SCAPULOTHORACIC RHYTHM
Fancy physio words for : The Shoulder Blades
Sandra Oxtoby, PT, MScPT, BKIn, BDN
Physiotherapist at Equus Physio, Grand Prix Dressage Rider,
World Western Dressage Reserve Champion, NCCP English Competition Coach
Shoulders are one of the most common injury sites amongst riders.
Now, how many muscles attach to the shoulder blade (scapula)?
17!
Which is the most common to injure?
Supraspinatus! (1 of 4 rotator cuff muscles)
Shoulder pain that occurs due to trauma (e.g. falling off a horse, when a horse pulls back, etc.) can commonly lead to a tear (graded on a 3 point scale based on the amount of fibers that are torn) in supraspinatus.
However, what we are going to discuss today is shoulder pain with NO obvious cause (fancy physio words: slow insidious onset). The pain where the rider “has no idea what happened!?!?” is due to postural repetitive microtrauma. This is when an imbalance in the 17 muscles attached to the scapula occurs. This is the equestrian with the inability to fight poor posture, and experiences chronic rounded shoulders. Biomechanically, this leads to increased length, strain and demand on the SUPRASPINATUS, causing inflammation commonly referred to as ‘tendonitis’ or ‘tendinosis’.
“Do not confuse misuse, with overuse”
- Movement Maestro
Common complaints in these equestrian shoulder patients include, but are not limited to:
Pain/inability to reaching in the back seat
Pain/inability to lift a saddle on
Pain/inability when doing ground work/lunging
Pain/inability to brush a horse’s back
Pain when taking the contact on the reins
The shoulder blades ‘wing’ off the back, as seen in photos or the mirror
Causing the horse to be heavier in one rein
“Let’s not use PAIN as a measure stick of tissue health”
-Chiro Strength
Consider the scenarios below:
Coach yells “pull your shoulder back!”
You try increasing the tension with all your might in your neck to hold them there, and arch the crap out of your low back. Despite your efforts, they round right back forward because your retractors aren't activated.
Coach yells, “don't wiggle your hands!”.
You try really, really hard to tighten your forearms to hold them in place, annoy the crap out of your horse, but you don’t have control of where they are in space.
Coach yells “no chicken wings!”
You suck those elbows to your body, but they slowly drift back into that poultry position.
Coach yells “for the 100th time, QUIT pulling”, and so on and so on.
Why does it never stop? Because you can’t stabilize your shoulder when your brain doesn't know how to control your scapulothoracic rhythm.
“If it hurts or you can't perform a movement, don't do it. Do it differently and do it better”
- Author Unknown
Let Equus awaken your rhythm and teach effective muscle memory patterns. Learn activation and control so your horse is happy, you decrease risk of injury and most importantly - that coach shuts it!
Equus Physio's Approach:
Assessment of muscle imbalance in these 17 muscles and beyond.
Training motor control of retractor muscles (therapeutic home exercise plan prescribed and emailed with pictures/video and descriptions)
Release of muscle trigger points (massage, cupping, dry needling)
Pain modulation (interferential current, manual therapy)
Facilitation of healing (ultrasound, laser, shockwave)
Movement of joints in the limbs and spine to the proper position
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