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Blaming the Shoulder Blade for Shoulder Pain

Many people have shoulder pain. Most have a hidden problem with the scapula (shoulder blade), but don't know it.

The scapula is a very important part of the shoulder. The scapula gives the upper arm (humerus) a socket for the ball of the shoulder joint to fit into. The scapula and humerus move together smoothly. The muscles around the scapula pivot, protect, position, and propel (move) the arm.

When a pitcher throws a ball the muscles of the scapula give the arm holding and throwing power. During swimming, the scapula helps position the upper arm, allowing the swimmer to lift the arm out of the water.

Normally, the scapula moves out of the way of the muscles and tendons in the shoulder. This keeps these tissues from getting pinched, a condition called shoulder impingement.

Conditions that cause abnormal scapular movement can lead to shoulder impingement. Poor posture, such as a stooped position of the head and neck is one cause. Another comes from weak stomach muscles and a swayback position of the spine. Torn shoulder tendons can also change the way the scapula moves and functions.

Anytime the scapula gets out of sync with the shoulder, problems are likely to occur. These can and must be treated in order to restore normal shoulder motion. Exercises to improve motion, flexibility, strength, and coordination are included in a scapular rehab program. The goal is to fix the problem by regaining normal function, not just by reducing painful symptoms.

References: Benjamin D. Rubin, MD, and W. Ben Kibler, MD. Fundamental Principles of Shoulder Rehabilitation: Conservative to Postoperative Management. In Arthroscopy. November/December 2002. Vol. 18. No. 9. Pp. 29-39.

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