So as you guys may have heard, the thoracic spine attaches to the ribcage which connects to the scapula (say what? Click HERE for an explanation). Because of this, we need to clear up any issues with the thoracic spine before we start worrying about the shoulder blades. Getting into the correct position with your shoulder blades is going to rely on having adequate alignment in the thoracic spine first. Good position of the thoracic spine will automatically clear up a lot of the other issues down the chain in our body. So what’s next?
2) Scapular stability and motor control:
If the thoracic spine is all cleared up, the scapula will be free to do its job. (Find out more about how this occurs HERE) So what are we trying to accomplish with our shoulder blades?
If we’re talking about front squats and cleans we want to position the shoulder blades in the most optimal position to keep our elbows up high and support the weight on our shoulders. A few things to keep in mind here:
- The position of the scapula directly affects the amount of external rotation we’ll need at the shoulder to get into an efficient position. If we have a better position of the scapula (slight retraction/neutral position of the scapula) we won’t need as much external rotation at the shoulder to get into a strong position (1). In other words, if your shoulders are tight, getting into a better position with your shoulder blades will automatically improve your position. This is good news for those who lack shoulder mobility because it will require less shoulder external rotation range of motion. Another reason why this is beneficial is because excess external rotation at the shoulder can lead to internal impingement at the shoulder.
If we’re talking about front rack for overhead press we’ll want to maximize scapular and rotator cuff muscle strength. Some things to keep in mind:
- The scapula is strongest in slight retraction (2 – Research in a rehab setting)
- Our rotator cuff musculature is strongest halfway between protraction and retraction (1)
- Protraction (and more specifically anterior tilt and internal rotation of the scapula) is not only a weaker position for the scapula and rotator cuff, but it’s also a position that is implicated in subacromial impingement syndrome (By theoretically decreasing the subacromial space)(3).
So what then are we really trying to accomplish with our shoulder blades? I’ve heard the cue elbows forward and up quite a bit. This cue gets the elbows nice and high which is great, but the part I don’t agree with is the shoulders forward part. As we just discussed having slight retraction is going to be a much stronger position for us. Driving the elbows forward is going to produce protraction at the shoulder. This isn’t really what we’re going for right before a big overhead press for the above mentioned reasons.
The cue I like better is elbows high and shoulders down. This places us into a more neutral shoulder blade position emphasizing posterior tilt. What this does is get the elbows high just as we wanted but also places the shoulder in a stronger and safer position.
The way I like to train this is to consciously try and pull the shoulder blades down during mobility drills and during your front squats, cleans and before overhead pressing. For most people getting into this position is a matter of practicing and also getting your spine in order like we spoke about in part 1.
3) Shoulder, Elbow and Wrist Mobility
After we get the thoracic spine and scapula taken care of we can start looking down the stream. The next joint down the line is the shoulder. At the shoulder we’re going to need some flexion/abduction and a lot of shoulder external rotation.
Side Note: A major consideration is whether or not you have any asymmetry between sides here. If you’ve been a throwing athlete at some point in the past there’s a chance you have a difference in rotation flexibility from left to right. If that’s the case then I’d spend more time trying to even up sides.
At the wrist and elbow we’ll need mobility too (For the majority of people). A major consideration here is that if we lack motion at the wrist, we’ll try to make the motion up at the shoulder and elbow. On the other hand, if we are lacking motion at the shoulder we’ll try and make it up at the elbow and wrist. This is a major reason why people experience wrist, shoulder or elbow pain during these exercises (And also why stretching your wrists won’t always fix the problem).
The end goal is to have enough mobility to keep a closed grip on the bar with the elbows high and the bar resting on the shoulders. It also shouldn’t feel like your elbows, shoulders and wrists are about to explode from the tension in this position either. I’ve compiled a list of my favorite exercises to fix this issue that I use with myself and patients in this video:
Next week we’ll talk the rest of the kinetic chain, ooh sounds so mysterious.
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- Kibler, W. B., Ludewig, P. M., McClure, P. W., Michener, L. A., Bak, K., & Sciascia, A. D. (2013). Clinical implications of scapular dyskinesis in shoulder injury: the 2013 consensus statement from the ‘scapular summit’. British Journal of Sports Medicine, 1-12.
- Mey, K. D., Danneels, L., Cagnie, B., Huyghe, L., Seyns, E., & Cools, A. M. (2013). Conscious correction of scapular orientation in overhead athletes performing selected shoulder rehabilitation exercises: The e.Journal of Orthopaedic and Sports Physical Therapy, 43(1), 3-10.
- Page, P., Frank, C. C., & Lardner, R. (2010). Assessment and treatment of muscle imbalances the janda approach. (pp. 195-207). Champaigne, IL: Human Kinetics.