Scapular Mobilization in Alleviating Shoulder Pain

Introduction

The scapula is the shoulder blade, a large bone on the upper back. This triangle-shaped bone connects the upper arm bone, the humerus, with the clavicle. The bone is supported by a network comprising muscles that allow a person to draw the arm. It serves as an anchor for the arm, shoulder, and upper back aspects. It is essential for the shoulder as it promotes the range of motion for the shoulder. Range of motion is the shoulder joint’s capability to undergo its full spectrum of movements. It is about how distant one can stretch the body with the joint or muscle.

What Is Scapular Mobilization?

Scapular mobilization is a technique employed as a physiotherapeutic approach in managing and rehabilitating all shoulder pain, dysfunction, mobility, and other concerns. The physiotherapist enacts direct pressure on the shoulder blade to rehabilitate the typical movement and function in the shoulder.

How Does the Scapular Mobilization Technique Alleviate Shoulder Pain?

One encounters pain and dysfunction when the movements of triangular scapulae are restricted. Here, the pain is alleviated with the scapular mobilization technique of manual manipulation and gradual stretching of the shoulders. Therefore, the scapular mobilization technique diminishes intra-articular pressure. This results in an increase in mobility of the joint, joint capsule, adjacent soft tissue, muscles, and tendons. Therefore, the pain is reduced eventually with a heightened state of function and range of motion.

How Does Scapular Mobilization Work?

It is the manual mobilization of the scapula or the shoulder blades. So, this hands-on approach is performed gradually by skilled, certified, and experienced physiotherapists. First, the physiotherapist asks the person to position on the side with the arms resting on the therapist’s arm. The ninety degrees is achieved. Finally, the therapist addresses the cup of the shoulder blades while drawing them upward, downward, forth, and back. The force or pressure can be gentle or more dynamic based on the degree of pain. This mobilization is achieved persistently through sessions. Scapular mobilization techniques are then followed to sustain, perpetuate, and enhance the progress achieved.

What Are the Scapular Mobilization Exercises?

As scapula mobilization exercises robustly rely on the manual mobilization of the shoulder blades, the physiotherapist comes up with the teaching of exercises once that is attained. Scapular mobilization incorporates several exercises, including modifications, while some are discussed below.

• Shoulder Rolls: It is a typical shoulder exercise that everyone is aware of. First, the person stands straight with the feet shoulder-width apart, then rotates the shoulder gradually forward, followed by backward directions aiming a big circle.

• The Shoulder Blade Squeezes: Here, the person is allowed to stand erect, raising their arms. The elbow seems to bend, and the palm faces the fore. Finally, it is all about gradually squeezing the shoulder blades in a backward and downward motion. The person retains the position for a few seconds and reverts.

• Scapular Retraction: It is very similar to a shoulder blade squeeze. Therefore, the person is asked to move the shoulder blades back together toward the spine. Such retraction contributes to the stability and strength of the protective muscles of the shoulder.

• Wall Exercises: Wall exercises could pave the way for managing winged scapula or shoulder blade instability. Here, the person pushes oneself and one’s shoulder blades while performing the below scapular mobilization exercises.

• Ball Roll: Holding and rolling the ball against the wall in smaller circles. This kind of leaning maintains the scapular squeeze.

• Wall Press-Ups: Here, the person stands erect, placing their arms on the wall. Then, after setting up the scapula, as in shoulder blade squeeze, the elbow is gradually bent, bringing the chest close to the wall. This exercise is more like a push-up.

• Band-Resisted Rows: The resistance band is tied to steady, stable stuff like a door. Then, holding it in both hands, the person pulls and squeezes the shoulder blades backward in a rowing motion. The position is retained for a few seconds and drawn back to normal forward.

• Resisted Shoulder Extension: The arms are held by the side, and the elbows are straight while holding the ends of the resistance band. Now, they are drawn backward as drawing the scapulae together.

• Side-Lying External Rotation: The person can now lie on the side, bent at ninety degrees, while the palm is supported on the abdomen. Finally, the person tugs the hand away from the stomach without moving the elbow.

• Stretches: Stretching is primed towards the soft tissue tightness relief in aspects of spastic muscles. Manual implementation enhances movement, motor function, and, thus, function efficacy. Passive stretching is when physiotherapists move the affected limbs and muscles to stimulate them. So, passive activities would regain movement.

• Table Push-Ups: Table push-ups are push-ups done while leaning on the table. First, the person leans forward on the stable table. The scapular squeeze position is achieved by drawing the shoulder blades backward and downward. Next, the elbow is bent, and the chest is dropped; the person attempts the push-ups.

• Modified Planks: The typical planks are modified so that the person rests on their forearm and knees.

What Are the Benefits of Scapular Mobilization?

Researchers uncovered the effects of scapular mobilization over the betterment of pain and function concerning the scapulae. Its efficacy is proven with clinical trials as it holds several benefits.

• It alleviates pain.

• Improvement of the shoulder range of motion.

• Enhances movements of the shoulder.

• Improvement of strength and integrity of muscles.

• It reinforces overall function.

Scapular mobilization is known to alleviate shoulder pain and other concerns. Hence, the physiotherapist recommends it as an intervention or rehabilitation for treating the following conditions:

• Adhesive capsulitis (frozen shoulder).

• Shoulder impingement.

• Scapular dyskinesis.

• Shoulder arthritis.

• Shoulder dislocation.

• Shoulder impingement syndrome.

• Subacromial pain syndrome.

• Post-operative management of humerus and clavicle fractures.

• Post-traumatic fractures of the humerus and clavicle.

• Post upper-extremity fracture.

What Are the Risks of Scapular Mobilization Techniques?

Scapular mobilization techniques are generally safe but may carry certain risks if not performed correctly or inappropriately applied. These risks include

• Worsening of existing shoulder injuries if the exercises are too aggressive or performed with poor form.

• Improper application of force during mobilization maneuvers can lead to joint hypermobility or instability.

• Individuals with certain medical conditions like fractures, dislocations, or severe osteoporosis, should exercise caution or avoid aggressive mobilization techniques altogether to prevent further injury.

Conclusion

Shoulder pain is a more profound concern as the movements of the shoulder and, thus, arms are restricted. Scapular mobilization plays an essential role in alleviating pain as it addresses the underlying determinant called shoulder blades. The intervention is not painful while the person feels the stretch or little strain in the process of mobilization.