with contributions by Keith Wittenstein. Special thanks to Sarah Court, Dinneen Viggiano and Trina Altman for editing and feedback
In my last post, I deconstructed scapuloclaviculohumeral rhythm, the co-movement of the bones of the shoulder (humerus, clavicle and scapula) during movement. To more thoroughly understand scapuloclaviculohumeral rhythm, it’s helpful to understand a big-picture role of the scapula in the overhead position. When the arms move overhead, the scapula guides the arm bone. More specifically, the glenoid fossa, or socket, of the scapula pushes the ball-shaped surface of the head of the humerus. Thus, the cue “shoulder blades down,” when the arms are overhead inherently confuses the role of the scapula and mistakes it as a puller downer rather than a pusher upper – another reason “shoulder blades down” when the arms are up is indeed a major downer. Reorienting your conception of the scapula as the pusher of the humerus, can also help clarify the movement the scapula makes in upward rotation.
Let’s say you are reaching your arms upward, as in upward hand pose (see picture). When the scapula upwardly rotates, its lateral border (the side that the socket is on, and in this image the side of her left shoulder blade that is closest to us) moves upward toward the hands. Its superior angle, (the upper inner triangle, which sits just below the base of her neck) moves downward toward the hips. During upward rotation, the outer shoulder blade goes up and the inner shoulder blade goes down. For this pose, you could cue “lift the outer shoulder blade (or outer armpit) upward to reach your arms overhead”.
Any cue that encourages the outer border of the scapula to move upward could help drive the glenoid fossa (shoulder socket) upward so that it can, in turn, push the head of the humerus upward. It’s definitely more nuanced, and thus harder to teach than just lifting the whole shoulder blade up (called scapular elevation), which can recruit muscles that are already excessively tense and that cause the shoulder blades to crowd at the base of the neck.
In fact, when you do lift the arms overhead and feel excessive tension at the base of your neck or see that your students’ scapulae are crowding that area, you can assume students are biasing elevation of their shoulder blades over upward rotation. In cases like this, the action “glide your inner shoulder blade downward (which is yet another way of cueing upward rotation of the scapulae!) will encourage the shoulder socket into an upward facing position while helping to create a feeling of more length at the neck. This is another major bonus of learning to refine the scapular movement of upward rotation. Upward rotation of the scapula inhibits contraction of a major culprit of neck tension, the levator scapulae.
As pictured to the right, your levator scapulae muscle attaches from the superior angle of your shoulder blade to the vertebrae of your neck. One of its muscle actions is downward rotation of the scapula. This means that this muscle is an antagonist to upward rotation of the shoulder blades and can lead to major inefficiencies in the way the scapulae move when taking the arms overhead. When the levator scapulae contracts to downwardly rotate the scapula, it pulls the superior angle of the scapula upward toward the head. This is the opposite direction the superior angle of the scapula needs to go in to find a position of upward rotation.
As it turns out, the levator scapula also elevates the shoulder blade when it contracts. So double whammy: when this muscle is chronically tense, it sabotages upward rotation so the shoulder joint can’t find a good position when the arms are over head and it yanks the shoulder blades up to crowd the back of the neck. The good news is that when you learn to better engage the muscles that upwardly rotate the scapula, there is a better chance that the levator scapula muscle will relax to allow for this movement to happen. This reflex of the body is called reciprocal inhibition. This will result in more efficient and stable positioning of the shoulder socket when taking the arm overhead. It will also help repattern chronic tension in this muscle that can lead to a crick in your neck. One of the ways many of us are guilt of misusing and abusing our levator scapulae muscle, is by pinching a phone between our ear and shoulder.
From a teaching standpoint, the challenge is to help the student accurately interpret how to spin their shoulder blades in the direction of upward rotation, or in layman’s terms, how to lift the outer border of the shoulder blade toward the upward reach of the hands while moving the inner border of the shoulder blade (the superior angle) toward the hips. This is complex, and will likely not be fully understood on the first try. It will take a lot of repetition and practice. However, when this scapular action is somatically understood, it can go a long way toward facilitating more efficiency in pushing the arm bone upward, avoiding excess tension at the back of the neck (namely in the levator scapulae muscle), as well as avoiding impingement of the soft tissues of the AC joint.
Keep tuning in this month for the rest of this series, Uplifting News for Depressed Shoulders!