Stephania Bell, PT, CSCS, OCS
Marshall LeMoine, PT, DPT, OCS, FAAOMPT
Drew Morcos, PT, DPT, OCS, SCS, ATC, CSCS, FAAOMPT
Michael Wong, DPT, OCS, FAAOMPT

Shoulder muscle dysfunction is often reported in the literature related to common upper quarter pathologies. It is well established that “Motor changes in the presence of pain and /or injury present across a spectrum from subtle changes in sharing of load between synergist muscles to a complete avoidance of movement.”

During motor coordination retraining, consider the following paradigm as a way to organize and progress your movement retraining.

1.     Activation or facilitation of established muscle impairments

2.     Exercises that increase middle and lower trapezius activity: Add external rotation component to exercise

3.     To improve Serratus anterior activation with less pectoralis minor activation

4.     For functional serratus anterior activation

5.     To decrease upper trapezius activity while increasing MT/LT activity

6.     Decrease pectoralis minor activity- Avoid closed chain or use open chain elevation with external rotation resistance

7.     Optimal exercise for restoring intramuscular trapezius muscle balance: UT/LT

8.     Optimal exercise for restoring intramuscular trapezius muscle balance: UT/MT

9.     Decrease levator scapulae activity

Shoulder Motor Control | Phase I

1.     Scapula control

2.     Humeral horizontal abduction with scapular control

3.     Increasing elevation with scapular control

4.     Return to function