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Cues That Need To Stop: “Shoulders Down and Back”

One of the most misused and misunderstood cues that I hear many coaches and rehab professionals use is the “shoulders down and back”cue.

Just typing that out damn near made me cringe.

 

via GIPHY

We go through our various courses while earning our degrees being taught that for every 2 degrees of shoulder elevation there is 1 degree of scapular upward rotation. So we get between 50-60 degrees of upward rotation of the shoulder blades with overhead motions. So why cue clients to hold them down and back with any type of shoulder elevation exercise?

Just let the shoulder blades fly!

I believe that there is a misnomer about what is “good” posture. Throughout the day we get into a lot of different postures, but we shouldn’t stuck in one for a long extended period of time. But I digress.

The down and back cue causes scapular and shoulder depression with some scapular downward rotation as well, represented in the images below.

We can see in the top image that he as a very sharp angle of his shoulders, and the green line is showing the inside border of his shoulder blade where he is stuck in downward rotation.

In the bottom image, we can see the collar bones are also depressed with a downward angle going away from the sternum.

This positioning leaves a lot to be desired as a copious amount of different things could be going on. Someone could be dealing with thoracic outlet causing symptoms down the arm, pain symptoms in various areas, and poor glenohumeral rhythm with any type of shoulder motion.

What can we do to improve this positioning?

One of the necessary steps I would take is to refer out to a good manual therapist.

This person likely has tight lats, rhomboids, pecs, and levator scapulae just to name a few muscles that I would like worked on.

Some clients may be experiencing pain in their upper traps, but I would hesitate to perform any manual work there due to the tender spots and trigger points likely being protective tension from the shoulders being depressed.

Along with the manual work being done, I would have these clients do a lot of different exercises that are going to promote scapular movement. Anything that has to do with reaching out in front or overhead are going to be winners.

Here are some of my favorite overhead exercises the promote scapular upward rotation.

With any of these exercises, or their variations, I want the client to put their mind on the shoulder blade and feel it reach long and rotate up and the top of the motion.

Over time, consistent training using proper cueing will help to decrease shoulder depression and improve scapular upward rotation.

But what is normal positioning of the shoulder blades?

I’m glad you asked!

 

The top angle of the shoulder blade should be about even with the T2 spinous process, the inside boarder about 3 inches from the spine, and the inferior angle about even with the T7 spinous process.

For the clavicle, the distal end should be about 1 inch above the proximal end. So there should be a slight upslope from the sternum.

Now as we go into any type of overhead motion the shoulder blades are going to move.

The angle from the spine  and the medial boarder of the shoulder blade to the inferior angle should be somewhere between 50-60 degrees. This should result in the inferior border ending about in the middle of the armpit during full shoulder elevation.

So when doing any type of overhead motion, let your shoulder blades do what they are going to do. The shoulder blades are an important part of shoulder motion, and they have the degrees of freedom to move for a reason.

If you are someone suffering from chronic shoulder pain and need help getting rid of it for good, consider working with me to help you get out of pain and back to doing what you do best.

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