Assessing Static Scapula Position

Assessing Static Scapula Position - Rear View

Introduction

The scapula or shoulder blade is the bone that connects the clavicle to the humerus. The scapula forms the posterior of the shoulder girdle. It is a sturdy, flat, triangular bone.

The scapula provides attachment to several groups of muscles.

The intrinsic muscles of the scapula include the rotator cuff muscles, teres major, subscapularis, teres minor, and infraspinatus. These muscles attach the scapular surface and assist with abduction and external and internal rotation of the glenohumeral joint (shoulder joint). The extrinsic muscles include the triceps, biceps, and deltoid.

The third group of muscles includes the levator scapulae, trapezius, rhomboids, and serratus anterior. These muscles are responsible for rotational movements and stabilization of the scapula.

#1 Scapula Elevation

Static Position - Rear View

Identify and help correct scapula elevation in the static position.

Scapula Elevation

Defined as the upward glide of the scapula.

A possible cause of an elevated static scapula position is an overactive/tight upper trapezius,

levator scapulae and/or rhomboids, these muscles all elevate the scapula.

At-a-glance Summary

Possible Weak Muscles: Lower trapezius.

Possible Tight muscles: Upper trapezius, Levator scapulae and/or Rhomboids.

#2 Scapula Winging

Static Position - Rear View

Identify and help correct scapula winging in the static position

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Scapula Winging

The scapula should rest on the rib cage without any observable winging.

At-a-glance Summary

Possible Weak Muscles: Serratus anterior and possibly the Lower trapezius.

Possible Tight Muscles: Upper trapezius.

#3 Scapula Protrusion

Static Position - Rear View

Identify and help correct scapula protrusion in the static position.

Scapula Protrusion

Refers to the jutting out (protrusion) of the inferior medial border of the scapula. It differs from scapula winging in that only the inferior angle of the scapula sticks out, rather than the entire medial border.

Due to its attachment point on the coracoid process and onto the ribs, a shortened pectoralis minor tilts the scapula forward causing the inferior medial border of the scapular to protrude posteriorly.

At-a-glance Summary

Possible Weak Muscles: Lower trapezius.

Possible Tight Muscles: Pectoralis minor.

#4 Scapula Downward Rotation

Static Position - Rear View

Identify and help correct scapula downward rotation in the static position.

Scapula rotation

The scapula rotates upwards and downwards in the frontal plane during normal movement as the arm is abducted.

The upper and lower trapezius work with the serratus anterior to create upward rotation of the scapula. Proper strength balance between these muscles is believed to decrease the risk of shoulder impingement

(Ludewig et al. 2004; Mottram 1997).

Downward Rotation as observed in static posture (rear view)

Possible Weak Muscles: Serratus anterior (lower fibres) and possibly the Lower trapezius.

Possible Tight Muscles: Upper trapezius.

Good to know

Upward and download rotation of the scapula during movement e.g: during shoulder abduction is normal for correct shoulder function. The scapula position described in the video above refers to the resting scapula position during a static postural evaluation.

Scapula Position