Scapula stability

[scottthephysio]

Anyone know of any good courses, books or papers which cover this area. I have had success with most of my patients with more stability around the scapulothoracic area, but still feel I'm not getting it 100% right.

Anyone got any advice, exercies, courses or decent papers on scapula stability?

Post messages here or email me on phy510@aol.com.

Thanks

[amandab]

Firstly you need to consider the requirements of the individual for work/sport as each task has different requirements regarding stability... unfortunately there is no recipe. It is often useful to consider the role of serratus anterior early on, some physios will address this prior to lower traps. Though lower traps are the most "popular" muscle, in some patients the upper trapezius can be weak or lacking in endurance. Start retraining in the most functional position that the patient is able to work in with 100% accuracy for their home program. Early on patients need a lot of feedback as it is hard to "feel" activity of traps and serratus and many athletes will try too hard. Also consider the role of subscapularis in stabilising the glenohumeral joint. It is often more appropriate to treat the Thoracic &/or cervical spine (if dysfunction is found) prior to starting with muscle activity in each treatment session. The best way to find out what works for each patient is to "play" with different strategies. It will be different for everyone. Think of the whole upper quadrant rather than focussing in on one component. Rehab them into tasks and positions that are ultimately going to be used daily for work/sport

[micdyl]

try the article in Manual Therapy, vol.8, Issue 4, (November 2003), pages 233-241, also there is a good article abaut glenohumeral functional stabilization. there was more papers But You must look for them - if I find them i'll let You know

[mattd8a]

Everyone seems to go straight for serratus or traps, what about Rhoms?
Personal question really, currently treating someone with possible neuropraxia of dorsal scapula and long thoraccic, both serratus and rhoms are weak and scapula timing has gone to pot.
Began with addressing the core stability issues that may have caused it (core stab was appalling!)
Pt still c/o some lower back pain (has overly lordotic posture, possibly due to over tight lx sp extensors and over tight hip flexors so have sent them away with strtching recommendations and more core work)
But really wanting to get some ideas about scapula retraining, in particular recruiting rhoms.

Much appreciated

[salsaqueen99]

I would be really interested if someone could explain to me how a physio would address scapula stability.

I have weak scap muscles probably due to my shoulder injury and have only recently after seeing a dance physio in the US started to work on activating the scaps. I also understand that instability an be affected by a number of things including an unstable g-h joint, tight pec and scalene muscles long with under used scap, lats and rhomboid muscles.

[alophysio]

With scapulohumeral rhythm, there is a nice article by Johnson et al (1994) on the anatomy and function of the upper traps.

With training rhomboids, they will tend to downwardly rotate the scapula whereas most people need help rotating it up and out of the way.

Lastly, salsaqueen, did you book an appointment with the physio where you are?

[salsaqueen99]

Hi there,
Thanks, I'll try and dig up the article. As for the physio I just came back from the U.S. and found a dance physio there. We made a lot of progress with stabilises movements in the upper ranges which is my weakest point. I am actually seeing a physio who works out at the AIS with swimmers and I am impressed with what he has come up with so far.

[physiofixme]

A bit late at having some input to this but if you are still interested there are two articles which I think are fantastic:

Turner, HM. "Rehabilitation of the sporting shoulder" Physiotherapy in sport Volume XIX No 1, Feb 1996.

Kibler, W.Ben. "The role of the scapula in athletic shoulder function" The american journal of sports medicine, Vol 26, No 2.