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April 25/26 2020 OTTAWA
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Last post (link) I spoke of the relationship between the scapula (shoulder blade) and the humerus (arm bone) and that it would be nice if they had a supportive relationship so that the arm could have full range of motion without damage to the tissues (muscles/tendons/nerves/blood vessels) of the shoulder. This time we’ll go over what the full range of motion is and how we get it.
This is where things get interesting.
Most anatomists talk about muscles and the bones they attach to, and the joints they move as the be-all and end-all of muscle action. Take the scapula for example. Now if you’ll recall, the entire scapula is on the back of the trunk so the front of the scapula sits on the ribs – in other words, the front of the scapula is still behind you. The serratus anterior muscle attaches to the front of the scapula and then wraps around the ribs and attaches to the front of the ribcage. So when it contracts, it pulls the scapula out and away from the spine and around the ribs toward the front of the body. The scapula can’t go that far, because there are muscles (rhomboids) that attach the medial (closest to the spine) edge of it to the spine and this muscle will limit how much forward movement it has (and sometimes the rhomboids prevent the amount of movement the scapulae should have due to their residual tension). The scapula does not have a bony attachment to the ribcage, thus the muscles that attach to it will limit how far it can go in any one direction, but it typically has, or should have, a lot of motion!
Recall that the scapula can move up/down, in/out, and rotate up/down (and combine these movements). Those are movements that it can do using one or a combination of the muscles that attach to it.
But what if there are other movements that the scapula can and should do that our muscles can’t provide? How would (or should) we get those movements? What if external forces provided those movements and if we didn’t use our body in that way, our shoulders would never experience their fullest potential? I’m talking about hanging and swinging, climbing and pulling ourselves up and around with our arms.
Certain movements of the scapula such as protraction on the frontal plane (i.e., straight out and not around the rib cage) is dependent on our body weight hanging from our hands in a variety of angles, planes and positions. There are no muscles that pull your body parts away from you, but a healthy shoulder depends on those movements.
And not only shoulder health is dependent on these movements; our ribcage and associated muscles, thoracic spine (the spine associated with the ribcage and area associated with hyperkyphosis or excessive forward curvature) and our breathing mechanics are all going to be affected negatively if these movements are not a part of our movement profile. The width of our shoulders can be affected by scapula positioning; the more protracted the scapula, the wider our shoulders – but only to a point, because the serratus anterior will start to move the scapula on an angle (sometimes called the angle of scaption) where they are no longer moving on a frontal plane (straight out) and start to move around the curvature of the ribs. IF the scapulae were stabilized more often against forces pulling on the arms such as would be experienced during hanging, allowing the attachments on the ribs 1-9 to be the focus of muscle action, who is to say that the shape and curvature of the ribcage would be different i.e., broader and more robust?
(It is for this reason that I don’t fiddle with someone’s breathing mechanics, but instead focus on shoulder function and scapular stability instead.)
So we can measure range of motion and suggest a “normal” or “average” range of motion of joints, but it is virtually impossible to suggest a range of motion or even a plane of motion that we should experience from outside sources!
Here’s where I would start:
Try to develop a relationship with your scapulae. I can’t tell you the number of people who tell me they don’t know when they are even touching that bone. Because it is behind you, it is often not something you are aware of. I call it the dark side of the moon, the part of us we don’t see is often out of our consciousness. Sometimes the bone is covered with a lot of tissue (adipose and muscle) and that makes it hard to find. Take one hand and cross it over your shoulder and lay it on your back as much as you are able (sometimes the tension of the shoulder of the hand doing the exploring is the limiting factor!). Move the arm that is hanging down in various ways.
Can feel the scapula move? Conversely, see how much you can move your arm and not feel the scapula move (both are necessary, movement of the arm with and without scap movement). Try it on the other side too.
Be aware of the movement of this bone as much as you are able. Note if you are not able (this may well change). Note especially if there are ways you move your arms that result in discomfort. If you experience extreme discomfort (or pain), keep your movement exploration in a safe and smaller range, but do note that that was a requirement.
When you move your scapulae apart, how much do they move? What does the front of your shoulders look like when you do that? Do you find it difficult to do that with the arms down by your sides? How much do they move OUT before they start to curve toward the front of your body? What does that do to your arm position?
Now, move the arm and scapula again through all those ranges and pause to breathe at each end range of motion. Is it harder to take a deep breath? Easier?
Question: Is there ever a too wide set of scapula?
Answer: Yes and no, and it depends on how you define “wide” and what plane the scapulae are on. We learn that the angle of scaption is “normal” but that is derived from a population that barely uses their arms in full range of motion during regular activity, without considering hanging or swinging.
In my experience, the scaps are more often too narrow, coming from our habit of rib thrusting alone, but if combined with deliberate shoulders-back posture can be even narrower. Too wide can be problematic if the plane in protraction is angled toward the front of the body. This results in a narrower shoulder. However, it might be a necessary evil on the path to a more functional position.
Photo Christaan Felber:
Climber Ashima Shiraishi (16) shows a broad shoulder with scapulae on the frontal plane.
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