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Scapular stabilization exercises are exercises intended to strengthen the muscles that hold the shoulder girdle, which is the bony structure that includes the shoulder blades and collarbones that supports the weight of the arms, in its normal, neutral position. These movements are also intended to strengthen the muscles that hold the scapulae steady during lifting movements in order to better support the shoulder joint. Finally, scapular stabilization exercises may include stretches for tight upper-body muscles, muscles that may inhibit the scapular stabilizers from functioning properly.
Because the glenohumeral joint has the most range of motion of any in the human body, it is also the most unstable. Therefore, several muscles must be recruited to maintain the stability of this joint via their attachments to the shoulder blades. The four muscles of the rotator cuff — the supraspinatus, infraspinatus, teres minor, and subscapularis — are often associated with scapular stabilization, as these are responsible for stabilizing the glenohumeral joint. It is the muscles of the upper back that attach to the shoulder blades, however, namely the trapezius, serratus anterior, and rhomboids, that must first be strengthened, as these hold the scapulae in place and therefore support the rotator cuff in doing its job.
The trapezius is the large, superficial muscle of the upper back that shrugs, retracts, and depresses the shoulder blades, depending on what part is being activated. While the upper trapezius can become quite tight and overactive from hunching the shoulders, the middle and lower trapezius are typically weak, which can result in shoulders that round forward. The same goes for the rhomboids, which are found beneath the trapezius and which also retract and depress, or pull back and pull down, the scapulae.
To strengthen these muscles, a suggested exercise is the scapular wall slide, which involves standing with one’s back against a wall, feet roughly 12 inches in front of the wall, and elbows and knuckles against the wall so that the arms form a W. Miming the movement of a lat pull down and keeping the shoulder blades retracted and depressed, one should slowly slide his arms up the wall while applying constant backwards pressure. He should then slide them back down into the W as far as he can without releasing the shoulder blades or allowing the elbows or knuckles to come off the wall, and repeat.
Another muscle of scapular stabilization is the serratus anterior, the ribbed muscle found below the chest to either side of the ribcage. In addition to stabilization, the serratus anterior pulls the shoulder blades forward and apart, as well as rotates them upward. To strengthen this muscle, experts recommend push-ups with scapular protraction and retraction, which begins with a military or kneeling push-up position. From this position with the shoulders directly above the hands, one should first draw the shoulder blades together, and then pull the shoulder blades apart. Returning the scapulae to neutral, she should next perform one repetition of a push-up and then repeat all three movements.
A final component of scapular stabilization training is stretching those muscles that are antagonistic to the scapular stabilizers and that therefore can inhibit them from doing their job. In many cases tight pectoralis major and anterior deltoid muscles, which pull the shoulders forward and rotate them internally, require the most stretching. To stretch these muscles, located in the front of the chest and shoulder, one should stand in a doorway with one hand placed on the back of the frame, palm forward, and arm extended sideways to shoulder height. Keeping the shoulder blades depressed, she should slowly turn her chest away from her extended hand, applying a stretch to the pectorals and holding for 20-30 seconds before repeating on the opposite side.
Similarly, it is recommended to stretch the upper trapezius, particularly for those who sit in front of a computer for long periods. To do so, one should clasp her hands behind her back while sitting or standing, keeping the arms straight and chest lifted. Retracting the head and tucking the chin slightly, she should pull down on the shoulders while depressing the shoulder blades, optionally tilting the head to either side to deepen the stretch. This stretch should be held for 20-30 seconds and, for sedentary office workers or anyone who carries a load like a briefcase at her side, performed several times daily.
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