Shoulder Blade separation exercises?

[kmfisher]

I'm done seeing my PT, but she has me continuing to do exercises for my shoulder.

She says that my shoulders are back, but are separated too much in the back. This is causing the tendonitis of the suprasinitis in my left shoulder.

The exercise I have been doing daily (soon only 3x per week) is an exercise where I lie prone position with my arms straight out to the sides of my body, and my forearms perpendicular to my upper arm. My hands are face down and open. I pull back my arms and raise my hands up as far back as I can for 3x15 everyday.

The other rehab exercise I do are cable rows, close-grip pulldowns, and bicep curls. I do these for 3x15 about 2x per week (along w/ squats, rdls, tricep rope pushdowns, crunches, and hyper extensions).

Are there other exercises I can do that would help pull my shoulder blades together, but not back? Thanks for the help. Also, she said I could start doing pressing exercises again in a couple of weeks, but I have no idea of how I should incorporate them back into my workout. So, if there are any suggestions, I'd really appreciate it. I really want to get rid of this! Thank you!

[Bill Hartman]

She says that my shoulders are back, but are separated too much in the back. This is causing the tendonitis of the suprasinitis in my left shoulder.

You're going to need to clarify what she meant by this.

My question would be are you able to actively retract your scapulae without elevating (shrugging)? If so, then it may be a simple case of reinforcement throughout the day.

Once you have sufficient flexibility and strength to assume the correct posture, you need to reprogram your nervous system to adopt that posture the rest of the day. Exercise alone does not correct posture.

Bill

[kmfisher]

Yeah, I'm not 100% sure what she means by it. She may have meant lateral winging or medial winging? Essentially, my shoulders are properly positioned if you look at me from the side, but if you look at me from the rear, the scapula have too much space horizontally between them.

The pain was/is in the front of my shoulder, tracing down to my biceps. She felt that it was caused by the suprasinitis being inflammed. I'm not really sure how they all relate, but that's why I'm not a doctor or a PT.

The exercise seems to pull my shoulders together and down on my back.

My question would be are you able to actively retract your scapulae without elevating (shrugging)? If so, then it may be a simple case of reinforcement throughout the day.

Yes, it seems so. Although, it seems like my shoulders are pulled forward some and I move them back, and then pull back (or this may be natural, and I am going crazy from this thing). My chest sticks out when I do that, and it seems like my shoulders are moving in arcing motions backwards. I feel like they would make a half-circle and touch behind my head if it was possible. I also feel like my shoulders are naturally pulled upward. I could take a video or some pictures, its hard for to describe all of this.

Sorry about all the questions. I wonder how good of a PT she is since I heard her recommended the butt-blaster machine to a coworker. Also, I told her that during rehab I was doing 3x15 @ 135 lbs for RDLs, and she thought that was a lot of weight for anybody. She was shocked when I told her that I was doing 305 for 5x5 pre-injury.

I just feel like I could be doing a lot more for my problem than a single exercise for 3x15 each day. Thank you again for your help, Bill.

[Bill Hartman]

She may have meant lateral winging or medial winging?

This would be more of an upward or downward rotation. Winging would be movement of the border of the scapulae away from the ribcage.

A possibility could be tight external rotators and/or tight posterior capsule. Both are a common finding on weight trained athletes. If you can't easily reach behind your back and touch the opposite scapula, this may be the case.

While scapular positioning certainly contributes to shoulder problems, with a decent training history, you're probably looking at some form of progressive instability resulting in impingement. Inflammation of the supraspinatus tendon (by the way, the referred pain into the biceps is probably impingement of biceps tendon or local pain at the insertion of you subscapularis) doesn't just happen. There is a precipitating combination of factors.

I would continue to work on retraction/depression of the scapula with your current exercise, Push up with a plus for protraction, and various external rotation exercises as long as they are painfree.

Once you feel "normal" break back into training with cable work and regular push-ups and then move to dumbbell press variations. Limit speed, limit load, and limit range of motion to prevent recurrence.

Hope that helps a bit.

Bill

[kmfisher]

Thanks for the help Bill. It sounds like you have nailed my problem perfectly. I'll add in the push up with a plus, and external rotation stuff (I was doing it in rehab).

I can touch my opposite shoulder blade, but this may be solely because I have long arms. The left arm is harder to use that the right arm for this.

It's been two months since I've done any real workout, and it is driving me crazy. I hope it is better soon.

Thanks again for the help. Should I work in the 3x15 to 3x20 range for the push ups w/ a plus? Thanks!

Edit: Something I forgot to add was that my shoulder feels better after some activity. Saturday I had to scrape wallpaper above my head. It was sore that day, and I only worked on it when there was no pain. But, the next day and yesterday it felt about 95% perfect. I don't really understand this at all. Thanks again Bill!

[Bill Hartman]

Higher reps to start(up to 30 reps each) for your shoulder stuff to improve motor learning and establish strength-endurance. Then progress as it feels comfortable.

Bill