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The following scapular stability exercises are designed to improve the strength and control of the muscles of the shoulder blade (scapula). You should discuss the suitability of these exercises with your physiotherapist prior to beginning them. Generally, they should only be performed provided they do not cause or increase pain. Begin with the basic scapular stability exercises. Once these are too easy, progress to the intermediate scapular stability exercises. As your shoulder blade strength and control improves, the advanced and other exercises can then be added to the intermediate program.
Basic Scapular Stability Exercises
To begin with, the following basic scapular stability exercises should be performed approximately 3 times daily. As your strength and control improves, the exercises can be progressed by gradually increasing the repetitions, frequency or duration of the exercises provided they do not cause or increase pain.
Shoulder Blade Squeeze
Begin this exercise standing or sitting with your back and neck straight. Your chin should be tucked in slightly and your shoulders should be back slightly. Slowly squeeze your shoulder blades together as hard and far as you can go without pain and provided you feel no more than a moderate stretch (figure 1). Hold for 5 seconds and repeat 10 times provided the exercise is pain free.
Shoulder Blade Shrug
Begin this exercise standing with your back and neck straight. Your arm should be at your side, slightly away from your body with your palm facing forwards as demonstrated (figure 2). Slowly elevate your shoulder blade towards your ear as far as possible provided the exercise is pain free (figure 2). Hold for 5 seconds and repeat 10 times on each side.
Shoulder Blades Forwards Against Wall
Begin this exercise standing with your back and neck straight and your hands against the wall as shown (figure 3). Your shoulder blades should be squeezed together fully in this position, your elbows straight and you should be leaning into the wall slightly. Keeping your back and neck straight, slowly bring your shoulder blades forward allowing your arms to lengthen. Hold for 2 seconds and then slowly return to the starting position. Repeat 10 times provided the exercise is pain free.
Darts
Begin this exercise lying on your stomach with your arms by your side. Squeeze your shoulder blades together and slowly lifting your arms and chest off the ground, keeping your neck straight (figure 4). Hold for 2 seconds at the top of the movement and then slowly return to the starting position. Perform 10 – 20 repetitions provided the exercise is pain free. This exercise may be performed with palms facing up or down.
Prone Scapular (Shoulder) Stabilization Series – I, Y, T, W, O Formation
Step 1
Starting Position: Lie on your stomach on a mat, with your arms outstretched overhead palms facing one another and your legs outstretched behind you with your toes pointed toward the wall behind you. Engage your abdominal muscles to stabilize your spine. Pull your shoulders blades back and down. Align your head with your upper spine. Keep these engagements throughout the exercise.
Step 2
“I” Formation: Gently exhale and slowly lift your arms off the floor, with palms facing inward. Keep your head aligned with your upper spine. Focus on lifting from the shoulders and not the low back. Hold this position for 5 – 10 seconds then relax and return to your starting position. Perform 2 – 4 repetitions.
Step 3
“Y” Formation: From the same starting position, gently exhale and slowly lift your arms off the floor, moving your arms into the “Y” formation as illustrated with palms facing inward. Keep your head aligned with your upper spine. Focus on lifting from the shoulders and not the low back. Hold this position for 5 – 10 seconds then relax and return to your starting position. Perform 2 – 4 repetitions.
Step 4
“T” Formation: From the same starting position, gently exhale and slowly lift your arms off the floor, moving your arms into the “T” formation as illustrated with palms facing forward. Keep your head aligned with your upper spine. Focus on lifting from the shoulders and not the low back. Hold this position for 5 – 10 seconds then relax and return to your starting position. Perform 2 – 4 repetitions.
Step 5
“W” Formation: From the same starting position, gently exhale and slowly lift your arms off the floor. Bend your elbows and pull them toward your waist, forming the letter “W” as illustrated Palms face inward. Keep your head aligned with your upper spine. Focus on lifting from the shoulders and not the low back. Hold this position for 5 – 10 seconds then relax and return to your starting position. Perform 2 – 4 repetitions.
Step 6
“O” Formation: Start with your arms down by your sides. Gently exhale. Lift your arms off of the floor. Rotate your arms inward in order to bring your hands together on your back. Stack your hands in the small of your back so that your arms create an “O” shape. Keep your head aligned with your upper spine. Focus on lifting from the shoulders and not the low back. Hold this position for 5 – 10 seconds then relax and return to your starting position. Perform 2 – 4 repetitions.
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