The cure for subacromial impingement syndrome: How to perform scapular upwards rotation
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- Опубликовано: 28 сен 2024
- Faulty scapular upwards rotation is undoubtedly the most common cause of chronic shoulder impingement syndrome and scapular dyskinesia. Patients who are able to perform gentle upwards rotation in posture are generally able to correct their scapular dyskinesis relatively quickly. However, patients who are not able to perform correct muscle activation tend to struggle heavily to correct their problem, and for these very patients this video guidance was made.
Learning proper scapular movement is crucial to resolve any shoulder impingement syndrome, but is also imperative for appropriate costoclavicular decompression in patients with TOS who wish to return to physical activities.
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Holy shit dude the queue to think about raising your subacromium joint/ collar bone during upward rotation saved my right shoulder pain for over 2 years man. It really helps involve my traps right along with the Serratus and feels more natural. I can’t thank you enough I hope I can meet you someday cause man I need to give you a hug for this. 🐐 👑
It definitely feels more natural. Personally, it is the "pull the scapula back and down" dumb tip that made me stop having proper scapular kinetics.
Good that you feel better too
I used this queue to do my incline db presses today. I went from 30 lbs with aching shoulders and neck pain to doing 50s with perfect form actually able to press till failure. Just mind blown tbh. I was extremely skeptical when I first saw your channel.. now I just wanna hug you! Lol thanks man
Kjetil...You look like a Viking warrior, and with the brilliance of a true scholar. Your education on muscular skeletal anatomy and in depth body mechanics have helped me invaluably. You provide such a wealth of crucial information that just can’t be found anywhere else❤️
The lat spread thing is an amazing cue, basically lat spread and then raise the acromion. Took a while for me to understand but now I can feel and see the upward rotation in practice, time to overhead press!!!!
My shoulder fixed after 3 years of pain you're a hero mate
I managed to bowl at cricket without pain
It was a weird but happy feeling when I didn't get any tingles down my arm
My MSK homeboy is stacked and jacked. Great vid!
Wow this was probably the best video in all youtube to explain and really theach this movement. Suffered 10 years of of chronic shoulder problems and this might finally be the fix. So thank you very very much nordic brother!
i not understand what he said
@@peamutbubber im arabic not English
عند رفعك ليدك حاول فرد جناح الكتف للامام مع رفع كتفك قليلا @@bome7sen
I wonder if you could shed some light on the scapula orientation in front squat.
Is the scapula position in push-ups identical to the one in bench press? And could you please also tell us how the scapula should move in dips, and how deep we can go without putting the shoulders at a greater risk of injury?
user-qx, I have worked out for decades and I can tell you dips put a tremendous amount of un-naturual stress on your shoulders. I would not do them. I did them when I was younger but stopped after a few months I noticed they caused pain. You really do not need them to develop shoulder muscles. If you insist on doing them just do a small range of motion do not go deep into the dip only go down about half way. Also do not add weight to your body when doing dips. I would advise not to even do them. Also the bench press and push ups scapula position is going to be slightly different but similar because it is the same movement
Thank you, Sir!
Excellent video! Thank you
Thank you
i have question,but, ineed a answer too.....
what about swimming or hanging on a bar?
How do i avoid activating the levator muscle when trying to achieve scapular upward rotation?
Tricky. Book a session.
I appreciate the videos about shoulders
So when at rest it seems like a decent way to cue yourself could be to just stop resisting the forward rotation of your shoulders (if you are muscular) and raise them slightly with traps?
i dont get the part in the abduction or lateral raises?basically u want to keep the scapula up during the movement?
is it normal for the scapula to sometimes pop on the way down (no pain associate with the popping)? I fell some tensioning the chest while performig upwards rotation
Common, yes, but not normal. It suggests either improper movement or very, very thin muscles between the scap and ribcage (serratus)
@@MSKNeurology Thank you for the response. I will focus more on proper mechanics and serratus strengthening
Nice video ^^ I just have one question : are we ok to say that the bar cannot touch our chest with that bench press technic ?
See my bench press video. Bar should touch the chest in BP, but not if military pressing or performing pull downs
@@MSKNeurology what about pullups
@@coachingconfidant2785 I don't recommend pulling up to the chest unless you're training for some kind of military, police or similar admittance. The only way to get the bar to the chest is by downwardly rotating the scapulae.
@@MSKNeurology what if you're pulling to the nape, behind the neck
@@MSKNeurology Are dead hangs OK for shoulder health? Video perhaps?
in the pull up and lat pull downs what need to be the position of the scapula in the bottom and the top? and should you lock out the arms in vertical and horizontal pulls? thank you.
Like the MP but reverse. No locking out
@@MSKNeurology but the rom tho😭
Scapula position for deadlifts and or squat?
See my bench press video
@@MSKNeurology 👍🙏🙏
If I can ask a question please, when executing a row, does the scapula also slightly elevate and follow the humerus as the arm goes in flexion when reaching and stays there for the movement?
I talk about rowing motions in the bench press video I made. I also have a rowing video somewhere on the channel
How qualified are you at reading MRI's? in comparison to a radiologist
im staring at the wall sometimes just trying to teach my body to do this right LOL
Awesome video thanks for sharing. Has pretty much eliminated some shoulder problems I've been having for a while and moving it feels much better!
Can you go over proper scapula movement during the bench press again in greater detail?
YES YES LOVE THE VIDEO! explained so well!
I just did this when doing barbell shrugs and for the first time I could feel my upper traps working.
That's gonna be to heavy for most patients, although it may have worked for you. Good job either way
Instead of raising the shoulders straight up for barbell shrugs what were you doing before that caused the upper traps not to be engaged? Were you retracting the scapula?
@@Letsgochamp-kh4wm I tried straight up and straight+back.
I can feel it fine with no weights but added weights I don't feel the muscle which has always puzzled me. It could be a technique issue but It looks the same to me. Maybe my nerves are getting affected by the weight?
@@MSKNeurology To my surprise I was not sore the next day. Maybe it was just a release or stretch. It felt good either way.
@@SheepDogTricks how heavy were you training with the shrugs? and how has it been going since your comment, are you still feeling the trap activation?
Your videos are a blessing. You can do with a better microphone though for the beginning of the video :)
Forgot to put the pods in and I couldn't hassle to redo the video. It is what it is.
You are hero
Thank you very much
This video very useful
شكرا لك أيها الرجل النبيل
نادرا ما نجد شخصا يحب مساعدة الآخرين
اخ محمد ممكن اتفهمني شنو قال ؟
Thanks will try
Thanks so much
My right shoulder impinges when I do lateral raises. I've had several PTs look at it and they gave me exercises to do (wall slides) but it's not helping. How do I train my scapula to rotate easily? I have to really focus on it for it to rotate.
Hi dear Kjetil, I am trying the flexion. I am severily struggling to do this correctly (have anterior shoulder rotation due to frozen shoulder post impingement surgery). When you say 'scapula wraps around the thorax', does the medial scapular border move towards or away from the spine? From your skeletal demo, I understand it moves laterally away from spine before the arm is going up? My medial scapular border is sticking out and I have the feeling it is already sitting too lateral/far off the spine before I start the movement. Do I first have to get my scapular border closer to the spine (medial direction and closer to thorax) and get the shoulder correctly aligned in cranio-caudal direction (so neutral rather than forward rotation) first prior to doing what you demonstrate? Many thanks for your help.
Thank you for this.
Thanks man. One off-topic question: In the past years, have you discovered any new conservative techniques for curing TOS? Would be very interested as you're arguably one of the most specialized persons in the world in that area
@Isak Tougaard Conservative = non-invasive i.e. no surgery. Has nothing to do with when the technique was discovered.
@Isak Tougaard conservative in relation to rehabilitation is basically any form of PT/ exercise to resolve said issues, without excessive injections or surgery
New? I have used the same protocol for years. No need to fix something that's not broken.
When you mention there are nuances to performing the upward rotation like a lat spread- what might they be for example?
In posture, straight upwards elevation of the scapula (with of course some inevitable upwards rotation) seems to help with my TOS, however, when I voluntarily “open up” as you describe at 3:54 and slightly abduct the scapula, I immediately feel a tightness in my pec minor. Should I then stick to straight upwards elevation until my PM is flexible enough to handle “opening up” the scapula?
Do vertical shrugs work on upper traps or middle traps?
Vertical upper, lean slightly forward, now it is middle. The upper traps pull up and the middle traps pull back and up. There are some nuances here that are hard to catch in a comment though.
@@MSKNeurology to be more specific I’ve been seeing that vertical shrugs don’t target upper traps because there’s no direct line of pull or correlation from the traps to the scapula and instead since the strongest upper trap fibers run horizontally the upper traps work best during movements like rows or pulling the clavicle posteriorly. What are your thoughts on this?
@@juansamudio1171 Need upwards rotation and need proper head posture to target it. Upper traps do not work more during rows, that is nonense
thanks bro!
Sir should we also NOT depress the scapulae during dips? Isn't shrugging while dips risky?
The dip is different because it doesn't require upwards rotation. However, it still doesn't mean you should depress the scapulae maximally. It is a little tricky becuase you want to maintain an adequate elevation to where you don't get brachial plexus compression but still do not want to elevate so much (ie. drop yourself fully with the weight) that your clavicles irritate the sternoclavicular joints and AC joints
Hi I am recovering from a frozen shoulder on my left side. Its been a little over two years. With lots of physio i have increased range of motion to about 90%. I still have one part that i cant figure out. When i perform the movement of an upright row i cant feel the fibers on back of my left shoulder activate like i feel on the right. There is strain in the area from the front deltoid region to the front upper pec. Its hard to describe exactly but what muscles might be tight that are preventing me to perform an upright row?
What areas of range of motion are you still limited in?
Have u had MRI to pinpoint the areas of joint capsule that are still stiif/thickened?
I as cause I have the same issues now 3 years post frozen shoulder...
When I do pull ups should I let my scapula come up all the way when I'm at the bottom? (Doint a dead hang).
No
thanks
thank you Sir. could you also address how the humorous turns into ER as we go for full elevation.
Weeeell, it SHOULD do so but it is not a MUST. I But you are right, especially during shoulder flexion, some degree of humeral ER should occur
i have shoulder impingement and i did surgery and now from 6 year after surgery i have tos also how i fix plz
Do you expect me to be able to help you with this in a youtube comment? Book a session
@@MSKNeurology i will do soon . but my English bad its ok ?
How do you treat a dislocated shoulder?
Correcting the scapular dyskinesia and strengthening all four rotator cuff muscles. And prayers. It won't always return to complete normal seeing as the ligaments will be compromised.
your videos are just unbelievably informative and helpful I'm just so thankful, thank you so much you're like the best physiotherapist. I went to your website and read your article "How to properly & permanently resolve scapular dyskinesis" and I did as you tell your patients to do, I raised my scapulars using my traps. I've managed to nearly fix my scapular dyskinesis in like a week, the only problem is when I hold my scapulars in this position for some reason my superior angle sticks out of my back unless I relax in this position. Will it eventually fix itself?
Levator weakness
@@MSKNeurology Thank you very much. I'm not sure if it's levator weakness because when I do exercises for it, I don't really feel that it is being worked and I've made sure that I'm doing them correctly. Could it be anything else or is it being worked but I just don't realize it? You're the expert here but It feels like maybe because my scapular is in the wrong position my levator is tight I should also add I have no pain or discomfort.
@@hh-pg6ov Listen or don't listen your choice
Levator literally prevents superior angle from overly retracting
When I do this I feel pins and needles in my arm. Is that normal?
No
@@MSKNeurology I dont get them anymore. It went away after a few days. I practice this every day, and in the beginning I could barely do one repetition. Thinking of starting to use a dumbbell to make it harder now
I see you've successfully integrated into South American society: Short sides and spike hair, jacked, lean, tanned, groomed chest hair and of course the masculine tattoo that could be interpreted as being Christian.
Good for you bro, is life good down there?
No grooming though. Yes I am christian
Hey Kjetil, do you think upright rows have a place in shoulder training or are they inherently dangerous?
Perfectly safe with good technique
@@MSKNeurology Great, thank you, tried them again today and felt good
@Deep Thinking The scapular mechanics of an upright row is similar to a front raise. Nothing special
How can someone upload a video with this Video and Sound quality in 2022? Sorry I cant understand a decision like this. Almost every $100 Smartphone has better video quality
Perfect, go to another channel and problem solved
Would you rather watch a video in 4K but it provides you with the wrong information? Just turn up the volume.
I get what you're saying in a general sense, but this guy is amazing.
Who cares for fancy graphics, 4K, lots of filler and influencer stuff when you get an actual expert who tells things as they are and knows what he is talking about.
I have seen a lot of videos from almost every "top" personality here on RUclips in recent years and none of them really know the mechanics of the shoulders like this guy.