Often referred to as the bridge between the neck and shoulder – the scapula (shoulder blade) is crucial to a well-functioning upper body. If there is a problem with the bridge – it affect either (or both!) ends. This can translate into a sore neck or shoulder.
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Whenever I see patients with neck or shoulder pain, I always make a note to assess how well their shoulder-blade is moving. Do they have a ‘dropped’ shoulder? Is the shoulder being pulled forward and out? Do the muscles around the shoulder blade not activate correctly compared to the ‘good’ side?
This can be made worse by the all-too familiar Crossed Syndrome (see image) which can develop in jobs that regular sitting for extended periods.
Sometimes there can be neurological or adaptive reasons why the shoulder blade is not functioning properly, but I will focus on the two most common causes I see in the clinic.
1) Poor flexibility around the shoulder
Often people (especially the office workers out there!) develop tight muscles around the shoulder which can ‘pull’ the shoulder blade forward and cause mal-alignment. It is important to regularly stretch the muscles around the back of the shoulder (posterior cuff) and front of the shoulder (pectoralis). It’s also important to maintain good mid-back (thoracic) mobility, as this is the area that the shoulder blade glides over.
2) Poor muscle performance
Sometimes just stretching muscles isn’t enough. As demonstrated by the image on the right, tight muscles around the shoulder can often inhibit the right muscles from working. This can translate into having weak back muscles around the shoulder blade, or an inability to use these muscles properly. Without these muscles firing correctly, the shoulder blade will not move properly and cause ongoing issues with the neck and/or shoulder. It is essential to reset your shoulder blade and learn to move your arm in this position. Additionally, strengthening the lower trapezius and serratus anterior muscles can help to even out any imbalances.
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