The Scapula: Why Your Client’s Shoulders and/or Thoracics are Probably Having a Meltdown
Shoulder pain is like that annoying friend who shows up uninvited to every party—it's EVERYWHERE, and honestly, most of us are handling it all wrong. While everyone's obsessing over the shoulder joint itself (classic mistake, people!), the real MVP sitting back there is getting completely ignored: the scapula.
Plot Twist: Your Client's Shoulder Blade is Basically Running the Show
Here's a fun fact that'll blow your mind: the scapula doesn't actually attach to the ribcage with bone! It's literally floating there, held up by 17 different muscles like some kind of anatomical magic trick. No wonder it has trust issues when we ignore it all day HAHA.
Think of your client's scapula as the foundation of a house—if their foundation is wonky, everything above it is going to be a hot mess. When their scapula can't do its job properly (which is basically being the world's most important backstage manager), their shoulder joint starts compensating harder than a people-pleaser at a family reunion.
The Scapula's Secret Superpowers (That Nobody Talks About)
Here's what's wild: your client's scapula moves in SIX different directions. Six! Most people can barely get theirs to move in two without looking like they're doing some weird chicken dance (not that the chicken dance isn’t fun and cute haha but probably not the goal). But here's the kicker—every time they lift their arm overhead, their scapula should be rotating upward about 60 degrees. When it doesn't? Hello, impingement city or something uncomfortable. Most likely this client has a a caved in chest and hip pain too am I right?
The Movement Game Plan (AKA How to Help Your Clients Make Friends with Their Shoulder Blades)
Let's get real about “fixing” this mess. I don’t love the word
fix” honestly, I think we are more of facilitators that guide people along their healing journey, WE don’t “fix” anything, anyway I DIGRESS. Start simple, people! I always tell my mentorship students: have your clients master the basics before you try to get fancy.
Step 1: Basic Scapula 101 Begin with slow, controlled movements—up and down FIRST (because the nervous system loves predictable patterns), then forward and back. Once their brain remembers, "Oh right, I have shoulder blades," THEN you can progress to those fancy unilateral circles that make them look like they know what they're doing. This will most likely take longer than either of you think. You will prepare it for today’s session and the client won’t even be able to elevate without recruiting the rest of their body or holding their breath so you’ll spend wayyyy more time on this than you think. It might takes weeks or months to get to circles.
Step 2: Add Some Stability Magic Here's where you get spicy with plank variations and scapular push-ups or “turtle-giraffes” as I like to call them. Your client's scapula needs to learn how to party in ALL planes of motion, not just the ones it's comfortable with. Think of it as cross-training for their shoulder blades.
The Breathing Connection (Because Everything Always Comes Back to Breathing)
Plot twist number two: your client's breathing is probably sabotaging their scapular intelligence and competency! When they're chest-breathing like they're perpetually surprised, their upper traps go into overdrive, and their poor scapula gets yanked around like a puppet on strings. MAKE SURE you explain this to them PLEASEEEE. REFER TO THIS POST to practice your explanations. Modify, edit, reframe what makes sense for you and your client, ALWAYS, this is just a jumping off point for you and per usual, I want you to make it your own based off of your profession and your specific population.
Teaching diaphragmatic breathing while focusing on scapular position? Chef's kiss That's the secret sauce for long-term shoulder happiness. Their nervous system will thank you, their posture will improve, and they'll finally stop looking like they're carrying the weight of the world on their shoulders (because, let's be honest, their upper traps are tired of that job).
The Bottom Line
Your client's scapula isn't just some boring bone hanging out back there—it's the unsung hero of shoulder function. Give it the attention it deserves, and watch your clients transform from shoulder-pain sufferers to movement rockstars. Trust me, their nervous systems (and their shoulders) will never be the same.
And before I let you go, CLICK HERE to follow along one of my favorite nerve glides for specific shoulder movements! Clients LOVE how this feels, go slow and always remember you can and should modify nerve glides based on the human in front of you.
See you next month my friend! Stay curious and be weird,
Missy B
P.S. Oh and I didn’t get much into in this blog, but the opposite of the shoulder is the HIP, so you can try this for hip pain and vice versa. Go through the other blogs to read more about that!