Continuing up the chain
Looking further into Shoulders & Ribs
The next stop is the shoulder joint, also known as the glenohumeral joint which comprises the humerus, clavicle and scapula. When talking about mobility of this joint we must look at how the humerus moves and how the scapula moves, unlike the hip, this joint has a bony structure, the scapula, that floats on the ribcage and is connected by some key muscles that play a role in shoulder health.
Shoulder mobility also means respecting how the rib cage moves underneath the scapula, remembering that our human asymmetries pull us into the right hemisphere, which pulls the lower spine to the right. Then we rotate back to the left to compensate which has a rotational effect on the ribcage. These forces now have put the scapula on the right in a different position than the left. If we do not get the ribcage to neutral then we are pre-positioned to have shoulder limitations.
The positions of the scapula will influence humeral (arm) movements (internal/external rotation, flexion and extension), with those joint range of motions we create movement strategies of compensation and/or impingement and pain. The scapulas (shoulder blades) should have optimal movement of protraction (reach), retraction (pull back) upward/downward rotation, elevation(shrug) and depression. If we lose the position on either right or left side, those movements become limited and affect the movements of the arm. With our right sided patterning we have to adjust for this engagement with the left abdominals to counterbalance the right “ab-wall pull” on the ribcage. This counterbalancing will set the ribcage to neutral, pull the ribcage back to the scapula and the scapula on the ribs.
Get Neutral & Smaller muscles work so the larger ones work evenly
The next step we have to take into consideration involves the muscles that hold the scapula onto the ribcage and help it move. The exercise we use to help regulate neutrality is the 90-90 hip lift with right arm reach and if you have a balloon, blowing up the balloon will help the abdominals engage by creating pressure and forcing the person to exhale and pause. Another exercise we use is a side lying right apical expansion with left arm reach to make sense of the left ab-wall.
Once repositioned through the ribcage we can now target the muscles that help the shoulder joint move, triceps, serratus anterior and low traps are big targets for training and strengthening. Strengthening these will ensure proper scapula movement on the cage below it, and reposition the socket joint to make sure that the head of the humerus can have the most range of motion for exercise and daily tasks such as reaching, overhead reaching.
The exercises best known for training shoulder health (aka rotator cuff muscles) are internal and external rotation of the arm with either a band or cable. (Referred to as “no-moneys”) Now these are good exercises but we need to appreciate the bodies’ asymmetrical structure to make these exercises work how we want them to. So if we are performing a cable external rotation, we want to make sure we are aligning the ribcage and shoulder blades in the correct position, with the left ab-wall engaged and making sure the ribcage is pushing back onto the scapula then moving the arm.