important to modify your resistance-training routine to strengthen all of the muscles that act on the shoulder joint. For most of us, the muscles that typically require the most attention are the lower trapezius and the shoulder external rotators. You can strengthen these muscles using the corrective exercises described below.
The site of pain is not always the cause of pain, and the shoulder blades are a prime example of this principle. If you have shoulder pain or dysfunction, your scapulae may be to blame. But don’t get mad at them — get even. Evenly balanced, that is.