with contributions by Keith Wittenstein. Special thanks to Sarah Court, Dinneen Viggiano and Trina Altman for editing and feedback
This article is Part 4 in a series on shoulder biomechanics.
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!
Enjoyed this article? Read Assess The Temperament Of Your Dog Before You Master The Pose.
I’m a massage therapist along with being a recent yoga teacher graduate and I see a large number of people walking around with their shoulders in constant elevation due to the levator scapulae. The points you make in your article will be a great help with working with this population. Thanks!
Thank you for this clear explanation of what is happening in shoulder flexion. It helps to make “cueing” more clear and precise.
OMG so much is going on when I just flex my arm! Tried these moves mindfully, constantly visualizing coordinated work of all above mentioned participants. Fascinating.
Thanks Laurel. I really love the intimate connection between the tension in the neck , the levator scapula and the scapula itself. Its interesting to learn how we can train the movement of the scapula and thereby trick the proper engagement of the muscle to avoid neck tension.
I like how you define the roll of the scapula as the “guider” “pusher” “lifter upper” of the humerus, highlighting the support that the scapula provides to the humerus during upward rotation. I also enjoyed the mention and corresponding photo of levator scapulae as an antagonist to upward rotation. This article so clearly defines the nuances and challenges of flexion of the shoulder.
Your explanation of levator scapulae as an antagonist to upward rotation 100 explains those guys I see in yoga class flexing their shoulders to their end range of motion with their arms bent out to the sides looking like they have just dropped the weapon and stepped away from the vehicle. This image made some sense to me visually on bulkier men, but I never understood how a practitioner without much upper body mass could hold so much tension in the neck when the arms were flexed to a comparatively small degree. I see now that what’s happening doesn’t have much to do with the size of the muscles, but the relationship between shoulder flexion, scapular upward rotation and tension in the levator scapulae. And now I know to use reciprocal inhibition to those students’ advantage 😉
The detailed breakdown of this anatomical movement phenomenon is helping me better understand what is happening in my body and this re-orientation is giving me a new roadmap into what seems from the outside the same movement – but now the movement feels so different now that you have taught me what is actually happening. It will take me some time to learn the details.
Really appreciate the clear depiction of the dance of the shoulders in flexion. Seems like with all the tension we carry in the upper back and neck these days, that the effort, so to speak, is in relaxing the levator scapula as we take the arms overhead.
I tried Laurel’s cues to “lift the outer shoulder blades or armpit.” The result was a sensation of lightness and arms floating toward the sky plus improved coordination of breath and relaxation / expansion with the movement. I think initially I would refer to armpit with a class since it’s a simpler visual. Additionally it focuses attention on the area close to lats and brings that side–back body into student awareness. The video was extremely helpful. Good job, Laurel!
I liked the cue “lift the outer shoulder blade (or outer armpit) upward to reach your arms overhead” it will be a challenge to help students figure out. Also levator scapula being tense causing restrictions for upward rotation of the arms is really interesting. Learning to control the muscles that move the scapula will certainly be fun to figure out – especially stopping holding the phone to my ear.
Wow! This is a great post for understanding the movement of the bones and muscles when the shoulder is brought into flexion. The video is so clear in showing what needs to happen for full flexion.
Thank you so much for this series – it’s really helped me to clarify the actions of the shoulder when the arms are overhead. I have a much better idea of how to instruct upward rotation of the scapula without elevating the shoulders.
Great detail on rotating the scapula and how the levator is like an elevator for the scapula, not what we want! Sometimes I have students flex their shoulders, arms about chest height, bend the elbows slightly and turn the palms away with fingers extended. Now abduct and adduct the shoulders by lifting and lowering the elbows. The hands will rotate with the movement of the arms and shoulders. Oh, and your shoulder blades, the scapulae, are also rotating. In fact the movement of your hands, right in front of you, mimics the movement of your shoulder blades (which you can’t see). This is a great way to teach how the shoulder blades should be moving to take the arms into flexion. I love also your ideas about how the scapula actually pushes the humerus up as it rotates thereby sealing the deal that rotation is a good thing.
I love this. I find this information so important – I will try cuing the spinning scapula in my flow class tonight and see if they get it too.
This is changing the way I look at my shoulders in my practice.
Laurel, I am really trying to understand the mechanics of the movement of the shoulders and your blogs are great. I’ve been elevating my arms and using my friends shoulders to visualize and also watching the video. When the arm is flexed overhead, the outer border of scapula moves outward (like a turn table) toward the armpit and upward towards the hands, while the superior angle moves towards the hips. As the superior angle moves down towards the hips, it would create less tension in the muscles of the neck (levator scapula) and a softening of the traps..correct? My question is that when the arm is flexed overhead is the shoulder externally rotating to create space? I believe the same scapula movement should take place in Downward Dog? Almost a “wrapping” of the upper back muscles, with shoulders in external rotation and paying attention to the serrates anterior muscles for stability? Would love to hear from you.
would love a video that clearly shows this action so I can visualize it and understand better. Thank you.
Great article! It really cleared up and refined my understanding of the movement of the scapula as the arms move overhead. I agree that relaying this to my students will be a challenge. It would be great to hear more cues for helping students embody this action. Thank you.
Very in depth. Thank you.
I read the previous post last night and then put my new-found knowledge into use while I was in class this morning. What a difference! Now, the challenge for me is in how to educate the staff at my studio about all of this… This is an important yoga “myth” to dispel! Thanks for providing all of the different suggestions for how to cue the proper movement in class.
Enlightening!! I had never thought of levator scapula as a scapular rotator… recipricol inhibition of lev. scap….. inspiring, I will definitely be musing on this for some time.