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SCAPULARSTABILIZATION HayoonKim October22,2016 2016CostaMesa ABSTRACT Theshouldergirdleiscomposedofoneclavicleandonescapulaandthescapulaslidesonthe ribcage,withonlymusclesconnectingittothespine.Theonlytruebodyconnectionofthe shouldergirdletotheaxilskeletonisthesternoclavicularjoint.Becauseoftheselimited connections,movementsoftheshouldergirdleareverydependentonmuscles,andmuscle imbalancescaneasilyleadtoalignmentproblems. Thefunctionofthescapularmusclesmayberelatedmoretopostureorpreventionofan undesiredscapularmotionsothatstabilityismaintainedthantoproducingvisiblemovement. Inmanyinstanceswithclients,Icandetectlessstabilityonscapularleadstomalfunctionsin performanceandeverydaylifeaswell.Well-functioningscapularmuscleswillprovidestability andefficiency,providingbetterposturesandlessfatigueresultingfrommisalignment. 2 TableofContents Title1 Abstract2 TableofContents3 AnatomicalDescription–ScapularMovementsandStabilization45 CaseStudy6 BASIBlockSystem78910 Conclusion11 Reference12 3 AnatomicalDescription-ScapularMovementsandStabilization Theshouldergirdleiscomposedofoneclavicleandonescapula.Unlikethepelvicgirdle,which isfirmlyattachedtothespineviathesacroiliacjoints,thescapulaslideontheribcage,with onlymusclesconnectingittothespine.Theonlytruebonyconnectionoftheshouldergirdleto theaxialskeletonisthesternoclavicularjoint,thesmalljointbetweentheclavicleandthe sternum.Becauseoftheselimitedconnections,movementsoftheshouldergirdlearevery dependentonmuscles,andmuscleimbalancescaneasilyleadtoalignmentproblems. Movementsoftheshouldergirdlecanbesimplifiedbyreferringtothemovementsofthe scapula. Movementsofthescapulae Elevation Depression** UpperTrapezius LowerTrapezius Rhomboids(MajorandMinor) SerratusAnterior LevatorScapula PectoralisMinor Abduction** Adduction MidTrapezius SerratusAnterior Rhomboids(MajorandMinor) PectoralisMinor UpwardRotation DownwardRotation UpperandLowerTrapezius Rhomboids(MajorandMinor) LevatorScapula SerratusAnterior PectoralisMinor RotatorCuffMuscles Supraspinatus,Infraspinatus,TeresMinorandSubscapularisareknownastherotatorcuff muscles.Togethertheyencompass,andthereforestabilize,theglenohumeraljoint.Theyareall connectedtothescapularmuscles,suchassupraspinatusandinfraspinatustotrapeziusand 4 subscapularistotheserratusanterior,engaginginmovingandstabilizingscapulae. ScapularDepressorsandScapularAdductors Amongmanyotherscapularmuscles,thesetwomusclegroupsplaycriticalrolesintermsofthe particularposturesinmodernlifestyle,whichareshouldersroundedforwardandelevated upwardwiththeexcessivescapulaeseparation. SerratusAnteriorTrapezius(Upper,Middle,Lower)Rhomboids(Major,Minor) Theserratusanteriorisuniqueinitsabilitytoabductthescapula,makingitanantagonistto therhomboids.Weakserratusanteriorresultsinscapularwinging.Understandingthetypesof musclecontractionsthatcanoccur,thevaryingrolesmusclescanplay,andtheabilityof musclestoworktogetherinaforcecouplewillallowabetterappreciationoffull-body movements. 5 CaseStudy Name:SangmiYun Age:35 Gender:Female YearsofDoingPilates:6months RehabilitationorTreatments:N/A Pains:shoulder,lowerbackandwristinminor Sheisafull-timemominhermid30sandgaveabirthabouttwoyearsago.Whensheiscaring herchild,sheusuallyholdsherbabyinherleftside.Sheisright-handedandclaimsleft shoulder,lowerbackandwristpains.Whensheflexesshoulderreachingarmoverhead,herleft forearmstartstohurt.Butshedidn’tgetanydiagnosisonthosefromthedoctor.Shehasbeen doingpilatesforsixmonthsandhashardtimedoingherabdominalworks,‘RollUp’andspinal articulation,‘RollOver’exercises.Icaneasilydetecthershoulderswaytoomuchgettensioned andelevatedwhatexercisesshedoes.Herheadusuallymisalignedwithherspine,pullingchin tooclosetoherchest. Shehasbeendoingpilateswithmeformonthsandisaboutfundamentalandpre-intermediate level.Iamgoingtoprogramone-hoursessionfocusingonshoulderstabilizing,shoulder depressing,lowerbackstretching,andspinalarticulationincludingwholebodyexercisesusing theBASIBlockSystem. 6 BASIBlockSystem Warmup(onMat) 1PelvicCurl(fivetimes) PlaceaballbetweenkneesengagingAdductorswhichhelpstabilizepelvisaswell.Atthefinal, haveherarmsreachingoverheadtostretchshoulder. 2SpineTwistSupine(tentimes) Beforethisexercise,practiceScapularAbductionreachingarmsforwardtowardceiling. 3ChestLift(sixtimes) Reachingarmsforwardandholdingthighswithhandstoliftbodyupengagingmore abdominals. 4ChestLiftwithRotation(tentimes) Shetendstolateralflexonspinalrotation,soIwilltrytogivemorefeedbacksonthisexercise. FootWork(onCadillac) 1ParallelHeels(tentimes) 2ParallelToes(tentimes) 3VPositionToes(tentimes) 4OpenVHeels(tentimes) 5OpenVToes(tentimes) 6CalfRaises(tentimes) 7Prances(tentimes) Atthefinaloneachside,holdingthepositiontostretchcalf. 7 8SingleLegHeel(eighttimesoneach) 9SingleLegToes(eighttimesoneach) AbdominalWork(onCadillac) 1Rolluptoploaded(fourtimes) Liftingupheavyspringscausesmoretensionsonheruppertrapezius,soImaketheresistance lighterforlesspressuresonshoulderbutstillactivatingabdominalsandbackextensorswith morescapularstabilizationandheadalignment. 2BreathingwithPushThruBar(fourtimes) Ichoosethisparticularexercisetostabilizescapulaeavoidingelevationofshoulders(onfirst phase),stretchlowerbackwhencurlingpelvicupandalignherheadwiththespine(onthird phase)engagingabdominalthroughout. HipWork(onCadillac) 1Frog(sixtimes) 2DownCircles(sixtimes) 3UpCircles(sixtimes) 4Walking(fivetimes) 5Bicycles(fivetimes) 6BicyclesReverse(fivetimes) SpinalArticulation(onCadillac) 1MonkeyOriginal(threetimes) Toliftuppushthrubar,shehastoactivateherkneeextensors,shoulderflexorsandback 8 extensorswithscapularstabilizationandheadalignment. Stretch(onCadillac) 1ShoulderStretch(sixtimesoneachside) Shehastightshouldersandminorpainsonherleftupperarmwhenreachingoverhead,soI pickthisexercisetostretchtightenedareaandfigureouttherangeofmotiononhershoulders. FullBodyIntegrationF/I(onReformer) 1Upstretch1(tentimes) 2Elephant(tentimes) ThesetwoFullBodyIntegrationexercisescanfocusonherserratusanteriorabductingthe scapulae. ArmWork(onReformer)–SittingArmSeries 1ChestExpansion(sixtimes) 2Biceps(sixtimes) 3Rhomboids(sixtimes) Activatingmidtrapeziusandrhomboidsmakespectoralisstretchedopeningchestwidewhichis goodexercisesforroundedshoulders. 4Hug-a-tree(sixtimes) 5Salute(sixtimes) +AdditionalArmWorkonChair 6Shrugs(eighttimes) 9 Basedonthescapulastabilization,Iwanttohaveherworkonbothscapularadductionand depressionadding‘Shrugs’onArmWorkBlock. LateralFlexion/SpinalRotation(onChair) 1SideStretch(sixtimesoneachside) Cueingonserratusanteriortodepressscapulardownonbothsides. BackExtension(onChair) 1SwanBasic(sixtimes) Atfinaltwo,Iwillencouragehertopullthepedaltowardherforengagingmiddletrapeziusand openingchest. 10 Conclusion Itrytofocusonscapularstabilizationonthisone-hoursession.Activatinglowertrapeziusfrom ‘Shrugs’andserratusanteriorfrom‘Upstretch1’and‘Elephant’willgiveherachanceofaware theshouldermechanismaswellasstretchingtightenedmusclesfrom‘Shoulderstretch.’Both strengthandflexibilityplayimportantrolesforbeingwell-conditionedbody. IstronglybelievethatBASIBlockSystemoffersamazingmomentstousealmostwholebody musclesandmovementswithmind-bodyawareness.Duringthis‘whole’bodysession,I alsocanpickadditionalorselectiveexercisesforparticularclients. 11 Reference Book Isacowitz,R.,andClippinger,K.2011.PilatesAnatomy.Champaign,IL:HumanKinetics. Biel,AndrewR.2014.TrailGuidetotheBody:Ahands-onguidetolocatingmuscles,bonesand moreFifthEdition.Boulder,CO:BookofDiscovery Images www.Google.com 12