Written by: Kevin Cann
This article is inspired by the numerous athletes and clients that have come into my office complaining of shoulder pain. One thing that I have noticed in this group is that almost all of them have increased tone in their upper traps.
This is not too hard to believe, as the modern day lifestyle puts us in a position to get the upper traps over dominant. We sit at our desks hunched over all day long. In this posture we shrug our shoulders up to our ears causing our upper traps to contract slightly. Then, 17 times every minute we take a breath in raising our shoulders even closer to our ears.
Then there are some of us that go to the gym and do direct upper trap exercises. I even saw a meme on T-Nation not too long ago that read “Traps are the new abs.” The problem with this is our upper traps become so strong, while the muscles they need to collaborate with can’t keep up. This alters mechanics at the shoulder joint and can lead to pain and injury.
One of these muscles that gets overlooked is part of the same family of the upper traps. This muscle is the lower traps, the forgotten little brother of the upper traps. The lower traps are responsible for depressing the scapula and helping to stabilize the scapula on the rib cage.
During an assessment, the majority of shoulder pain clients demonstrate significant “winging” of the scapula during movement and have noticeably weak lower traps. Winging is when the scapula actually rotates away from the rib cage. When this happens we are demonstrating an inability to stabilize the joint.
Many clients and athletes that present with shoulder pain fail an overhead arm assessment and lack shoulder internal rotation. The upper traps, lower traps, and serratus anterior need to work together to get the arm overhead properly. When one of these becomes stronger than the others our fluid movement is going to be altered. Also, if we do not have balance amongst the muscles in the shoulder, we will not be able to centrate the head of the humerus in the glenohumeral joint. This will also lead to dysfunctional shoulder mechanics and can lead to pain or injury over time.
The inability to get our arms overhead can negatively affect our ability to overhead press. However, the inability to properly centrate our humerus in the shoulder joint can leave weight on the bar in all of our lifts, including the squat and the deadlift. In these lifts we want to depress our scapula. With the upper traps dominating the lower traps, this is very difficult. It also makes it difficult to engage our lats.
According to Dr. McGill our lats play a major role in spinal stability during heavy lifting (1). Most anatomy textbooks show the lats passing right over the scapula. However, research has shown something a tad different.
Researchers looked at 100 cadavers and the potential role that the lats play in shoulder stability. The amazing thing is that not everyone is structurally built the same way. 43% of the cadavers actually had a direct anchor of the lats onto the inferior angle of the scapula, and 57% had a fascial connection or a linking bursa between the lats and the inferior angle. Having this direct connection to the shoulder blade shows that the lats may not only be a major stabilizer of the spine during movement, but also the shoulder. The lats insertion on the humeral head also ranged a bit from person to person. The researchers concluded that that the tendon insertion of the lats may play a direct role in helping to stabilize the shoulder joint (2).
If we are not maximally utilizing our lats during lifts, we will not be able to maximize our strength potential in the lifts. Our body will always choose the path of least resistance and this will be seen with a shrugging action at lockout for a deadlift. You will also see more shrugging into the bar to get the back tight when squatting. Neither of these scenarios is ideal and getting into better positions will only make you stronger.
The first thing that we want to do is to decrease tone in the upper traps. Rolling out the upper traps with a barbell for 2-5 minutes per side is effective. Set a bar up in a rack with some weight on it so that it does not come out of the rack. Look away from the side being rolled out and start smashing up that tissue.
After we decrease tone in the upper traps, we want to mobilize positions we struggle in. I like Dr. Starret’s Banded Bully stretch here, as it has the banded distraction to help loosen up that posterior shoulder capsule that tends to be tight, but it also continues to stretch the upper traps. After we stretch we want to do something active to make the new ROM stick. Wall slides are a great exercise here to get these muscles to work together. The wall is great because it disallows the winging of the scapula and ensures everything is in the right position. This exercise also stretches the pecs, which is important due to Janda’s Upper Crossed Syndrome.
After wall slides I like to do some type of exercise that will provide some rhythmic stabilization of the shoulder. Typically, when we have upper trap dominance we get a little dysfunction in the cuff. Most people will attempt to do some weighted shoulder external rotation exercises when they get shoulder pain, but this is not really helping the issue.
Our rotator cuff muscles are small, they do not typically become weak, unless there is some type of direct trauma to the tissue like surgery. The problem with the function of the shoulder lies in position and timing of the muscles.
We need the rotator cuff to fire first and optimally centrate the humerus into the shoulder joint. The upper traps will overpower the rotator cuff when they have a lot of tone, pulling the humerus superiorly in the joint. At this point the cuff is placed at an ineffective position to stabilize the joint, and the larger muscles begin to take over that role. In this scenario we often see tenderness or injury to the labrum and/or biceps tendon.
After we get our body into a better position, we want to reestablish the timing of the muscles and force the rotator cuff to do its primary job of stabilizing the humerus in the joint. Bottom up KB carries are a great exercise here to stabilize the overhead position. I also like TGU, where when we get to the halfway point (hip bridge, shoulders stacked, and one hand on the ground) we perform some neck rotations. By looking down at our hand and up at the KB repeatedly, we stretch the larger muscles and force the rotator cuff to actually do its job.
Our shoulders take a beating from life and from training. Almost everyone that comes into my office complaining of shoulder pain has upper trap dominance. This can be leading to shoulder pain as well as not allowing us to maximize our potential in the lifts. Decrease muscle tone in the traps, stretch dysfunctional positions, and strengthen movements 2-3 times per week.
A good manually trained PT can assist by utilizing soft tissue work, GH mobilization and occasionally trigger point acupuncture needling
Thanks for this great post. I try to do wall slides during the day as a break from all of my computer/desk work to help move my tissues around… and it’s done wonders.
Also feels amazing!