Raise your hand if you’ve ever been in a class or training session and heard the cue, “shoulder blades down and back.”
Raise your hand, but this time keep your shoulder blades down and back.
Congrats – you’ve just caused a shoulder impingement!
But don’t worry, impinging your shoulder this one time isn’t an issue. It’s when it’s repeated over and over that can cause inflammation and damage to the rotator cuff tendon and/or subacromial bursa.
One of the most common places I hear this cue is in yoga, but you can hear it in any fitness setting, especially on YouTube, ironically to keep your shoulders “healthy” and/or “stable” when you’re lifting big weightzzz.
You might even hear it cued as a way to improve your posture.
It makes sense, on the surface: one of the most common muscle imbalances is tight upper trapezius and pectoral muscles, and weak lower trapezius and rhomboid muscles (this is part of what’s known as Upper Crossed Syndrome).
Think of the slouched position the average desk jockey can fall victim to: shoulders slumped forward and yet up by their ears. So of course the right way of correcting that is by telling people to pull their shoulders blades down and back, right?
Let’s first start with a quick and dirty anatomy lesson…
What we think of as our “shoulder” is actually the combination of four different joints to make up what’s properly known as the shoulder complex. We have our glenohumeral joint, which is what most people immediately think of when hearing about shoulder movement. But we also have our sternoclavicular joint (which is between the collarbone and chest bone), our acromioclavicular joint (which connects the collarbone with the shoulder blade), and our scapulothoroacic joint (which connects the shoulder blade to the ribcage via muscles). All four are responsible for the full range of movement of the shoulder complex.
The glenohumeral joint is only responsible for roughly 110 degrees of movement when lifting our arms overhead. The rest of the movement comes from the remaining three joints working together. This is known as scapulohumeral rhythm: this precise pattern that allows us to move our arms up and overhead, a pattern that involves movement of the arm AND the scapula.
Proper scapulohumeral rhythm rotates the glenoid cavity, which puts the head of the humerus in an ideal (and safe) position for overhead movement.
But what happens when we force the scapulae down and back so that they can’t elevate and upwardly rotate in the way they need to?
Well, what happens when a four-person team has three of its members sit out?
The remaining player has got to do a lot of work, and he’s probably not going to do it well.
To compensate, the humerus is going to glide more than it’s designed to in the glenohumeral joint, taking it out of its ideal alignment in the glenoid cavity.
This can lead to a multitude of problems, including the head of the humerus meeting the acromion process. In that meeting, anything in the space between the two – for example, your subacromial bursa, the tendon of your biceps and rotator cuff – can get pinched aka shoulder impingement.
If you’ve never had shoulder impingement, consider yourself lucky. It is, in short, a pain in the front of the shoulders that can make you dread even reaching for the cereal on top of the fridge.
So what do we do instead?
If we are concerned about our posture, forcing our shoulder blades down and back is not going to fix it. Posture is far more than just activation of the lower trapezius and rhomboids and activating muscles to pull the shoulder blades down and back isn’t the answer. Correcting posture will take more than just following one alignment cue. For example, you need to look deeper, such as this exercise, which is fantastic at getting to the root cause of hunchback.
As for movement of the shoulder, we need to encourage proper scapulohumeral rhythm. Addressing posture, particularly thoracic spine mobility first is necessary because if the t-spine is stuck in flexion, the scapulae cannot properly upwardly rotate.
Next is ensuring the serratus anterior is functioning correctly. I’ve got a video with 5 exercises for the serratus here.
Once you’ve got t-spine mobility and serratus function covered, it’s time to re-pattern – when you do lift your arms up overhead, whether it’s to reach for something on the top shelf or press a dumbbell overhead, allow the scapulae to upwardly naturally to allow the entire shoulder complex to move the arm.
You may even need to actively think of shrugging and posteriorly tilting the scapulae if you’ve trained yourself with the improper cue to reset the damaging movement pattern. Refer to these exercises for further help with this.
It can be very difficult to break from the habitual movement patterns we’ve been training for years. But adjusting the movements in our body to proper patterns can mean the difference between injury and a body that is moving freely and without pain now and for the long-term.