The All Important Lower Trap
Posterior tilt often getslittle play when it comes to talk about healthy shoulders. The lower trap functions to posteriorly tilt the scapula to allow clearance in the subacromial space. Kibler has stated that posterior tilt of the scapula may be the most important aspect to injury prevention in the shoulder of an overhead athlete.
The subacromial space is an important one. It's the gap between the humeral head and the acromion process where important structures like the rotator cuff and bursa reside. Decreasing that space can create a host of problems, ranging from irritation to impingement and rotator cuff fraying to severe inflammation. Without posterior tilting the scapula the arm essentially runs into a wall in overhead flexion. Overhead motion really isn't overhead motion when the arm stops in front of the face.
Limiting the ability to get overhead can open another can of worms in the form of pain resulting from altered mechanics, compensation patterns, and eventually injury concerns. Letting the scapula posteriority tilt along the thoracic spine opens up space for the humerus to do its job.
Upper Crossed Syndrome
With how much athletes sit these days and stare at screens its no wonder many lose the ability to posteriorly tilit the scapula. Lacking posterior tilt fully ties in with physiotherapist Vladamir Janda's Upper Crossed Syndome from decades ago. Janda's Upper Crossed Syndrome essentially is where the upper body posture becomes rounded forward. This results in inhibited, long, and weakened backside. The frontside becomes shortened and overactive pulling the shoulders and head forward. Upper Crossed Syndrome happens as a result of lifestyle, training, daily posture habits. etc.
With that being said some of the best ways to regain the ability of the lower trap and posterior tilt are a 3-step progression.
- Soft tissue work
Lengthening the pectoralis major and especially minor can be vital in the attempt to break the chain of scapular anterior tilt and poor posture. The pec minor attaches to the scapula at the corocoid process. Any dysfunction leads to altered scapular mechanics. Eliminating an overactive pull that leads to anterior scapular tilt should be the first priority. In a study by Lee on the effect of correcting scapular tilt it was found that, “posterior tilting exercise after pec minor stretching was the most effective method for eliciting greater lower trap muscle activation among the interventions tested.” It's tough to posteriorly tilt the scapula is the scapula won't posteriorly tilt because of an overactive pec minor. Get moving correctly first, then activate and build strength.
- T-Spine Extension
Full overhead motion requires the ability of the t-spine to extend. The scapula rests on the ribcage. Poor thoracic extension places the scapula at a disadvantage to move. An athlete unable to extend through the t-spine will be unable to effectively posteriorly tilt the scapula resulting in less than stellar overhead ability. The kinetic chain comes into play on everything.
Thoracic Extension for Overhead Athletes
- Posterior Tilt and Lower Trap Activation
The lower trap is what drives posterior tilt of the scapula. The Y exercise is certainly a staple in our lower trap training. Studies show the lower trap is most active when the humerus is in line with muscle pull itself. For most that is around 135 degrees of abduction. There are a multitude of movements possible with that knowledge. The following is a progression I use with athletes to connect the mind to the movement of posterior tilt. Dr. Caleb Burgess has some excellent ideas when it comes to the lower trap training and I have adapted some of his movements into our progression.
Posterior Tilt + ER
Posterior Tilt + Y Pickups
Posterior Tilt + Full Y
The rotator cuff gets all the play when it comes to talking about injury prevention with baseball players, but without a strong foundation of the scapula, the rotator cuff means little. Two-thirds of rotator cuff problems and 100% of shoulder problems can be traced back to the scapular stabilizers—most importantly the lower trapezius. Creating scapular control is often easier said than done. Many coaches prescribe exercises, but few focus time and attention on their execution. Focus on creating healthy postures, and efficient scapular movement and watch athletes stay injury free.
- Kibler, W. B. “The role of the scapula in athletic shoulder function.” The American Journal of Sports Medicine,1998;26(2):325-37.
- Lee, Ji-Hyun, et al. “The Effect of Scapular Posterior Tilt Exercise, Pectoralis Minor Stretching, and Shoulder Brace on Scapular Alignment and Muscles Activity in Subjects with Round-Shoulder Posture.” Journal of Electromyography and Kinesiology, vol. 25, no. 1, 2015, pp. 107–114., doi:10.1016/j.jelekin.2014.10.010.