- Basic exercises for the thoracic spine 3. Basic exercises for the thoracic spine 4. Basic exercises for the shoulder girdle and the cervicothoracic junction4. Basic exercises for the shoulder girdle and the cervicothoracic junction
4. Basic exercises for the shoulder girdle
and the cervicothoracic junction
The shoulder girdle consists of the two clavicles
and the scapulae. The glenohumeral joints, the ball
and socket joints connecting the scapula and the
humerus, are the most mobile and least stable joints
in the body. Before prescribing a specific exercise
program for the shoulder girdle a thorough diagno-
sis should be focused on finding out whether the
restriction is in the scapulothoracic area or whether
it is compensation for weakness or hypermobility in
the glenohumeral joint. In such cases mobilizing the
glenohumeral joint further would cause discomfort,
whereas it is often helpful to improve the mobility
of the scapulae. Stable shoulder blades help to pro-
tect in weight-bearing. The clavicles are moved in
most shoulder exercises as well.
The shoulder girdle is connected to many
other structures, from the skull to the pelvis. It
is worth considering these areas as well, partic-
ularly if there is no improvement from working
on the shoulder girdle itself. A frequent cause of
shoulder problems is restriction in the upper ribs.
Then it is sensible to include rib-mobilizing exer-
cises. As the anatomical structures and functions
of the cervicothoracic junction are closely related
to the shoulder girdle, we will give a summary of
these two areas here.
The shoulder girdle has a wide range of movement
possibilities. We shall consider movements with the
main emphasis on the glenohumeral joints, and on
the scapulae. Flexion (forward and upward move-
ment of the arms) and abduction (movement of the
arms to the side and upwards) are summarized as
elevation of the shoulder by some authors (Kingston
2001 ). But rotation of the arms is different. If you
start, for example, with the arms downwards and
the palms facing the thighs, after raising the arms
by moving them forwards and upwards, the palms
are facing each other (see Codman's paradox, Magee
1997). After raising the arms by moving them to
the sides and upwards, the backs of the hands are
facing each other. The last phase of elevation needs
extra movement of the cervicothoracic area and the
upper thoracic spine. If both arms are elevated there
is some back-bending, whereas when you elevate one
arm there is side-bending in this area.
Exercise 4.1: Pendulum exercises
standing
Aims: mobilizing the shoulder joints, particularly
encouraging fluid transport.
- Stand with your feet one step apart, one foot
forward, one foot backwards, the front leg
slightly bent, in a natural position.
- To adjust your pelvis as if you are going to walk,
slightly lift your back heel and then bring it back
to the floor.
- Swing your arms in opposition in a natural
rhythm like a pendulum up to 1 minute; be
aware of the weight of your arms (Figure 6.76).
- Change your feet and again swing your arms as
described in point 3.
Figure 6.76
