Those of you who are familiar with Shirley Sahrmann's work on the upper quarter are likely familiar with how scapular positioning can impact cervical mobility and pain. With downwardly rotated and depressed scapula, the upper trapezius, in addition to other cervical musculature, is placed on stretch providing a compressive force to the cervical spine, limiting cervical mobility and potentially causing pain. This can be assessed by providing support to the shoulder girdles and reassessing the motion and pain levels. When positive, treatment should include this kind of support for the UE's. This can be done by keeping the arms supported throughout daily life by crossing arms when standing or walking, adjusting arm rests to appropriate height, and avoiding carrying anything heavy. Exercises can be performed by using pillows to supports the UE's when strengthening the parascapular muscles or retraining cervical motion. Stretching of the upper trapezius should be avoided as it may further rotated the scapulae downwardly, thus increasing the compressive force. Check out the video below to see for yourself! -Chris
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