Scapulothoracic Therapy

An exercise and proprioceptive program designed to restore normal glenohumeral biomechanics and scapular rhythm.

Pupose:

To address and treat the root cause of inflammatory conditions of the shoulder. To prevent adhesive capsulitis and atraumatic Rotator cuff tears. To restore shoulder biomechanics after costovertebral joint dysfunctions. To note: The scapula dictates what happens at the Gleno-Humeral joint.

Abnormal S-T stabilization leds to bicipital tendonitis, shoulder bursitis, capsulitis, and atraumatic rotator cuff tears over time. This occurs because the head of the humerus is unable to maintain its normal axis of rotation nor its relationship with the glenoid fossa. Therefore, the humeral head constantly irritates capsular, tendonous, and bursal tissues much like an ill-fitting boot causes blisters on an ankle. Also, if the supraspinatus is weakened after minor trauma and synchrony with the deltoid is not restored, the humeral head will move superiorly and abut the tissues under the acromioclavicular joint. With repeated motion and abutment over time, the result is any of the "-itis".

Unfavorable Relationships:

• Bleno-Humeral (shoulder) hypomobility with S-T (scapulothoracic) hypermobility
• Gleno-Humeral hypermobility with S-T hypomobililty

Favorable Relationships:

• Gleno-Humeral dominance with S-T responsiveness

Conditions that Respond to S-T Stabilization:

Capsulitis, bursitis, tendonitis, "snapping scapula" which occur due to:

• Poor mechanical integrity after trauma or strain
• Postural adaptations with age or overuse or overtraining one m. group
• Posterior capsule tightness causing forward humeral head displacement
• Cosovertebral joint dysfunctions that interfere with normal scapular rhythm
• Trauma of rotator cuff without restoration of muscular function
• Asynchronous supraspinatus-deltoid firing
• Thoracic kyphosis (abnormal scapular mobility)

Muscles to Exercise, strengthen, Restore Endurance:

• Lower & Middle Trapezius
• Infraspinatus
• Teres Minor
• Serratus Anterior

Tissues/Muscles to Elongate:

• Pectoralis Minor
• Pectoralis Major
• Posterior Shoulder Capsule