Proper shoulder function is all about proper starting posture. Many of our patients start from a poor position, and therefore have pain with overhead movements. For example, many patients rest is scapular downward rotation. This position places the rhomboids in a short, dominant position. In the same example, the serratus anterior and lower trapezius (both upward rotators) are lengthening and relatively inhibited. If we can neutralize scapulothoracic mechanics, chances of pain free overhead movement will increase. In this post, I break down Eric Cressey's video on Cues to Improve Shoulder Flexion.
Eric Cressey's 3 Cues:
1) Assess for an adducted/downward rotated posture. This patient is not appropriately activating their upward rotators. With these individuals cue them to make a bigger arc of motion as they are raising overhead. The bigger arc will allow for more scapular upward rotation.
2) Assess for anterior tilt and a prominent inferior angle of the scapula. With this cue, manually assist the patient into posterior tilt as they are raising their arm overhead. The practitioner will be mimicking the function of the lower trap and serratus by posteriorly tilting the scapula.
3) Assess for scapular depression and Lat Dorsi dominance. Due to their resting posture (clinically interpreted as downsloping shoulders), these patients often have lengthened upper trapezius muscles. Start in a neutral scapular posture. Have the patient raise overhead. When the subject gets to about 90 degrees of shoulder flexion have them perform a small shoulder shrug. This will help engage the upper trapezius and allow for better clearance of the humerus under the acromion.
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