Jill Murphy, DPT, LAT, CSCS
Part of our Build A Better Body series.
Unlike last month’s article, the topic of this article is fairly unknown and unheralded. Do most people know what a scapula is, much less the scapular stabilizing muscles that anchor the wing-shaped bone to the back of your rib cage? My guess is that not many of us have heard about, or target these unsung heroes, but this article can change that!
Your scapulae are situated in the upper back region, and are the attachment sites for nearly every muscle in this region, as well as the muscles that support the shoulder, including the more familiar rotator cuff group of muscles. More important than the bone, the muscles that we will be discussing are arguably the most crucial in keeping the scapulae flat against your back as you move your arms. The rhomboid, middle trap, and lower trap connect the medial or inner borders of your scapula to your spine in the middle of your back.
Trapezius MusclesThis group of muscles, along with several other muscles like serratus anterior, upper trap, levator, and many others contribute to the normal function of your shoulders. And if you like to throw a football, paint ceilings, throw a fastball 90 miles per hour, or if you’d settle for lifting groceries, hanging laundry on a clothes line, and reaching for dishes out of overhead cupboards, these muscles, in conjunction with your rotator cuff, are the key to allowing your arms to perform those motions.
What is so important about these muscles is not so much what they do, but what they prevent. Lack of strength in these muscles can contribute to early rotator cuff degeneration, rotator cuff tears, anterior shoulder pain and impingement (pain at the front of your shoulder when you lift your arm to shoulder height), neck pain and tension, headaches, and thoracic outlet syndrome, which can cause numbness and tingling in your upper extremities. Scapular dyskinesia is the diagnosis frequently given to patients whose scapula wing or tilt (stick out from the back) either at rest or with arm elevation and the return from elevation. This recently popular diagnosis is given to patients in the first three decades of life, because after that, usually other problems at the shoulder joint itself have been established, requiring more substantial intervention, surgeries like sub-acromial decompressions and rotator cuff repairs.
If the scapulae can work synergistically with the rotator cuff in the shoulder, and if the muscles are well balanced and able to successfully stabilize the scapula with arm movements, most of these more serious shoulder pathologies can be prevented. The key to preventing serious shoulder pathology is to address strength and stability in these muscles early in life. Even the youngest among us engage regularly in strengthening this area, although we fail to recognize how critical crawling is to scapular stabilizer muscle development, and instead we encourage our little sports stars to walk early. Unfortunately, it is the most athletic kids who need to spend their time in free play crawling through tunnels at the playground, scrambling over jungle gyms, and crossing the monkey bars to encourage stable shoulders before they are pitching in little league, throwing a football, spiking a volleyball, and swimming morning and night like little Olympians in training.
If these early training opportunities are missed, kids and adults alike can perform specific exercises to strengthen the scapular stabilizing muscles. Here you will find three basic exercises with advanced progressions that will get you started strengthening three of the most commonly weak scapular stabilizing muscles, rhomboid, middle trapezius, and lower trapezius. For those wondering about shoulder shrugs and the need to strengthen upper traps, I have to say that in 16 years as a health and fitness professional, I have yet to find anyone with a weak upper trap muscle! So save the extra workout time to meet the first challenge with each of these exercises, which is to effectively activate the muscles (hints are included below to help you achieve this). There are more advanced exercises beyond these as well, and in future articles, we will roll them out; however, the three provided here with the progressions will keep you busy for quite a while! Don’t judge them unless you have actually tried them!
Scapular Stabilization Exercises
Rhomboid
Position: prone with your head resting on a towel roll with your arms resting by your sides (on your tummy- you can place a pillow under your stomach, especially if you have current or a history of back pain). A towel roll is just an old, well-used bath towel rolled up tightly and taped securely.
1) Pull you shoulder blades down and back towards the small of your back (think of a diagonal pull towards the opposite back hip pocket for each scapula).
2) Hold this position for 5 seconds. Hint: make sure you feel the muscles between the shoulder blades tighten; try not to use the muscles directly behind your shoulders- this is a common compensation and will not actually work your scap stabilizers.
3) Relax. Repeat steps 1-2, and perform 2-3 sets of 15 reps.
Advanced Rhomboid Strengthening
Steps are the same as above, but now lift your arms after pulling your shoulder blades down and back instead of leaving them resting on the table and still hold for 5 seconds. Once this becomes easy for 2-3 sets of 15 without any compensation with upper trap (see directions above), you can add a 1# weight in each hand to increase the difficulty. Keep in mind quality is much better than quantity - no compensations!!
Middle Trap
Position: prone with your head resting on a towel roll with your arms resting on the floor in a T position (on your tummy- you can place a pillow under your stomach, especially if you have current or a history of back pain).
1) Pull you shoulder blades down and back towards the small of your back (think of a diagonal pull towards the opposite back hip pocket for each scapula).
2) Hold this position for 5 seconds. Hint: make sure you feel the muscles between the shoulder blades tighten; try not to use the muscles directly behind your shoulders- this is a common compensation and will not actually work your scap stabilizers. Also keep your upper traps relaxed (on the top of your shoulder next to your neck and ear).
3) Relax. Repeat steps 1-2, 15x.
Advanced Middle Trap Strengthening
Steps are the same as above, but now lift your arms after pulling your shoulder blades down and back, instead of leaving them resting on the table and hold for 5 seconds. Once this becomes easy for 2-3 sets of 15 without any compensation with upper trap (see directions above), you can add a 1# weight in each hand to increase the difficulty. Keep in mind quality is much better than quantity - no compensations!!
Lower Trap
Position: prone with your head resting on a towel roll with your arms resting on the floor in a Y position (on your tummy- you can place a pillow under your stomach, especially if you have current or a history of back pain).
1) Pull you shoulder blades straight down toward your feet; you should feel about one inch of movement of your shoulder blades down.
2) Hold this position for 5 seconds. Hint: Keep your upper traps relaxed (on the top of your shoulder next to your neck and ear).
3) Relax. Repeat steps 1-2, 15x.
Advanced Lower Trap Strengthening
Steps are the same as above, but now lift your arms after pulling your shoulder blades down, instead of leaving them resting on the table and hold for 5 seconds. Once this becomes easy for 2-3 sets of 15 without any compensation with upper trap (see directions above), you can add a 1# weight in each hand to increase the difficulty. Keep in mind quality is much better than quantity - no upper trap compensation whatsoever!!
Read the Entire Build A Better Body Series
Part I Hips: Laying the Foundation
Part II: Myth Busting Abs
Part III: Stabilizing the Scapula: The Secret to Strong Shoulders
Part IV: Strengthening Stabilizing the Neck
Part V: The Big Picture
Part VI: Have a Ball
Part VII: Advanced Exercise Ball Routine
You can now Build A Better Body at MotionWorks by joining one of our Build A Better Body fitness classes!