Shoulder Pain Part 2 – The Scapula

Shoulder Pain Part 1 covered shoulder pain in overhead athletes. Another commonly overlooked component of a healthy shoulder joint is the scapula or shoulder blade. The scapula, a relatively flat bone, sits on the posterior part of your rib cage. Why is this bone important? Well, the glenohumeral joint consists of the humerus (upper arm bone) and shoulder blade. This is the major portion what is considered the shoulder girdle, so problems with either one of these bones, or the muscles that control the movement of them, often lead to problems.

One of the more common issues seen with the scapula is the ability to control and maintain proper movement as the arm moves overhead. As one lifts the arm overhead, it is imperative that the scapula glides in an upward tilting direction. This motion allows space for the humerus to get into an overhead position. If not, there is a decreased space, which usually leads to a pinching sensation in the shoulder joint. This offers just one example of what abnormal scapular motion can lead to.

Normally, one can control elevation, depression, protraction, retraction, and upward and downward tilting with fluidity. Certain muscles that control these movements frequently become overactive, for example the upper trapezius and levator scapula muscles, causing the scapula to stay in an elevated position. Alternatively, when muscles like the serratus anterior, which contribute to proper scapular protraction, become inhibited it leads to scapular winging.

Shoulder Examination

Our chiropractors at Elite Sport & Spine will perform an examination of the entire upper extremity, as well as the spine to help determine the cause of your shoulder pain. This usually consists of palpation, range of motion evaluations, muscle testing, orthopedic testing, and functional movement screens. These diagnostic tools help us determine if the scapula contributes to your shoulder pain.

Shoulder Treatment

Treatment of abnormal scapular mechanics depends on the cause of this problem. Often times treatment combines spinal manipulation, scapular mobilization, myofascial release, and rehabilitative exercises. We frequently see those with desk jobs holding a lot of tension in the upper back/lower neck. To help relax some of these overactive tissues, our chiropractors often perform myofascial release either with an instrument, like a Graston Technique® instrument, or by hand. Next, the chiropractor prescribes certain exercises to help retrain proper scapular movement. This helps restore balance to the muscles controlling this bone and shoulder joint. Commonly, these exercises target the lower trapezius and serratus anterior muscles to increase strength. These muscles commonly get underworked, but are vitally important for a healthy shoulder!

 

If you, or someone you know, suffers with shoulder pain call 262-373-9168 or schedule online to have one of our chiropractors evaluate you today!

Read part 1 of the shoulder pain series.

Blog by Dr. Adam Cosson