‘Need to Correct Scapula Function to Treat Reduce Shoulder Pain’
In last week’s article I spoke about the importance of basing successful treatment of shoulder pain on segment of the shoulder examination that was found in the clinic to be dysfunction. Then by correcting that dysfunction of the shoulder blade, shoulder joint or upper spine we can then arrive at the treatment solution for shoulder pain. Again, this is in relation to common shoulder conditions such as rotator cuff tendonopathy and bursitis issues. This weak I will focus my article on the Dysfunction of the Shoulder Blade (Scapula) and what needs to be stretched and strengthened to help improve the scapula’s movement.
Poor tendon Flexibility of Shoulder Blade
Patients with a slouched posture causing excessive curvature of the neck andd middle thoracic spine will have a poorly functional scapula that is highly associated with causing shoulder impingement pain. Muscles within the Shoulder can become tight and lack poor flexibility. Such muscles include the Pectoralis Minor which is found to tight is patients and athletes with shoulder impingement pain as the pectoralis minor muscle pulls the shoulder blade forward and causes restriction in the ability of the collar bone to correctly move backwards. Hence treatment should focus on achieving normal flexibility of the Pectoralis minor muscle. A tight Posterior Capsule that sits behind the shoulder joint has been found to reduce shoulder internal rotation movement such which means that you are restricted or in pain when bring your ‘hand behind your back’, hence the posterior capsule and its closely surrounding tendons of need greater stretching qualities.
Poor Muscle Strength
Treatment of Shoulder Blade Dysnfunction needs to focus further on strengthening its weak attaching muscles. The Serratus Anterior that sits underneath the shoulder blade is responsible for Upward movement of the Shoulder is a controlled fashion. A weak Serratus Anterior fails to achieve this normal alignment control leading to abnormal shoulder blade (Scapula) tilting. We then need to focus on reducing the early activation or firing of the upper trapezius muscles that attach from the shoulder blade to the neck. This is best seen as an early ‘Shoulder Shrug’ when someone lifts that arm upwards. To counteract this, we need to focus on strengthening the lower trapezius that is situated between the lower half of the shoulder blades.
Next week’s article will focus on further rehabilitation of the Shoulder.
Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy and is based in Thurles. Contact Number: 0504 26672