PT Pregame: Why Scapular Stabilization in Overhead Athletes Matters

Posted by Angela Gordon, PT, DSc, MPT, FAAOMPT, COMT, ATC, OCS, FMS on Jan 31, 2019 7:21:29 AM

In my experience working with professional athletes of all stages during their careers, veteran players definitively understand how much effort is needed to maintain their bodies in order to prevent injuries. It takes dedication and time to put in the right amount of work to keep the body healthy.

Overhead athletes as a whole require more preventive work to maintain the delicate balance between range of motion and stabilization. The injury prevention process for the shoulder needs to begin with the proper scapular retraining prior to any other dynamic strength work. This scapular retraction test article stresses that the rotator cuff will only be able to achieve a level of strength in proportion to the amount of scapular stabilization present. The rotator cuff originates off the scapula and if the scapula is not positioned correctly on the thoracic cage, the cuff muscles will not be at their optimal length to produce the most efficient forces. Proper scapular position is dependent on the static stabilization of the muscles.

So what is proper scapular stabilization? We believe this concept is not very well understood. Lets just take a moment and look at the way the scapular muscles truly function. The scapular muscles are small static stabilizers. They are NOT meant to PRODUCE motion but to CONTROL motion. So why do we “strengthen” the scapular muscles in a fashion to produce motion? We will need to begin to train these muscles in an endurance eccentric fashion to allow them to function naturally.

The long arm movements in the traditional W, T, Y exercises have been shown to have high EMG activity in the rotator cuff muscles and the scapular position is not isolated. Therefore these exercises are truly strengthening the rotator cuff.

The concept of scapular neuromuscular re-education before rotator cuff strengthening should be a standard of care for our rehabilitation protocols. In our Advanced Concepts of the Overhead Athlete course we discuss the scapula in depth including the evaluation and treatment of scapular dyskinesis. Check out these scapular stabilization exercises.



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