STABILIZATION

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STABILIZATION

• SCAPULA
• PERIPHERAL JOINTS

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RHOMBOID MAJOR AND MINOR
STABILIZATION
MOTIONS
Prevents abduction (protraction) Prevents
winging Prevents depression
Scapular elevation Scapular adduction (retraction
)
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UPPER TRAPEZIUS
MOTIONS
STABILIZATION
Prevent Scapular Depression Stabilize
Scapula For Humeral Elevation
Elevate Scapula Upward Rotate Scapula
4
LOWER TRAPEZIUS
MOTIONS
STABILIZATION
Prevent Protraction and Elevation of
Scapula Anchor Scapula For Upward Rotation In
Humeral Elevation
Depress Scapula Retract Scapula
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MIDDLE TRAPEZIUS
STABILIZATION
MOTIONS
Prevent Protraction of Scapula Anchor
Scapula For Upward Rotation In Humeral
Elevation
Retract Scapula
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LEVATOR SCAPULAE
UPPER 3-4 TRANSVERSE PROCESSES
MOTIONS
STABILIZATION
Elevate Scapula
Prevent Scapular Depression
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SERRATUS ANTERIOR
MOTIONS
STABILIZATION
Prevents Scapular Winging
Protract Scapula Upward Rotation Of Scapula for
Humeral Elevation
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PECTORALIS MINOR
STABILIZATION
MOTIONS
Prevents Scapular Retraction Prevents Scapular
Abduction
Scapular Protraction
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SCAPULAR TENDENCY(Common Scapular Abnormalities)

• Postural Protraction
• Postural Elevation/Excessive Elevation during
  movement
• Postural Winging/Winging during movement

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SCAPULAR INFLUENCE ON GHJ

• DECREASED STABILITY OF SCAP
• CHANGE IN GLENOHUMERAL ALIGNMENT
• DECREASE SUBACROMIAL SPACE
• INCREASE IMINGEMENT OF STRUCTURES BETWEEN
  ACROMION AND HUMERAL HEAD
• EXAMPLE

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INFLUENCE ON CERVICAL ALIGNMENT/BIOMECHANICS

• INCREASED CERVICAL LORDOSIS
• SHORTENED MUSCLES (Upper trap, levator scap,
  sterncleidomastoid)
• INCREASED FACET IMPINGEMENT
• CLOSING OF INTERVERTEBRAL FORAMEN

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COORDINATION

• TRAIN TO DECREASE M. TONE/ACTIVITY
• TRAIN TO INCREASE M. FLEXIBILITY
• TRAIN TO INCREASE M. ACTIVITY
• TRAIN TO INCREASE M. STRENGTH
• Strength does not always M activity
• Flexibility does not always M activity

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STRENGTH

• LOWER TRAP
• MIDDLE TRAP
• RHOMBOIDS
• ISOLATE!

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FLEXIBILITY

• UPPER TRAP
• LEVATOR SCAPULA
• PEC MINOR
• MASSAGETRIGGER POINT PRESSUREBIOFEEDBACKSTRETCH
  

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SCAPULAR STABILITY AND SHOULDER OVERUSE

• Fitzgibbon 1994
• Irish Nat Swim Team
• Examined length of M.s (pec, m trap, low trap)
• Measured onset of activiation
• Measusred max EMG of pec minor, mid trap, lower
  trap, delt
• Swimmers and controls with shorter pec min poor
  firing pattern (Delts come in earlier than upper
  trap and lower trap fires less or late)
• Particularly swimmers with overuse injuries

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SCAPULAR STABILITY AND SHOULDER OVERUSE

• Lauzon (UCLA)
• Shoulder probs in swimmers due to weak scap M.s
• Lower trap weak compared to upper trap
• Latissimus excessively tight
• Treatment
• Ice, US, X friction of overused tissues
• Mandatory icing after practice
• Specific individual exercises for some swimmers
• Coach, ATC, athlete work together
• Do not overstretch inferior capsule
• Crosstraining to prevent overuse

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PERIPHERAL JOINT STABILITY

• EXAMPLES
• Subluxing patella
• Subluxing GH joint
• Recurrent ankle sprain
• STATIC vs. DYNAMIC STABILITY
• COORDINATION AS PART OF STABILIZTION

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FUNCTIONALLY UNSTABLE ANKLES (Rozzi et al, 1999)

• 13 unstable, 13 unimpaired subjects
• Biodex Stability System (Visual Feedback)
• Program 3x/wk, 4 wk training on Biodex
• Unstable ankles improved significantly, as did
  unimpaired ankles. Untreated ankles also improved

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Pre Training
Post Training