Stop Telling Clients to Squeeze The Shoulder Blades

“Squeeze the shoulder blades.”  I remember learning this cue when I started in the industry.  I also remember using it for many years.  The “squeeze the shoulder blades” cue was supposed to bring people into the proper posture, typically for pulling exercises.  It was also supposedly the way to stabilize the scapula.

But then I realized that was wrong.  As I continued to learn and grow, I started to question whether the intention of this cue actually led to the appropriate result.  I realized that perhaps it even perpetuated muscle imbalances that could get clients into trouble.

Placing the scapula in the right position to create scapulothoracic stability is much more complex than squeezing the shoulder blades together

The fact that I continue to hear this cue being used only makes me hate it more.  Here’s why the cue is wrong and what solutions you can implement to improve scapulothoracic stability.

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SCAPULOTHORACIC FORCE COUPLES

The shoulder joint is complex, and its optimal function relies on equally complex glenohumeral and scapulothoracic force couples for dynamic stability throughout its large range of motion.

Muscle imbalances, strength deficits, and alterations in activation patterns of these force couples can become a biomechanical nightmare that impacts movement, performance and even pain.

Anatomy Trains describes the Scapular X, a sort of scapular crossed syndrome.  One leg of the X is the force couple between the rhomboids and serratus anterior.  The rhomboids act on the scapula in the direction of retraction and downward rotation and the serratus, in the direction of protraction and upward rotation.

The other leg is the force couple between the inferior trapezius and pec minor.  The inferior trapezius contributes to upward rotation and posterior tilt of the scapula.  The pec minor pulls on the acromion process of the scapula pulling it into anterior tilt and downward rotation.

WHAT HAPPENS WHEN WE SQUEEZE THE SHOULDER BLADES

When we squeeze the shoulder blades, we essentially contract primarily the rhomboids.  Don’t get me wrong, the rhomboids are absolutely an important scapulothoracic muscle involved in scapular rotation and stability.  But an over-emphasis on squeezing the shoulder blades and using the rhomboids as prime stabilizers is not the way to go.

As mentioned above, the rhomboids retract and downward rotate the scapulae.  Because of the angle of the fibers, they also elevate the scapulae with assistance from the levator scapula.   

The excessive retraction and elevation of the scapula that results from focusing on squeezing the shoulder blades can also lead to excessive activation of the upper trapezius.  

It is thought that this excessive activation of the upper trapezius can further inhibit the inferior trapezius creating further imbalance with the pec minor.

Here’s how you can really feel what I mean:

-Sit or stand with your arms held out in front of you.  

-Squeeze your shoulder blades just slightly.  

-Now focus on really squeezing them together really hard, like someone was telling you to “squeeze a pencil between them” (perish the thought…).

-Can you feel how the entire shoulder girdle elevates?  

MAKE SURE YOU WATCH THE YOUTUBE VIDEO TO SEE WHAT THIS LOOKS LIKE

For one, this overly retracted and elevated position is not the most advantageous for movement.  Of course, some would argue that it depends on WHAT movement and WHY you are doing it, but we will discuss context later.

More importantly, if the rhomboids become very facilitated or even adaptively shortened, this perturbs the force couple with the serratus anterior.  

And as the upper traps become increasingly facilitated, it becomes increasingly more difficult for the lower traps to activate to a sufficient level to do their job.

OVERHEAD MOVEMENT VS HORIZONTAL PULLING

For overhead movement, the scapula needs to upward rotate and protract.  Still, I have heard the cue “squeeze the shoulder blades” being used for scap pull-ups.

Let me be clear:  

It is not possible to squeeze the shoulder blades, that is, trying to downward rotate and retract the scapulae, with the arms overhead  

We do, however, want to create stable position from which to pull.  I’ll get to that in a minute…

As far as horizontal pulling goes, some might argue that you can efficiently pull with the shoulder blades in a retracted position.  I will argue that focusing on excessive retraction puts you in a position that is not natural for pulling and that will result in the shoulder rolling forward excessively.

WHAT SHOULD WE BE DOING?

The question should always be: what is it that we want the client to be able to do?  I always say a cue only reminds; it doesn’t explain.  It doesn’t teach either and I think that too often cues are being used in the place of actually teaching clients the proper way to move.  

When you say “squeeze the shoulder blades”, what you want essentially is to stabilize the scapula for movement.  As I mentioned earlier, creating scapulothoracic stability is much more complex than squeezing the shoulder blades together.

In fact, an optimal pulling position requires neither full retraction, nor full protraction.  What we want to “set” the scapulae is a subtle balance of the two.  I discuss this at length in my blog article Functional Positions of the Shoulder You Need to Own.

WATCH THE YOUTUBE VIDEO IN THIS ARTICLE TO SEE HOW THIS APPLIES FOR AN OVERHEAD POSITION

I usually teach this by bringing focus to an element of rotation as opposed to having clients focus on squeezing the shoulder blades.  The prone retract & reach exercise is usually the first step to creating this awareness.

The focus is on just peeling or rolling the front of the shoulder off the floor, or rotating the shoulders open, and then slightly reaching down with the fingertips.  You will see that the scapulae will naturally retract, but much less so than if you squeeze the shoulder blades.

Once your client gets the feel for that element of “rotating the shoulders”, they can transfer that slight retraction and depression with their hands on dumbbells or barbells by creating an external rotation torque via the hands.  This will probably remind you of the “break the bar” cue, also a famous one.

One great horizontal pulling exercise for creating that subtle balance of scapular protraction and retraction is the Pendlay row.  Because the barbell starts off the floor, if you squeeze the shoulder blades, you’ll actually pull yourself out of position.  Plus, you can reset at every rep and get a great feel for the position.

CLEAN UP THE CUES

Squeeze the shoulder blades is not the right way to create scapulothoracic stability.  

The scapula serves as a strong base for shoulder movement, but establishing this base depends on synchronous activation patterns of force couples.  These force couples provide the dynamic stability to maintain the joint in a position that will allow the most effective mechanical advantage.

One static posture, like retraction, is not the answer and can even cause problems with muscle balance and activation patterns.

So, stop telling clients to squeeze the shoulder blades and teach them the right way to stabilize.  Once they know the intended result, you can use a cue to remind them, but I doubt this one will be it.  

In fact, drop your ideas and cues that you use in the comment box below and let’s keep the conversation going!

REFERENCES

Page, P. (2011). Shoulder muscle imbalance and subacromial impingement syndrome in overhead athletes. The International Journal of Sports Physical Therapy, 6(1), 51-58.

Mai-Linh Dovan M.SC., CAT(C)
Certified Athletic Therapist
Founder of Rehab-U