Shoulder Strength and Stability: A Beginner’s Guide

All 17 of these muscles are included in the two videos provided above. You can see all layers of them from the front (anterior) and back (posterior) views.

Why You Don’t Want to Forget About the Scapula

Hitting your delts at the gym just won’t be enough to build true shoulder strength. You might get some “boulder shoulders,” but it won’t do much for your function.

With the 17 muscle attachments to the scapula, all of these muscles must work synchronously together to get your arm up overhead. They must also work together to spike a volleyball, throw a baseball, lift luggage into the overhead compartment, and grab that coffee mug from the top shelf for that morning coffee. If there is weakness, tightness, or poor activation somewhere in this complex system, it could lead to pain and/or injury in the shoulder, elbow, or wrist.

These muscles help to stabilize the shoulder blade on the ribcage and by controlling the movement that occurs at the shoulder blade. Poor scapular control can lead to injuries such as shoulder impingement, rotator cuff tears, labral tears, golfer’s elbow, and tennis elbow (to name a few).

Scapulohumeral Rhythm

The coordinated movement of the arm and scapula is referred to as scapulohumeral rhythm. The scapula needs to be able to upwardly rotate 60 degrees to fully get your arm overhead. The other 120 degrees comes from the glenohumeral joint. During the first 120 degrees, the scapula upwardly rotates 1 degree for every 2 degrees of arm elevation. For the remaining 60 degrees to reach maximum elevation of 180 degrees, the scapula upwardly rotates 1 degree for every degree of elevation until maximum elevation is reached.

When observing poor scapulohumeral rhythm, certain muscle groups tend to be overactive, whereas other muscle groups are weak or inhibited. The muscles that tend to be weak and inhibited are the mid trap and low trap. The muscles that tend to be overactive or tight are the the upper trap, pec major/minor, and sternocleidomastoid (SCM).

In order to get the scapula to upwardly rotate as it should, the upper trap, low trap, and serratus anterior all need to work synchronously together. Even just a slight increase in upper trap recruitment will result in a faulty movement pattern. Instead of the scapula upwardly rotating, the scapula will elevate instead. This can lead to shoulder issues, including shoulder impingement. This shows the importance of incorporating shoulder exercises that specifically target scapular mobility and stability for overall shoulder health.

The Benefits of Shoulder Stability

Remember when you could throw a ball with force behind it and now experience pain? Remember when you wouldn’t think twice about reaching up to grab something from the top shelf? This is the power of shoulder stability.

Having functional shoulder stability and strength gives us the foundation for enhanced performance. This helps significantly reduce the risk of common injuries, including shoulder instability. In fact, a stable shoulder helps maintain muscle balance and joint stability, further contributing to better posture.

Want More Info on Shoulder Injuries, Pain, and Treatment? Check Out These Related Articles:

• How to Improve Shoulder Range of Motion
• How to Fix Rounded Shoulders
• 5 Important Shoulder Rehab Exercises for Optimal Function
• The Exercise You Need for Pinching in Shoulder When Reaching
• 5 Best Shoulder Strengthening Exercises for Healthy Movement and Stability
• Shoulder Mobility Exercises: Proven Stretches to Unlock Your Mobility
• Physical Therapy Exercises for Shoulder Pain: What You Should Know

Common Shoulder Injuries

Understanding the nuances of shoulder anatomy provides insight into the critical roles of the scapula and rotator cuff. Common shoulder injuries like shoulder impingement, rotator cuff strains or tears, labral tears, and shoulder instability all significantly impact daily activities. These injuries are often the result of inadequate shoulder strength and stability and faulty mechanics.

Shoulder Impingement

Shoulder impingement occurs when there is a narrowing of space within the shoulder joint, causing pinching commonly on the rotator cuff tendons. The root of impingement often comes from a combination of factors including poor neuromuscular control, muscle imbalances, postural abnormalities, insufficient scapular mobility, and overuse.

Some individuals may develop shoulder impingement due to an acromion deformity that is typically present at birth. If the acromion is either hooked or curved instead of flat, it may lead to impingement-like symptoms.

Individuals with shoulder impingement typically respond well to conservative treatment through physical therapy. Physical therapy will address the postural abnormalities, faulty mechanics, and muscle imbalances that could be leading to your impingement symptoms. Activity modification may also be necessary in the beginning stages depending on the severity of your pain. A graded exercise program will cover the faulty mechanics and restore normal scapulohumeral rhythm so you can get back to doing what you love without the nagging pain.

Rotator Cuff Strains and Tears

Rotator cuff injuries can be traumatic or atraumatic. It is very common to find rotator cuff tears in individuals 50+ due to normal degenerative changes. A rotator cuff injury can be treated conservatively or surgically, depending on the degree of the tear, the age and activity level of the injured individual, and other factors. Regardless of what lead to the rotator cuff injury or if surgery was performed or not, physical therapy is important to restore normal function of the shoulder and mitigate pain.

The supraspinatus muscle is very susceptible to injury and the most commonly torn of the four rotator cuff muscles. This muscle is very important when initiating movement of the arm. Infraspinatus, another rotator cuff muscle, is also commonly injured. The infraspinatus muscle is responsible for external rotation of the shoulder. Both of these muscles must be strong to perform many tasks involving lifting overhead and throwing.

Shoulder Instability

Instability of the shoulder refers to the inability of the structures surrounding the shoulder joint to keep the ball within the socket. Shoulder instability can also be referenced as hypermobility. If you have ever suffered a dislocation or subluxation of the shoulder joint, then you have shoulder instability. Instability can also come from laxity of the ligaments either from excessive overuse that stresses the ligaments over time or from a connective tissue disorder such as Ehlers-Danlos Syndrome (EDS).

Strengthening the muscles surrounding the shoulder joint and scapula are extremely important in cases of instability. Because the ligamentous structures around the shoulder joint are not able to perform their job as optimally as they should, the muscles now have to pick up the slack. Muscle strengthening provides the shoulder joint with the stability that it lacks.

Treating muscular imbalances and poor neuromuscular control is paramount to restore normal functional to an unstable shoulder. Performing the wrong exercises can lead to more pain, further instability, possible dislocation, and worsening muscular imbalances. Physical therapy can help address these issues and safely prescribe an exercise program to give you back the stability your shoulder needs without further impacting risk of injury.

Injury Prevention (Prehab)

Injury prevention is more commonly associated with the athletic population. However, it can refer to anybody, as injuries do not limit themselves to only athletes. The current healthcare system is reactive: it is set up to wait for an injury to occur or pain to be present before addressing the problem. Prehab refers to a proactive approach to rehabilitation. You can address the muscle imbalances and postural impairments before it even leads to pain.

The body is great at compensating. Muscle imbalances could be present before pain even presents itself. The body will do everything it can to help prevent pain from occurring. This is why many individuals experience pain with no mechanism of injury. The problem at hand (muscle imbalance, poor posture, etc.) was likely there long before and the body can no longer keep up with the compensatory patterns without pain being present.

You can take your healing into your own hands. You can address any issues you may have proactively. Just as athletes work hard on injury prevention, you can too! Speaking with a licensed physical therapist can open the doors to improve your shoulder health before pain is even present.