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Your Shoulder Hurts. Is Your Scapula Tilting?

1/22/2015

12 Comments

 
There are a few things in life that everyone knows to be true. We all have to pay taxes, we all will die one day and if you have poor extension in your upper back you will have a poor overhead position. Maybe the third one isn’t quite as obvious as the first two but it’s absolutely true!

Why is it that your upper back causes so many problems for the shoulder? That answer is very complex and for the sake of you borderline ADHD people like myself, I’ll keep this to one simple concept, scapular tilting.

Scapular tilting occurs anytime that we raise or lower our arm in front of us. In the picture below you can see the the shoulder blade of the person on the right is tilted forward more than the person on the left. This forward tilt is called anterior tilting of the shoulder blade. Anterior tilting is a problem because it creates a bone block as the arm raises overhead. You can’t push through this and force it into a better overhead position.

We can see in the person on the left in the same picture that the shoulder blade is now perpendicular with the ground. This is a good thing and called posterior tilting of the scapula. We need to get the shoulder blade into this position in order to achieve a full overhead position. This posterior tilt of the shoulder blade is primarily allowed by our upper back's ability to extend or flatten out. This is why people that have rounded or what we call kyphotic upper backs have a very difficult time with achieving a fully locked out overhead position.

Picture
So how do we get that thoracic spine to flatten out and allow the shoulder blade to tilt posterior? It's not easy if you have lost a ton of mobility, but here's a simple two-step process to start improving this movement.

1. Get the hell out of your chair! 

If you sit for a long period of time everyday, chances are you have really poor mobility in your upper back. Get a standing desk or put your chair on your desk and force yourself to get out of that position. If you sit for 8 hours with a  rounded upper back and think 5 minutes of mobility work will negate that, you're completely wrong.

2. Work on mobilizing to improve thoracic extension. 
This is the hard part. You have to chip away at this problem daily if you have a significant loss in mobility. The good news is there's a ton of great video content out from my boy, Kelly Starrett on improving upper back mobility. Here's a great video to give you a better idea of what types of mobility techniques you need to add in to your training.  

Good luck and leave us a comment if you have any questions.


-Danny
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12 Comments
Carrie
9/18/2015 07:24:03 am

I have 2 questions: this video showed him working on one side - is there a way of mobilizing bilaterally? Would laying the weight flat still have the same effect in stabilizing the ribcage?

Reply
Danny Matta link
9/18/2015 11:36:23 am

Hey Carrie, thanks for reading. Yes, you can mobilize bilaterally. You can use two lacrosse balls taped together to hit both sides of the t-spine. I personally like the Yoga Tune Up Balls Plus. They are softer but still dense enough to get some good pressure into the t-spine. Laying with the weight flat would still work. I like to use a dynimax ball instead because it's softer and hugging it causes the shoulder blades to open up a ton. Thanks again for reading! -Danny

Reply
Robert
1/28/2016 02:47:59 pm

thanks Danny...love the blogs, keep 'em up

Reply
Paul
7/7/2016 10:58:06 am

I didn't see exactly where the peanut is placed. I know it's between the scapulae, but high, low, or do we need to play around with to see where it does the best work?

Reply
Danny
7/7/2016 11:03:11 am

Hi Paul,
Mid back is a great place to aim for. Use this video to help with placement: https://www.youtube.com/watch?v=Qw0e3MzV8fA

Reply
Paul
7/7/2016 11:30:09 am

Thnx!

Reply
Paul
7/7/2016 12:01:31 pm

Last question,
I have one concerning coracoid process. Okay to ask here? Or do you prefer another format?

Reply
Danny
7/7/2016 01:02:27 pm

Hey Paul, shoot us an email and we'll answer to the best of our abilities. info@athletespotential.com. Thanks!

Reply
Andrew
10/31/2018 03:10:36 pm

Great post, i have this exact problem with my scapular anterior tilting. what exercises in the gym should i avoid based on this?

Reply
Dr. Ravi
11/1/2018 09:57:47 am

Hey Andrew, thanks for reading. It’s tough to say without knowing more details. Typically, overhead movements like shoulder press or pull-ups can give people trouble. I don’t think there’s any reason to avoid movements unless you have pain or if technique is a concern. My suggestion is to start off light and progress your load and volume from there. This video describing the goal of posterior scapular tilt can also be helpful for you: https://www.youtube.com/watch?v=BCI6IMOIjnE
Landmine press variations tend to be a good bridge for getting better position of your scapula. If you do have pain or concerns with these movements, then I’d recommend getting it checked out by a Physical Therapist in your area. Thanks!

Reply
Stella O link
12/30/2020 05:23:37 am

Interestiing thoughts

Reply
Rafael
3/21/2022 12:54:59 am

Great post, I just had one question though and it’s how often should we do the exercises mentioned in the video to see permanent results in our scapula alignment becoming corrected?

Reply



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