Supine Weighted Scapular Protraction
What?
This is a PRI technique for scapula thoracic stabilization during thoracic flexion. It is a supine technique that facilitates thoracic flexion, without depending on muscles that posteriorly rotate the pelvis. It’s a good technique to use with the posterior exterior chain (PEC) oriented patient who is having difficulty reaching and flexing shoulders without extending the back first or concomitantly. Muscles that are activated include the pectorals, the triceps, the lower trapezius, the serratus anterior and the abdominals.
Why?
The ability to reach with good thoracic stabilization requires cooperative function between the abdominals for diaphragm and rib cage opposition and the scapula protractors. Often, upper extremity weight, extensor back tone, paravertebral overdevelopment, paradoxical breathing patterns, the diaphragms influence on the thoracic-lumbar spine, and the latissimus dorsum diminish thoracic stability and support of the scapula and place the cervical and cranial musculature in a position to become primary agonistic shoulder elevators and supporters. These individuals, who are often going through shoulder and cervical rehabilitation from trauma or repetitive upper quadrant activity, cannot disassociate thoracic extension from scapula protraction. Consequently, they develop dysfunctional use of the non-scapula humeral internal rotators and non-thoracic scapula stabilizers and depend on thoracic humeral internal rotators, cervical scapula elevators, and accessory muscle for forward, elevated upright upper extremity function. This technique provides these individuals the direction and guidance to reduce these primary substitution patterns that become interferences for all appendage or extremity non-stressful function. Before one can learn how to manage supination, pronation, and extension of the forearm and the wrist or internal rotation, flexion, and abduction of the shoulder, appropriate thoracic-scapula function must be experienced and pre-exist.
When?
This technique facilitates thoracic flexion with pectoral and serratus anterior function. Therefore, it is a good technique to introduce posterior pelvic rotation, normal cervical lordotic function, and abdominal position for diaphragmatic opposition. Without needing to engage the glutes, hamstrings, abdominals or digastrics first. Reaching and squatting requires elbows and knees to move forward, without the center of gravity going forward. These are strong PRI concepts and this technique introduces how to use integrative opposition muscle to gravitational influence in the early stages of developing thoracic scapula position and scapula thoracic function.
Where?
This technique encourages thoracic-mediastinal motion required for maximal scapula stabilization and control. It should be considered, early on, in the PRI process of reducing forward head postures, scapula suspensory strain and cranial-cervical-thoracic compression syndromes. Gravitational influence is placed on the musculature responsible for rib kinematic restriction during scapula protraction and not on the musculature that promotes rib external rotation and protraction when in upright positions. The former is necessary for reduced strain on the latter.
Who?
Those who experience symptoms of, or are associated with, thoracic outlet syndrome, cervical-mandibular whiplash, shoulder instability or impingement, chronic fatigue, upright back strain, interscapula weakness, precordial catch or tietze syndromes, groin impingement, and cervical or thoracic radiculopathy. An excellent technique for the PRI clinician who is having difficulty in establishing feed forward thoracic position during right low trap and right tricep programming.
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