The scapula has a crucial role in shoulder function. It forms the socket for the shoulder, has several layers of muscles that attach to it, and it forms three joints. One of these joints, the scapulothoracic joint, is of particular interest. It is not a true joint; it sits on top of the rib cage with a layer of muscle between. In a sense, it is floating on the rib cage and the resting tone in the muscles that attach to it dictate its position. If there are imbalances, it can change the angle that the scapula rests. Depending on severity, this can cause symptoms. There are several planes of motion that the scapula can move within (elevation, depression, retraction, protraction, upward/downward rotation… the blades can rotate around the ribs and also peel off the ribs in a couple of distinct ways: We can see this in scapular winging, where the blade peels off through more of the transverse plane, but we can also see it in a sagittal plane rotation with anterior tilt…). So, one plane in particular can become problematic; anterior tipping (anterior scapular tilt, AST, is such a common problem).
There are two particular muscles that have a strong influence on the degree of tipping of the scapula: pectoralis minor and lower trapezius. Pec minor attaches to the scapula at the coracoid process. If it is tight, it will pull it forward.
On the back side of the scapula, the lower trapezius attaches by the spine of the scapula. It acts to pull the scapula downward. If you have a weak lower trap and a tight pec minor, the resting position of the scapula will bias towards anterior tipping. This is very common among anterior dominant athletes/lifters and computer workers/people in general.
So how do we test for this? An easy way to see it, is to lay on your back. Do your shoulders comfortably rest on the floor? Or is there a gap between your shoulder and the floor? If the answer is yes to the last question, your pec is probably tight in relation to your trap.
So how do we address this? Most people are familiar with pec stretching or how to use a lacrosse ball or foam roller to lengthen the pec (look the pic below).
The part most people leave out is to address the tone in the lower trap. The prone “Y” is probably the best way to strengthen the lower trap (look the photo below).
So, this is a great exercise for the lower trap. It’s one of my go to exercises for many people that need to work on scapular upward rotation and posterior tilt. It’s a double whammy.
But often times, if people are weak in the low traps, they will flex their elbow a little bit to make the exercise easier. Look at the pic in the photo above. Notice how the dumbbell is in the same place in space? The person often thinks they are doing the exercise well because they moved the weight from point A to point B. However, by flexing the arm, it lowers the angle of the arm and essentially becomes a retraction exercise for the middle trap, not the lower! So straighten that arm prior to the start of the exercise and focus on performing the exercise in line with the lower trap to assure you get posterior tilt of the scapula.
With seasoned lifters, anterior tilt is a pretty common thing to see as the upper traps and biceps as well can cause the scap to rotate forward (suitable attachments) and over the top of the ribs unless the individual has some sick lower traps and rhomboids as well to balance that out. Since most lifters will prefer training biceps and upper traps to smashing out some low trap raises, this imbalance is kind of a sign of a seasoned lifter. That or someone who sits at a computer all day long.
A challenge with this anterior scap tilt is that it pulls the acromion process forward and down relative to the starting position of the humerus, and effectively limits the clearance between the two compared to being in more of a posterior tilt. This anterior tilt creates an earlier point of compression between the humeral head and acromion, which limits overhead motion (look at the cover pic), plus also ups the odds of an impingement type injury to the supraspinatus tendon. Tilting the scap back opens the door, so to speak, to allow an easier range of motion of the shoulder into an overhead position with less risk of impingement injuries, plus helps balance some of the forces acting on the scap so more muscles can contribute to the motion and stability of the structure, making it stronger and easier to get yoked within your training sessions.
Another area that often gets overlooked is the thoracic spine. If you have too much kyphosis (think hunchback), it will contribute to this situation. You can test this out for yourself. Sit with back posture and slump your upper back. Now try to raise your arm overhead. It will stop prematurely or even given you a pinching sensation. Now sit up straight. Do you suddenly have more range overhead? That is because kyphosis of the spine is another way to produce and anterior tip of the scapula. This slight change in angle affects the rotator cuff and can lead to shoulder impingement. There are ways to address kyphosis of the spine, but this is best done with a physical therapist (or a good strength coach) as self treatment can easily be done wrong and cause other issues. …Basically, kyphosis and shoulder internal rotation both tilt scaps anteriorly, and this is the most common reasoning behind impairing shoulder mechanics while throwing i.e. Of course, many reasons could be behind both this kind of posture/deformity and AST (they are interconnected way more often than not).
When many people do biceps curls, they wind up letting their shoulder blades roll forward into an anterior tilted position, which tends to look like rolled forward shoulders and wind up coupled with more thoracic flexion than useful. Also, when people do any rowing variation, they usually go (when pulling past torso) too much back with an elbow – which also causes AST (and strains the ligaments in front of the glenohumeral/shoulder joint).
By rolling forward, it puts the muscles that would hold the scapula against the ribs in a disadvantageous state, specifically muscles like the lower traps, rhomboids, and lats. These muscles aren’t typically over developed, so…
Of course, other causes could play role when we talk about AST (i.e. weak posterior rotator cuff muscles, tight pec major…), but the aforementioned reason(s) is often the overlooked one. So, assess – don’t guess!
- If you have a weak lower trap and a tight pec minor, the resting position of the scapula will bias towards anterior tipping. This is very common among anterior dominant athletes/lifters and computer workers/people in general. Here is one extra video on how to release pec minor. So how do we test for this? An easy way to see it, is to lay on your back. Do your shoulders comfortably rest on the floor? Or is there a gap between your shoulder and the floor? If the answer is yes to the last question, your pec is probably tight in relation to your trap. Or, as we already said, you can assume that you have some kind of tilting (at least tight pec minor and “weak” lower traps too) if you are an anterior dominant athlete/lifter and a computer worker (or spending a lot of time in front of the computer/phone, or simply have rounded shoulders/kyphosis under the influence of gravitation and bad postural habits at least). Or, if you can’t fully overhead your arm from standing position without low back and shruging compensation, or a blocky feeling, it probably means you have it to a degree. As we said, the prone “Y” is probably the best way to strengthen the lower trap (read above for techniqual details). Of course, you can do some variations if you like different vars (or you don’t have some extra back issues). Here you can see one of them: https://www.youtube.com/watch?v=EY6plCRrp14. You just add dumbbells and do it from the standing (a bit bent-over) position in the beginning (bent-over because there is more tension). The position from the video can be tough because (besides including legs) you stretch lats a bit, when squatting deeper, and consequently move arms overhead with a bit more effort (but could be more useful than normal standing position because you tilt torso over a bit – more tension, and fix butt to the wall). Make sure to consciously move shoulders back while performing this drill (helping scaps to tilt posteriorly), and don’t shrug shoulders;
- With seasoned lifters, anterior tilt is a pretty common thing to see as the upper traps and biceps as well can cause the scap to rotate forward (suitable attachments) and over the top of the ribs. We know that training upper traps and biceps is very popular among seasoned lifters, so they need to pay particular attention to these issues. Whatever exercise you do, keep shoulders in neutral position (any plane), as this will help balancing posture at least. When many people do biceps curls, they wind up letting their shoulder blades roll forward into an anterior tilted position, which tends to look like rolled forward shoulders and wind up coupled with more thoracic flexion than useful. Also, when people do any rowing variation, they usually go (when pulling past torso) too much back with an elbow – which also causes AST (and strains the ligaments in front of the glenohumeral/shoulder joint). So, proper technique is key, which you can see above. Don’t worry you will not see any less gains if you do this way (reducing ROM a bit), you can just help your shoulders staying healthy long-term;
- Also, make sure to strengthen rhombs (bent-over DB rowing vars with sticking scaps together i.e.), posterior rotator cuffs (rubber band vars, cuff pull aparts…), and serratus anterior (wall slides, plank reach, reach roll & lift, push up vars with reach…). You can also stretch some “tight” muscles, but remember that proper strengthening is the most important.
For the love of movement,