SCAPULARSTABILIZATION

HayoonKimOctober22,20162016CostaMesa

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ABSTRACTTheshouldergirdleiscomposedofoneclavicleandonescapulaandthescapulaslidesontheribcage,withonlymusclesconnectingittothespine.Theonlytruebodyconnectionoftheshouldergirdletotheaxilskeletonisthesternoclavicularjoint.Becauseoftheselimitedconnections,movementsoftheshouldergirdleareverydependentonmuscles,andmuscleimbalancescaneasilyleadtoalignmentproblems.Thefunctionofthescapularmusclesmayberelatedmoretopostureorpreventionofanundesiredscapularmotionsothatstabilityismaintainedthantoproducingvisiblemovement.Inmanyinstanceswithclients,Icandetectlessstabilityonscapularleadstomalfunctionsinperformanceandeverydaylifeaswell.Well-functioningscapularmuscleswillprovidestabilityandefficiency,providingbetterposturesandlessfatigueresultingfrommisalignment.

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TableofContentsTitle1Abstract2TableofContents3AnatomicalDescription–ScapularMovementsandStabilization45CaseStudy6BASIBlockSystem78910Conclusion11Reference12

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AnatomicalDescription-ScapularMovementsandStabilizationTheshouldergirdleiscomposedofoneclavicleandonescapula.Unlikethepelvicgirdle,whichisfirmlyattachedtothespineviathesacroiliacjoints,thescapulaslideontheribcage,withonlymusclesconnectingittothespine.Theonlytruebonyconnectionoftheshouldergirdletotheaxialskeletonisthesternoclavicularjoint,thesmalljointbetweentheclavicleandthesternum.Becauseoftheselimitedconnections,movementsoftheshouldergirdleareverydependentonmuscles,andmuscleimbalancescaneasilyleadtoalignmentproblems.Movementsoftheshouldergirdlecanbesimplifiedbyreferringtothemovementsofthescapula.Movementsofthescapulae

Elevation Depression**UpperTrapezius

Rhomboids(MajorandMinor)LevatorScapula

LowerTrapeziusSerratusAnteriorPectoralisMinor

Abduction** AdductionMidTrapezius

Rhomboids(MajorandMinor)SerratusAnteriorPectoralisMinor

UpwardRotation DownwardRotation

UpperandLowerTrapezius

SerratusAnterior

Rhomboids(MajorandMinor)LevatorScapulaPectoralisMinor

RotatorCuffMusclesSupraspinatus,Infraspinatus,TeresMinorandSubscapularisareknownastherotatorcuffmuscles.Togethertheyencompass,andthereforestabilize,theglenohumeraljoint.Theyareallconnectedtothescapularmuscles,suchassupraspinatusandinfraspinatustotrapeziusand

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subscapularistotheserratusanterior,engaginginmovingandstabilizingscapulae.ScapularDepressorsandScapularAdductorsAmongmanyotherscapularmuscles,thesetwomusclegroupsplaycriticalrolesintermsoftheparticularposturesinmodernlifestyle,whichareshouldersroundedforwardandelevatedupwardwiththeexcessivescapulaeseparation.

SerratusAnteriorTrapezius(Upper,Middle,Lower)Rhomboids(Major,Minor)

Theserratusanteriorisuniqueinitsabilitytoabductthescapula,makingitanantagonisttotherhomboids.Weakserratusanteriorresultsinscapularwinging.Understandingthetypesofmusclecontractionsthatcanoccur,thevaryingrolesmusclescanplay,andtheabilityofmusclestoworktogetherinaforcecouplewillallowabetterappreciationoffull-bodymovements.

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CaseStudyName:SangmiYunAge:35Gender:FemaleYearsofDoingPilates:6monthsRehabilitationorTreatments:N/APains:shoulder,lowerbackandwristinminorSheisafull-timemominhermid30sandgaveabirthabouttwoyearsago.Whensheiscaringherchild,sheusuallyholdsherbabyinherleftside.Sheisright-handedandclaimsleftshoulder,lowerbackandwristpains.Whensheflexesshoulderreachingarmoverhead,herleftforearmstartstohurt.Butshedidn’tgetanydiagnosisonthosefromthedoctor.Shehasbeendoingpilatesforsixmonthsandhashardtimedoingherabdominalworks,‘RollUp’andspinalarticulation,‘RollOver’exercises.Icaneasilydetecthershoulderswaytoomuchgettensionedandelevatedwhatexercisesshedoes.Herheadusuallymisalignedwithherspine,pullingchintooclosetoherchest.Shehasbeendoingpilateswithmeformonthsandisaboutfundamentalandpre-intermediatelevel.Iamgoingtoprogramone-hoursessionfocusingonshoulderstabilizing,shoulderdepressing,lowerbackstretching,andspinalarticulationincludingwholebodyexercisesusingtheBASIBlockSystem.

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BASIBlockSystemWarmup(onMat)1PelvicCurl(fivetimes)PlaceaballbetweenkneesengagingAdductorswhichhelpstabilizepelvisaswell.Atthefinal,haveherarmsreachingoverheadtostretchshoulder.2SpineTwistSupine(tentimes)Beforethisexercise,practiceScapularAbductionreachingarmsforwardtowardceiling.3ChestLift(sixtimes)Reachingarmsforwardandholdingthighswithhandstoliftbodyupengagingmoreabdominals.4ChestLiftwithRotation(tentimes)Shetendstolateralflexonspinalrotation,soIwilltrytogivemorefeedbacksonthisexercise.FootWork(onCadillac)1ParallelHeels(tentimes)2ParallelToes(tentimes)3VPositionToes(tentimes)4OpenVHeels(tentimes)5OpenVToes(tentimes)6CalfRaises(tentimes)7Prances(tentimes)Atthefinaloneachside,holdingthepositiontostretchcalf.

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8SingleLegHeel(eighttimesoneach)9SingleLegToes(eighttimesoneach)AbdominalWork(onCadillac)1Rolluptoploaded(fourtimes)Liftingupheavyspringscausesmoretensionsonheruppertrapezius,soImaketheresistancelighterforlesspressuresonshoulderbutstillactivatingabdominalsandbackextensorswithmorescapularstabilizationandheadalignment.2BreathingwithPushThruBar(fourtimes)Ichoosethisparticularexercisetostabilizescapulaeavoidingelevationofshoulders(onfirstphase),stretchlowerbackwhencurlingpelvicupandalignherheadwiththespine(onthirdphase)engagingabdominalthroughout.HipWork(onCadillac)1Frog(sixtimes)2DownCircles(sixtimes)3UpCircles(sixtimes)4Walking(fivetimes)5Bicycles(fivetimes)6BicyclesReverse(fivetimes)SpinalArticulation(onCadillac)1MonkeyOriginal(threetimes)Toliftuppushthrubar,shehastoactivateherkneeextensors,shoulderflexorsandback

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extensorswithscapularstabilizationandheadalignment.Stretch(onCadillac)1ShoulderStretch(sixtimesoneachside)Shehastightshouldersandminorpainsonherleftupperarmwhenreachingoverhead,soIpickthisexercisetostretchtightenedareaandfigureouttherangeofmotiononhershoulders.FullBodyIntegrationF/I(onReformer)1Upstretch1(tentimes)2Elephant(tentimes)ThesetwoFullBodyIntegrationexercisescanfocusonherserratusanteriorabductingthescapulae.ArmWork(onReformer)–SittingArmSeries1ChestExpansion(sixtimes)2Biceps(sixtimes)3Rhomboids(sixtimes)Activatingmidtrapeziusandrhomboidsmakespectoralisstretchedopeningchestwidewhichisgoodexercisesforroundedshoulders.4Hug-a-tree(sixtimes)5Salute(sixtimes)+AdditionalArmWorkonChair6Shrugs(eighttimes)

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Basedonthescapulastabilization,Iwanttohaveherworkonbothscapularadductionanddepressionadding‘Shrugs’onArmWorkBlock.LateralFlexion/SpinalRotation(onChair)1SideStretch(sixtimesoneachside)Cueingonserratusanteriortodepressscapulardownonbothsides.BackExtension(onChair)1SwanBasic(sixtimes)Atfinaltwo,Iwillencouragehertopullthepedaltowardherforengagingmiddletrapeziusandopeningchest.

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ConclusionItrytofocusonscapularstabilizationonthisone-hoursession.Activatinglowertrapeziusfrom‘Shrugs’andserratusanteriorfrom‘Upstretch1’and‘Elephant’willgiveherachanceofawaretheshouldermechanismaswellasstretchingtightenedmusclesfrom‘Shoulderstretch.’Bothstrengthandflexibilityplayimportantrolesforbeingwell-conditionedbody.IstronglybelievethatBASIBlockSystemoffersamazingmomentstousealmostwholebodymusclesandmovementswithmind-bodyawareness.Duringthis‘whole’bodysession,Ialsocanpickadditionalorselectiveexercisesforparticularclients.

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ReferenceBookIsacowitz,R.,andClippinger,K.2011.PilatesAnatomy.Champaign,IL:HumanKinetics.Biel,AndrewR.2014.TrailGuidetotheBody:Ahands-onguidetolocatingmuscles,bonesandmoreFifthEdition.Boulder,CO:BookofDiscoveryImageswww.Google.com