T Nation

Jacked Up Scapula, Need Help


#1


Hello everyone! First post on this site for me and I've found all the information found on T nation to be the most accurate so I need some help from the outside community. For about 2 years I've been having migraine/ tension headaches from neck pain and I got the verdict that it's cervicalgenic and its due to muscle imbalance. Pt tried telling me it's a front to back imbalance but I discovered there's more to it.

My scapula is stuck in downward rotation with very overactive rhomboids and levaotor scapula (I play very high level volleyball and it's likely due to that). I haven't worked chest in a long time due to pec minor increasing downward rotation along w rhomboid dominance. I've done serratus work and recently started overhead shrugging which seems to help but any other suggestions would help.

Rotator cuff work seems to do nothing for me so I minimized that emphasis. Thank you! I feel you can almost tell from my photo how my lev and rhomboids are stabilizing my scap.


#2

Try this: https://m.youtube.com/watch?v=EYMu5UL-ans

5 sets of 5 breaths, really emphasizing reaching through the ground and creating a dome with the upper back. Breath in through your nose, out with your mouth.

Let me know if it seems to help.


#3

Appreciate the response! It seems to make breathing a little easier after yes, I do have some anterior pelvic tilt (which is tuck during this). Is the focus of this for the serratus? It definitely helped my overall breathing though, any thought on what’s causing all of this imbalance/ any other advice on exercises or stretches I should be following? Thanks a ton!


#4

Hard to say what the cause of the issue is without doing an assessment, but what you describe can definitely be part or a larger pattern which is fed by poor breathing mechanics.

The drill above does activate the serratus, but there is a lot more going on. Expansion of the posterior rib cage, reversal of lumbar extension, “opening up” of upper back musculature, etc. Primarily, though, it works to reduce sympathetic nervous system tone and allow your body to relax into a more neutral position.

As for further work you can do, I can only guess based off of this single picture so realize that this may not be entirely accurate. However, it looks like you are extremely extended (lots of erector development, t-spine looks flat, toned-up rhomboids, etc), so anything you can do to get out of extension will likely help with your shoulders. Positional breathing work, like above, can be a powerful tool when properly applied.

Where are you located? I can provide you with suggestions on people to seek out for help if you are in the right area. Alternatively, there is an online coaching service I am aware of that I believe would be beneficial for you. I think the current cost is $40, so it would be worth it if it helped.


#5

Makes sense, and I live near buffalo,Ny. Any suggestions on things I shouldn’t be doing/ more I should be doing? My only workout routine has been some overhead shrugs, face pulls, and shoulder work. Some mild serratus activation but nothing too outgoing. Here’s another picture at rest. Again thanks a ton, it seems breathing has been very difficult over the last few years when this problem came about and I have tight upper body / back muscles.


#6

Looks like your t-spine and posterior rib cage is flat, leaving your scapulae without a surface to rest on. Realize that your scapulae have a natural curve to them which matches the natural curve of an upper back. When that spinal (and rib) curve is lost, the scapula are going to be floating out in no-man’s land and the strongest serratus anterior in the world isn’t going to be able to do it’s job.

Restoring a natural curve can be done with movements like the one I posted above. Pushups, when done with a specific technique (https://www.youtube.com/watch?v=U0h76iBtoBw) can also be useful.

Were you working out regularly before this issue presented itself? I see no reason to stop training altogether. Just don’t do overhead work and avoid what hurts, and you should be alright.

I don’t know anyone out in Buffalo, unfortunately. This is a link to that service I mentioned: http://www.lancegoyke.com/mobility-problems.
I am 100% not affiliated with him, have not met him, and stand to gain nothing by you choosing to use that service. However, based on the writings on his blog and his educational and professional background, I think he would have the knowledge necessary to help you out.


#7

[quote]TrevorLPT wrote:
Looks like your t-spine and posterior rib cage is flat, leaving your scapula without a surface to rest on. Realize that your scapula have a natural curve to them which matches the natural curve that of an upper back. When that spinal (and rib) curve is lost, the scapula are going to be floating out in no-man’s land and the strongest serratus anterior in the world isn’t going to be able to do it’s job.

Restoring a natural curve can be done with movements like the one I posted above. Pushups, when done with a specific technique (https://www.youtube.com/watch?v=U0h76iBtoBw) can also be useful.

Were you working out regularly before this issue presented itself? I see no reason to stop training altogether. Just don’t do overhead work and avoid what hurts, and you should be alright.

I don’t know anyone out in Buffalo, unfortunately. This is a link to that service I mentioned: http://www.lancegoyke.com/mobility-problems.
I am 100% not affiliated with him, have not met him, and stand to gain nothing by you choosing to use that service. However, based on the writings on his blog and his educational and professional background, I think he would have the knowledge necessary to help you out. [/quote]

Thanks for all the advice! I was training very hard before this started happening. I feel limited because of my neck tension however so it really limits what I can do until I eliminate the overlying cause of the imbalance. I’ve been trying to fill my upper back now for a few years and have gotten some improvements but nothing seems to stick so could it be the lumbar extension causing my upper body to fall forward and create scapula problems like you mentioned? During the time of this happening when it was severe I had ridiculous hip flexor tightness (more right than left) and even now I feel my quads and hip flexors overpower my glutes and abs, could that be a cause of something else going wrong further up the chain to my neck and scapula? Again I appreciate the feedback and even saw a few articles you wrote on lumbar lydosis! Maybe some glute bridges and planks to combat this on top of that breathing exercise? Let me know what else you think because I really need to get over this neck tension/unstable scap’


#8

Yes, it is very likely all connected. Glute bridges, planks, dead bugs, etc may all be helpful or they may not. It really depends on your particular pattern. Many people seek out this kind of advice online, follow it to a T, and get absolutely nowhere because it was not tailored to their individual case. For instance, people with “tight hip flexors” and an excessive lordosis are often told to stretch their hip flexors – which makes sense, until you put them up on a table and see that their hip flexors aren’t actually short and the tightness they’re feeling is a result of bad pelvic positioning. Sometimes this is the case and sometimes it isn’t. Thats what makes giving advice on this kind of forum exceedingly difficult.

I encourage you to check out that link I posted above. It is a very cost-effective option for you to correct your issues. If you would rather seek a conventional physical therapist, I can offer suggestions on what to look for when choosing one.


#9

I’m absolutely going to give that link a try! I did pt for a while and they really emphasized upper back and rotator cuff work but seemed to have plateaued after seeing some improvements but my top half always seems to crunch down which makes me think it could be my pelvis playing the role now. Have you heard of cases where excessive lumbar arching messes with thoracic spine? Here is a picture of myself (random at a gun range I know ha) but you can just tell something is off posture wise, thanks again man you’re spot on with what you’re talking about.


#10

Cuff work can be useful in some cases, but not in all (or very many, actually). The shoulder joint itself can only be stable if the scapulae are, which can only be stable if the T-spine and rib cage have the proper shape and position. Trying to stabilize the shoulder with cuff work when the scapulae aren’t in a stable position on the ribcage is an exercise in futility.

Similarly, trying to stabilize the scap properly on the ribcage when your T-spine is either too extended or too kyphotic isn’t going to get you very far.

Short answer: yes, position of the pelvis and lumbar spine can influence the shape and position of the thoracic spine. Slightly longer but still insufficient answer: an extended/ flat upper back, excessively tight rhomboids, levators, and lats, a deep lordosis, anterior pelvic tilt, weak abs and hamstrings, and “tight” (or at least tight-feeling) hip flexors are all a part of the same pattern. When things get really funky is when you start looking at the way that this pattern influences the nervous system, blood pressure, resting heart rate, breathing mechanics, sleep quality, your ability to recover from exercise, etc.

It’s hard to tell from the picture, but it looks like the classic extension posture referenced above. Let me know what Lance (the guy I linked to) has to say, and keep me posted on your progress.


#11

[quote]TrevorLPT wrote:
Cuff work can be useful in some cases, but not in all (or very many, actually). The shoulder joint itself can only be stable if the scapulae are, which can only be stable if the T-spine and rib cage have the proper shape and position. Trying to stabilize the shoulder with cuff work when the scapulae isn’t in a stable position on the ribcage is an exercise in futility. Similarly, trying to stabilize the scap properly on the ribcage when your T-spine is either too extended or too kyphotic isn’t going to get you very far.

Short answer: yes, position of the pelvis and lumbar spine can influence the shape and position of the thoracic spine. Slightly longer but still insufficient answer: an extended/ flat upper back, excessively tight rhomboids, levators, and lats, a deep lordosis, anterior pelvic tilt, weak abs and hamstrings, and “tight” (or at least tight-feeling) hip flexors are all a part of the same pattern. When things get really funky is when you start looking at the way that this pattern influences the nervous system, blood pressure, resting heart rate, breathing mechanics, sleep quality, your ability to recover from exercise, etc.

It’s hard to tell from the picture, but it looks like the classic extension posture referenced above. Let me know what Lance (the guy I linked to) has to say, and keep me posted on your progress. [/quote]

Much appreciated man! Feels great knowing that there’s much more to it than a anterior/ posterior imbalance and I’m going to reach out to that link later on tonight or tomorrow and I will keep you posted… Again thank you!


#12

[quote]TrevorLPT wrote:
Cuff work can be useful in some cases, but not in all (or very many, actually). The shoulder joint itself can only be stable if the scapulae are, which can only be stable if the T-spine and rib cage have the proper shape and position. Trying to stabilize the shoulder with cuff work when the scapulae aren’t in a stable position on the ribcage is an exercise in futility.

Similarly, trying to stabilize the scap properly on the ribcage when your T-spine is either too extended or too kyphotic isn’t going to get you very far.

Short answer: yes, position of the pelvis and lumbar spine can influence the shape and position of the thoracic spine. Slightly longer but still insufficient answer: an extended/ flat upper back, excessively tight rhomboids, levators, and lats, a deep lordosis, anterior pelvic tilt, weak abs and hamstrings, and “tight” (or at least tight-feeling) hip flexors are all a part of the same pattern. When things get really funky is when you start looking at the way that this pattern influences the nervous system, blood pressure, resting heart rate, breathing mechanics, sleep quality, your ability to recover from exercise, etc.

It’s hard to tell from the picture, but it looks like the classic extension posture referenced above. Let me know what Lance (the guy I linked to) has to say, and keep me posted on your progress. [/quote]

Hey just a side question, I emailed that guy btw just waiting on a response. Why does this extended position effect the body as much as it does nervous system wise? Just a question for you and if you have any read I can find on why it does what it does thanks again man.


#13

The “why” is a very hard question, but I’ll take a crack.

Extension is a great position if you need to sprint 400 meters as fast as possible, squat 500 lbs, or fight off a hungry lion. It has a direct link to your “fight or flight” (sympathetic) nervous system for this reason. The problem comes about when extension becomes your default position, and you lose the ability to switch between flexion/neutrality and extension in posture, and sympathetic and parasympathetic bias in regards to your nervous system.

Essentially, your physiology is feeding your position, and your position is feeding your physiology.

There are probably a variety of mechanisms for this to happen, but the one that is most obvious is the change in breathing pattern that occurs while in a very extended position. Because of changes in the orientation of the pelvic floor to the diaphragm and an increase in accessory respiratory muscle activity, extensions leads to quick, choppy breathing that emphasizes inhalation over exhalation. Again, this is useful when you need to outrun a hungry lion, but not so much as a default daily pattern.

I hope this helps to clear things up a little bit. Please keep in mind that the above is simply a representation of my limited understanding on the subject. I’m not an expert on this stuff – I just find it all very interesting and do my best to wrap my head around it.


#14

[quote]TrevorLPT wrote:
The “why” is a very hard question, but I’ll take a crack.

Extension is a great position if you need to sprint 400 meters as fast as possible, squat 500 lbs, or fight off a hungry lion. It has a direct link to your “fight or flight” (sympathetic) nervous system for this reason. The problem comes about when extension becomes your default position, and you lose the ability to switch between flexion/neutrality and extension in posture, and sympathetic and parasympathetic bias in regards to your nervous system.

Essentially, your physiology is feeding your position, and your position is feeding your physiology.

There are probably a variety of mechanisms for this to happen, but the one that is most obvious is the change in breathing pattern that occurs while in a very extended position. Because of changes in the orientation of the pelvic floor to the diaphragm and an increase in accessory respiratory muscle activity, extensions leads to quick, choppy breathing that emphasizes inhalation over exhalation. Again, this is useful when you need to outrun a hungry lion, but not so much as a default daily pattern.

I hope this helps to clear things up a little bit. Please keep in mind that the above is simply a representation of my limited understanding on the subject. I’m not an expert on this stuff – I just find it all very interesting and do my best to wrap my head around it. [/quote]

Well said that makes a ton of sense, so hard to fully relax and I’m guessing it’s for that reason. That’s why it was so hard initially determining what was going on when symptoms started occurring. Can’t wait to hear what this guys advice is but still I’m going to try to work on core work and glutes!


#15

More core strength and glute strength is rarely a bad thing. I’d suggest you emphasize hamstrings as well, as they have a more direct influence on pelvic position than the glutes do.


#16

I’ve been dealing with a similar, over extension issue myself.

Like you, after awhile my scapula and then my hips felt “frozen,” just kinda locked into a bad position.

Push up plus and scap pushups have been good to restore motion. I also like “band shoulder tractions” where you use flex bands to assist the stretch.

For hips and glutes I’ve been doing tons of clam shells, hip hikes, seated abductions with bands around the knees, and seated Psoas lifts/holds with a mini band around the knees. Anything to get my hips mobile, and my glutes working to get my pelvis underneath me. And to keep my spine neutral.

Like Trevor mentioned, weak hamstrings are part of the issue. I don’t know if weak hams made me overextend, or if being in over extension made them weak, but my hamstrings were garbage. I’ve been doing hamstring curls of all kinds ( 1 leg, 2 leg, standing, laying, bands, ankle weights) to get “connected” to them better. Then inverse curls (a bodyweight calesthenic, like an easy Glute/Ham raise) to try and move better.

For other stuff, 1 arm farmer’s walk and sidebends have helped me get the obliques going, to help with posture, and a neutral spine.

Lunges with a dumbbell held on one side are good too. The off set weight challenges hip stability while moving around.


#17

[quote]FlatsFarmer wrote:
I’ve been dealing with a similar, over extension issue myself.

Like you, after awhile my scapula and then my hips felt “frozen,” just kinda locked into a bad position.

Push up plus and scap pushups have been good to restore motion. I also like “band shoulder tractions” where you use flex bands to assist the stretch.

For hips and glutes I’ve been doing tons of clam shells, hip hikes, seated abductions with bands around the knees, and seated Psoas lifts/holds with a mini band around the knees. Anything to get my hips mobile, and my glutes working to get my pelvis underneath me. And to keep my spine neutral.

Like Trevor mentioned, weak hamstrings are part of the issue. I don’t know if weak hams made me overextend, or if being in over extension made them weak, but my hamstrings were garbage. I’ve been doing hamstring curls of all kinds ( 1 leg, 2 leg, standing, laying, bands, ankle weights) to get “connected” to them better. Then inverse curls (a bodyweight calesthenic, like an easy Glute/Ham raise) to try and move better.

For other stuff, 1 arm farmer’s walk and sidebends have helped me get the obliques going, to help with posture, and a neutral spine.

Lunges with a dumbbell held on one side are good too. The off set weight challenges hip stability while moving around.

[/quote]

Thank you for the response! Is your posture similar to mine shown here? I’m guessing that I have the same situation your describing and I’ll try all that you posted… My overall guess is that I have crazy overpowering quads from being explosive in volleyball and my erectors are very hypertrophied from the loading phase of spiking a volleyball. Going to really try hitting my inhibited glutes and hamstrings to bring the hips to neutral and a little core work as well!

Found a few good videos on YouTube on reversing this and said it takes a few weeks so I’m hoping this corrects my thoracic spine positioning since I know it can’t be a weak upper back necessarily because I’ve been doing upper back work for way too long with somewhat good results but I’m reach to fix this pelvis now. Oh the negative results of playing a power sport and being too active… Haha


#18

Yes, my posture was similar, kinda “slumped” or “loose.” So I think about pushing my hips “forward” or “in” and pulling my ribcage “down” towards the front/top of my pelvis. More neutral. More like a column, supported by my hips instead leaning forward like a chicken, supported by my mid-back.

Doing stuff from the half-kneeling position helped me figure out how to re-position myself too. 1 arm presses, or 1 arm cable rows, or Pallof presses or even 1 arm shrugs in the half kneel. They all require using hips/abs/obliques to stay balanced and upright.

I totally agree with you. Being in your ready, athletic position, and doing the motions of your sport for years have over developed some of your parts, while under developing others. You’ve just got to spend some time doing lifts and moves and drills that require you to develop the stuff that volleyball misses. Back in high school, you probably ran track, played baseball or did pushups with your bros, and got all kinds of different moves and activities in. So you couldn’t get “unbalanced” like you are now. Put some general moving around, and some 1 arm/leg/side stuff back in your routine. Do some work everday to “undo” what volleyball has done to you.


#19

Thanks for the post! So glad to hear how all this can correlate with upper body disfunction. I spent way too much time addressing everything up top and posteriorly and didn’t realize my pelvis imbalance could/ most likely is the overall problem throwing everything out of whack resulting in back pain/ neck pain. I’m really looking at imbalances from a workout enthusiast and a PE teacher and can really tell my quads are ridiculously overpowering compared to my glutes and my hip flexors are picking up the slack.

I’m gonna try hammering my glutes after some activation exercises and then some core strengthening… The combo from explosiveness in my legs and cocking phase of attacking a ball has left my erectors crazy tight, here is a picture from about a year ago and I can really tell the progress I made on upper back and you can really see how tight my erectors were when it was a very big issue.


#20

Any word from the coaching service?