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When shoulders aren't working right, the usual advice is to pinch the scapulae down and back to reposition the upper back and set the shoulderblades in the right place. But what if that doesn't work - or, worse, does more harm than good?

When you bust your shoulder, here’s what will happen – I know, because I did mine a few weeks ago.  First, you’ll admit to yourself that you’ve actually got an injury. 

Tweaks don’t keep you awake at night with the pain, or stop you opening doors with the affected arm.  That’s an injury. 

Next, you go and see the doctor, who gives you pills, which you take.  The pain’s not so bad – but you’re a bit concerned that you still can’t move the arm.  Your friends will take the opportunity to tell you about when they did theirs, or nod wisely and mumble something about rotator cuffs. 

At long, long last, you might get to see a physiotherapist or other movement-based healthcare professional.

And they will open up their bibles and read the following:

‘You have damaged your rotator cuff because your scapular retractors and depressors are too weak, and your upper trapezius is too strong.  Your upper back is too week because you press too much, and you need to do exercises to build your scapular retractors.’

You’ll get some instruction in how to do pull-aparts, YLWTs, and rhomboid retractions, and sent on your way. 

And gradually, your injury will improve, as your scapular retrac- wait, what? 

The chances are good that there’s nothing wrong with your scapular retractors

If you have awful posture with slumped, chronically protracted scapulae, pronounced kyphosis and compensatory cervical lordosis – then you probably still don’t really have anything all that wrong with your scapular retractors.  And for most people, this staple of the fitness industry’s response to the most common injury this side of ‘dropped dumbbell on foot’ is just plain wrong. 

It’s not that scapular retractor exercises don’t build strength in the scapular retractors;

It’s that the problem isn’t retractor strength, or even retractor tonus – resting length. 

Because strength exercises tend to increase tonus – decrease resting length – many trainers take advantage of that by having trainees exercise short, weak muscles to strengthen and tighten them at the same time.  Nothing wrong with that – but in this case it’s the right answer to the wrong question.

Partly it’s down to an oversimplification of the way the scapulae work.  We see the shoulder pushed forward and down and thing the answer lies in pulling the shoulderblade back around the ribcage, ‘pinching’ the shoulderblades together.  Don’t get me wrong – this is an elementary component of scapular health that everyone should be able to do.  But it’s not the solution, because scapular protraction, per se, is not the problem.

The problem is poor motor control of scapular movement when you move your arm. 

The scapula isn’t supposed to stay locked down tight when you move your arm.  It’s not a part of a hard, bony joint system.  The major role the scapula plays in your body is as a surface to attach muscles to; the whole shoulder complex is really only supported by soft tissue.  It’s built to move.  And it’s built to move overhead, though some people’s acromiae don’t take to that too well these days.

So what about the famous rotator cuff?  Well, most of that either runs along the scapula (supraspinatus, the most commonly injured rotator cuff muscle) or attaches to it.  In the case of infraspinatus, this important muscle covers virtually the whole underside of the scapula, deep to the lats and lower traps.  Its purpose is to move the arm opposite to the supraspinatus – to externally rotate and adduct where supraspinatus internally rotates and abducts. 

Maybe scapular instability and supraspinatus injury are related?

Could be. 

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