Jim Heafner's Shoulder Abduction/Flexion

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Initial Starting Posture

-Protracted shoulders

-Scapular winging

-Depressed Scapula on right relative to the left

Things we noted, while observing:

-Depressed right scapula relative to left

-Bilateral scapular winging

-Anterior tilt of right scapula

-Early scapular upward rotation of right scapula

-Increased activity of right upper trap, especially at end-range

-Poor eccentric control of downward rotators bilateral (R > L)

-Protrusion of ribs (attachment of serratus anterior) noted during sagittal view

-Thoracic extension at end-range of shoulder flexion

Summary: During the motions, we noted poor dynamic stabilization of the scapular stabilizers due to a lack of fluid rotation at the scapulothoracic and glenohumeral joints. Because of the lack of scapular stability, Jim's rotator cuff has been excessively working to maintain the humeral head in the glenoid fossa. Many impairments could be seen more significantly on the Right vs. Left due to a recent thoracic surgery. It is evident that the surgery has altered him mechanics and his axioscapular muscles are not functioning at the proper length/ tension relationship. 

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Over the next 3 weeks, we have prescribed Jim the following exercises to improve the timing, coordination, and neuromuscular endurance of the scapular stabilizers:

1) Seated theraband scapular retractions, emphasizing eccentric control. 
    3 sets x 15 repetitions, with a 5 second eccentric contraction.
2) Push-up Plus 
    3 sets x 12 repetitions
3) Plank Plus
    2 sets x 12 repetitions
4) Standing wall "W's" w/ arms externally rotated and forearms pronated (little finger against the wall)  
    2 sets x 15 repetitions

Each exercise will be performed daily.

Check back in 3 weeks to see an update on Jim's Shoulder Mechanics!