The Joint Ventures' Blog

Scapular Involvement in Overhead Athletes

Thursday, March 22, 2018

Spring seems to be the overhead athlete season. It marks the beginning of baseball, softball, lacrosse, tennis, and the CrossFit open, among others. Great demands placed on the shoulder, scapula (shoulder blade), and thoracic spine (middle of the back) during these sports often brings on the onset of shoulder pain. However, not all shoulder pain is directly related to the shoulder, and may in fact be a combination of shoulder, scapula, and spine coordination.1

The scapula helps the shoulder to move overhead and retain control of that movement alongside the muscles. When this movement isn’t well controlled, or the movement has changed in some way, it contributes directly to shoulder pain.1 This may be caused by lack of muscle flexibility or strength, or by decreased movement at the shoulder or clavicular joints (the "clavicle" is the medical term for the bone commonly known as the collar bone).1.2

It has been demonstrated that when the thoracic spine is flexed forward, the scapula will rest in a slightly altered position - elevated and pointed forward. This leads to less shoulder and scapula movement and decreased force production out of the joint.3 These changes may cause enough altered movement over time to cause an injury.


As Physical Therapists, our interest lies in both the prevention of injury and the rehabilitation from injury. If you plan on ramping up your training, increasing your weight, or starting a new sport, try these exercises below for shoulder health:

  1. While lying over a foam roller, grab a light weight (up to 5 lbs) and raise your arms straight above you at chest height. Keeping your elbow extended, lower one arm toward the ground overhead with good control.  Then bring the arm back to the starting position.  Repeat with the other arm.  Do each arm 10 times.
  2. Lie on your stomach without weight, arms outstretched overhead. Pull your arms down to form a "W" by squeezing your shoulder blades together.  Your wrists should end at shoulder height.


Shoulder and spine health is integral to having a successful sporting or athletic season. If you have questions, please contact our office at 617-536-1161 or email Martha Adams, PT, DPT at



  1. Cools AM, Struyf F, DeMey K, Maenhout A, Castelein B, Cagnie B. Rehabilitation of scapular dyskinesis: from the office worker to the elite overhead athlete. Br J Sports Med 2014; 48:692-697.
  2. DePalma MJ, Johnson EW. Detecting and treating shoulder impingement syndrome: The role of scapulothoracic dyskinesis. Phys and Sportsmedicine 2015; 7: 25-32.
  3. Umer M, Qadir I, Azam M. Subacromial impingement syndrome. Orthop Rev (Pavia) 2012; 4(2): e18.

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