Rehabilitation of Scapular Muscle Balance

Abstract

In the selection of rehabilitation exercises, the clinician should have a preference for exercises with high activation of the LT and MT and low activity of the UT.

Lower Trapezius Muscle Strength in Individuals With Unilateral Neck Pain

“…Previous research has suggested that exercises which increase the ratio of lower trapezius to upper trapezius strength in patients with shoulder pathologies may lessen scapulothoracic muscle imbalances and improve scapulothoracic posture. 8,32 The current study did not investigate the ratio of lower trapezius to upper trapezius strength, so it is unclear if exercises that increase the ratio of lower trapezius to upper trapezius strength would also benefit individuals with neck pain. Future investigation of this topic is warranted.…”

“…This study suggests a possible association between lower trapezius muscle weakness and neck pain. [7][8][9] Such research has focused on scapulothoracic muscle imbalances, which disrupt normal scapular positioning, resulting in impaired biomechanics and, ultimately, pain. 7-9 Janda 15 described muscle imbalances as impaired relationships between muscles prone to tightness that lose extensibility, and those prone to inhibition and weakness.…”

“…It has been suggested that muscle imbalances in the scapulothoracic region occur when the upper trapezius becomes tight and the middle trapezius and lower trapezius become weak. 7,8,20 Exercises that enhance the ratio of lower trapezius to upper trapezius strength have been suggested to reduce this muscle imbalance and improve scapulothoracic posture in patients with shoulder pathologies. 8,32 Characteristics of scapulothoracic muscle imbalances are found not only in patients with shoulder pathologies but also in individuals with neck pain and cervicogenic headaches.…”

“…7,8,20 Exercises that enhance the ratio of lower trapezius to upper trapezius strength have been suggested to reduce this muscle imbalance and improve scapulothoracic posture in patients with shoulder pathologies. 8,32 Characteristics of scapulothoracic muscle imbalances are found not only in patients with shoulder pathologies but also in individuals with neck pain and cervicogenic headaches. 18,19 Jull et al 19 determined that upper trapezius tightness was more prevalent in individuals with cervicogenic headaches than in asymptomatic individuals.…”

Upper to Middle Trapezius Muscle Activation Ratio During Scapular Retraction Exercise at Different Shoulder Abduction Angles

“…The purpose of the exercises for shoulder rehabilitation is to recruit MT, LT, and SA with the minimal activity of the UT (17). Scapula retraction exercises are the starting point of the several shoulder rehabilitation protocols, and these exercises are prescribed for recovering the scapular control via strengthening scapula-thoracic muscles primarily MT, LT and rhomboid muscles (17,21).…”