Strengthening the Upper Trapezius Muscles and Checking Out the Rhomboid Muscles Regarding Scapular Control for a Pain Free Shoulder Joint

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Dr. David Middaugh of El Paso Manual Physical Therapy Clinic explains 16 points involving shoulder and scapular rotation mechanics that help an individual understand how to prevent damage and pain in the shoulder joint (SOURCE: YouTube@@epmanualphysicaltherapy).

Dr. David Middaugh, PT, DPT provides sixteen points to consider to help the healthy mechanics of the shoulder joint and scapular rotation. The two points of many important points that stand out are ...

1) the importance of upper trapezius muscle strength for the power to upwardly rotate the scapula (shoulder blade) to lift the shoulder joint to contribute to the full 180-degree motion of lifting the arm, and 

2) the importance of the consideration of rhomboid muscles, which can possibly over-dominate the balance equation of scapular mechanics and inhibit the lift of the shoulder joint.

Dr. David Middaugh explains that the involvement of 180 degrees of typical range of motion of the arm from side to overhead is provided by about 120 degrees at the shoulder joint where the upper arm connects to the scapula, and is provided by about 60 degrees from scapular rotation where the shoulder blade slides and rotates to lift the entire shoulder joint.

Upward motion of the arm at the shoulder joint is primarily provided by the deltoid muscles, and stability and positioning of the upper arm bone (specifically the head of the humerus) is provided by the four rotator cuff muscles (supraspinatus, teres minor, infrapsinatus, and subscapularis). The function of the rotator cuff muscles is to rotate and hold the head of the humerus in an "instant center" which is a functionally safe position in the joint space.

Upward motion of the entire shoulder joint is primarily provided by the upper trapezius muscle, which connects the head (bottom of skull) and neck (vertebrae) to the scapula, and causes upward rotation of the scapula that rotates the entire shoulder joint upward when the upper trapezius contracts. Weak upper trapezius muscles results in poor lift of the upward rotation of the scapular, which inhibits the full 60 degree contribution combined with the 120 degrees of arm motion available from the combined shoulder joint and scapula rotation combined.  When the 60 degrees of scapular rotation is dysfunctional, there is the risk of poor mechanic at the center of the shoulder joint, which can cause compression in the joint, wear and tear, and rotator cuff and biceps tendon injury.

The importance of over-dominating rhomboid muscles is the harm that can be caused by the vector that rotates the entire shoulder joint downward when the rhomboid muscles pull the bottom tip of the scapula toward the spinal column. When the bottom tip of the scapula rotates upward toward the spinal column, the other side of the scapula consisting of the upper, outer tip of the scapula (the shoulder joint) rotates downward, or acts to inhibit the upward lift of the upper trapezius muscle. Again, when the 60 degrees of scapular rotation is dysfunctional by inhibition, there is the risk of poor mechanics at the center of the shoulder joint, which can cause compression in the joint, wear and tear, and rotator cuff and biceps tendon injury.

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