If you ever have suffered from neck pain, shoulder pain, and/or elbow pain, then this information is right up your alley. Research has continued to demonstrate the role of the muscles in the mid back/scapulothoracic region and their contribution to these conditions. A recent article evaluated muscle strength in this region as it relates to elbow pain or lateral epicondylitis. With tennis and golf season right around the corner, it is inevitable patients will enter the office with an increase in these complaints.

Why are the scapular thoracic muscles important?

The muscles within the mid back and surrounding scapular region control stability for the entire upper kinetic chain (ie. neck, shoulder and elbow). These muscles provide a strong base of support for all movements of the shoulder and arm. They also play a direct role in stability of the neck/cervical spine. When describing to patients what happens when these muscle are not working well I often use the analogy “Imagine shooting a canon from a canoe”.  As a result of poor muscle activation and or stability in this region you tend to overload tissues within the upper body. Without a strong base of support, conditions like neck pain, shoulder pain, shoulder impingement, and medial and lateral epicondylitis may persist.

What are the important scapulothoracic muscles?

Serratus anterior:  The serratus anterior is a crucial muscle when talking about scapular stability, although it is often overlooked and rarely trained.  As you can see, it is located on the lateral side of the chest and extends beneath the shoulder blade. Its primary role includes adherence of the shoulder blade to the rib cage, protraction of the shoulder, and flexion of the shoulder. When weakness is present we often see what is called “wining of the scapula”.

As you can see from the video below, this patient has severe scapular stability issues and as a result suffers from chronic shoulder pain.

Mid to lower trapezius: The trapezius muscle as you can see has three distinct parts, the upper, mid and lower portions. When talking about scapular stability the mid to lower portion is very important. Research has continuously demonstrated a lack of activity in this muscle group can be directly related to injuries like shoulder pain or shoulder impingement.

Now that you have an idea of the role scapular muscles play in common neck, shoulder, and elbow injuries, the big question is how do we get better activation?

Check out these videos below for  examples of exercises we use here at Central Ohio Spine and Joint on a daily basis.

Do you suffer from neck, shoulder, or elbow pain? Let our highly trained physicians perform an evaluation on you to determine if scapular stability is the root cause of your condition.  Contact us today to set up your complimentary evaluation. Click here.

  • Day et al., J Orthop Sports Phys Ther (2015) (Epub ahead of print). All rights reserved to Journal of Orthopaedic & Sports Physical Therapy.
  • Smith, M., Sparkes, V., Busse, M., & Enright, S. (2009). Upper and lower trapezius muscle activity in subjects with subacromial impingement symptoms: Is there imbalance and can taping change it?Physical Therapy in Sport, 10 (2), 45-50 DOI: 10.1016/j.ptsp.2008.12.002