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The scapular stabilizers are a group of muscles that attach to the scapula (shoulder blade) and allow it to move as it should. These muscles work together with the deltoid and rotator cuff muscles to rotate the scapula upwards or downwards while the arm is moving. The scapular stabilizers include the serratus anterior, rhomboids, trapezius, levator scapula, and pectoralis minor. These muscles play a crucial role in maintaining normal shoulder function and preventing injuries. Weak or underdeveloped scapular stabilizers can lead to shoulder pain and dysfunction, affecting athletes and individuals with muscle imbalances in the shoulder.
| Characteristics | Values |
|---|---|
| Muscles that make up the scapular stabilizers | Serratus anterior, trapezius, levator scapula, rhomboids, pectoralis minor |
| Muscle functions | Upwardly rotate the scapula, elevate the scapula, depress the scapula, rotate the scapula downward, abduct and adduct the scapula |
| Shoulder injuries related to scapular stabilizers | Impingement, torn labrum, torn biceps tendon, stress fractures, torn rotator cuffs, scapular dyskinesis, adhesive capsulitis, glenohumeral joint stiffness, shoulder instability |
| Scapular stabilizers exercises | Standing snow angels, seated pike lift, wall clock exercise, floor T-exercise |
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The Serratus Anterior
The vascular supply to the serratus anterior comes from the superior and lateral thoracic arteries (branches of the axillary artery) and branches from the thoracodorsal artery (branch of the subscapular artery). The serratus anterior is innervated by the long thoracic nerve, which arises from the upper portion of the brachial plexus and is typically composed of cervical nerves C5, C6, and C7.
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Trapezius
The trapezius is a large, paired, trapezoid-shaped surface muscle that extends longitudinally from the occipital bone to the lower thoracic vertebrae of the spine and laterally to the spine of the scapula. It is the most superficial of the extrinsic muscles of the back. The main function of the trapezius is to stabilize the scapula in its anatomical place and control it during movements of the shoulder and upper limb. The trapezius muscle is divided into three functional parts: the descending (upper) part, composed of superior fibres, the transverse (middle) part, composed of middle fibres, and the ascending (lower) part, composed of inferior fibres.
The descending (upper) fibres of the trapezius produce an ipsilateral lateral flexion of the head and neck by acting on the atlanto-occipital joint and upper cervical vertebrae. Unilateral contraction may also result in a contralateral rotation of the head at the atlantoaxial joint. Bilateral contraction of the descending part causes an extension of the head and neck. The ascending (lower) fibres are responsible for the depression of the medial part of the scapula, thus lowering the shoulder. This action is important for activities in which the shoulders are lowered against resistance, such as using the hands to help oneself up from a seated position. Together with the descending part, the ascending fibres also produce a rotation of the scapula around an axis that runs anteroposteriorly through the base of the scapular spine.
The transverse (middle) part of the muscle is supplied by the superficial cervical artery or by a branch from the transverse cervical artery. The ascending (lower) part is supplied by muscular branches of the dorsal scapular artery, which arises from the subclavian artery. The trapezius works in conjunction with the serratus anterior to rotate the scapula upward during arm elevation, allowing the arm to lift smoothly above shoulder height. It also prevents scapular winging, ensuring efficient shoulder movement, especially during pushing or punching actions.
The trapezius is crucial during movements that involve pushing, reaching forward, or pulling down, as it helps maintain scapular stability, allowing the shoulder to move efficiently during various activities. It is also involved in the movements of the head and neck. For example, the trapezius is active during the throwing action, along with the deltoid muscle and the rotator cuff muscles. The trapezius also assists in abduction of the shoulder above 90 degrees by rotating the glenoid upward.
Dysfunction of the trapezius can result in winged scapula, sometimes referred to as "lateral winging", and in abnormal mobility or function of the scapula (scapular dyskinesia). Tearing or straining the trapezius is uncommon, usually only happening to bodybuilders lifting extremely heavy weights or in high-velocity accidents such as car crashes.
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Rotator Cuff
The rotator cuff is a group of four muscles that surround the scapula (shoulder blade) and work together with the deltoid and scapular stabiliser muscles to rotate the scapula during arm movement. The four muscles that make up the rotator cuff are the infraspinatus, supraspinatus, teres minor, and subscapularis.
The rotator cuff muscles are crucial in maintaining normal shoulder function and biomechanics. They work synergistically with the deltoid and scapular stabiliser muscles to rotate the scapula while the shoulder joint/arm is moving overhead, behind the back, or reaching away from the trunk. For example, a baseball pitcher or competitive swimmer will rely on their rotator cuff muscles to rotate their shoulders hundreds to thousands of times during a season and preseason.
The rotator cuff muscles also control the fine-tuning movements of the shoulder complex. For smooth, synchronous movement of the shoulder complex, the force couplings of the glenohumeral and scapulothoracic joints must work in synchronised timing with adequate forces to offset each other. The middle deltoid muscle, for example, acts to stabilise the humeral head against the glenoid cavity during arm elevation, while the rotator cuff muscles control the fine-tuning movements.
The rotator cuff muscles are also susceptible to injury and inflammation. Many patients who experience shoulder pain have weak and underdeveloped rotator cuff muscles. Overuse injuries related to muscle weakness can occur, leading to pain and dysfunction. Impingement can occur when the shoulder joint or glenohumeral hits the top of the scapula or acromion, causing pain and inflammation. If left untreated, this can lead to muscle inflammation or rotator cuff tears.
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Shoulder Dysfunction
The scapular stabilizers are a group of muscles that surround the scapula (shoulder blade) and work with the deltoid and rotator cuff muscles to maintain normal shoulder function and biomechanics. These muscles include the serratus anterior, trapezius, levator scapula, and rhomboids.
To prevent and address shoulder dysfunction, it is important to exercise and strengthen the scapular stabilizers. Specific exercises targeting these muscles can improve shoulder function and performance, leading to a healthier, pain-free shoulder joint. Some examples of scapular stabilization exercises include:
- Standing "snow angels": Performed with the back against a wall, this exercise involves moving the hands in an overhead pressing motion and then returning them to the sides while keeping the scapula, back of the hands, and forearms in contact with the wall.
- Seated pike lift: Using large dumbbells or blocks, lift your buttocks off a table and hold for 20 seconds. This targets the lower trapezius muscle.
- Medicine ball exercise: Press a medicine ball against a wall with one hand, then roll it in small circles both clockwise and counterclockwise using only your palm.
- Pushup position: Start in a pushup position with your hands on a stability ball and your feet hip-width apart. Inhale and lower yourself down, then exhale and press back up to the starting position.
These exercises can be incorporated into a daily training routine or used as a warm-up to improve scapular stability and prevent shoulder dysfunction.
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Shoulder Injuries
The scapular stabilizers are a group of muscles that surround the scapula (shoulder blade) and work with the deltoid and rotator cuff muscles to rotate the scapula while the shoulder joint/arm moves. The scapular stabilizers include the serratus anterior, trapezius, levator scapula, and rhomboids. These muscles help to maintain proper scapular position and control during arm movements such as shoulder abduction, flexion, and rotation.
To prevent and rehabilitate shoulder injuries, it is important to strengthen the scapular stabilizers through specific exercises. This can include standing "snow angels" or seated pike lifts to target the lower trapezius muscle. By improving scapula stability, individuals can maintain coordinated movement between the shoulder blades and shoulder joints, reducing the risk of injury.
Additionally, maintaining proper form during physical activities can help prevent shoulder injuries. For example, when raising your arms above your head, maintaining a tall posture can help avoid discomfort and abnormal hunching of the shoulders. Seeking guidance from a physical therapist or sports medicine professional can help ensure proper form and provide personalized exercises to target scapular stabilizers.
Overall, the scapular stabilizers play a crucial role in maintaining shoulder health and stability. By understanding their importance and incorporating specific exercises into training routines, individuals can reduce the risk of shoulder injuries and improve athletic performance.
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Frequently asked questions
Scapular stabilizers are several muscles that attach to the scapula (shoulder blade) and allow it to move as it should.
The scapula is an important bone in the function of the shoulder joint. It engages in 6 types of motion, which allow for full-functional upper extremity movement. Normal shoulder function requires coordinated movement between the shoulder blades and shoulder joints.
The major muscles associated with the scapular stabilizers include the serratus anterior, rhomboids, trapezius, levator scapula, and pectoralis minor.
Weak scapular stabilizers can cause scapular winging and scapular dyskinesis, which is the alteration of normal scapular kinematics. This can lead to pain and dysfunction in the shoulder.
