![]() This strengthens all the movements that we need to have safe healthy shoulders, with a big emphasis on the lower traps, serratus anterior, mid traps(scapular retraction), posterior deltoid, and rotator cuff muscles.The Latarjet procedure with transfer of the coracoid process and its attached conjoint tendon is a well-established surgical technique for the treatment of anterior glenohumeral instability in patients with anteroinferior bone loss and/or high risk for recurrence. The YTA targets the force couples that occur in the shoulder. We must acquire both to be safe overhead, and/or to reach full athletic potential. One is not more important than the other. ![]() We need to have adequate muscle length and strength. We need to understand that the shoulder is the most mobile and the most prone to instability. If they are already shortened, then they are in an ineffective position to produce the force necessary to stabilize the shoulder. Muscles can only pull, and to do that, they shorten. So if the scapula is moving incorrectly, lets say winging out due to lack of serratus anterior and lower trap weakness, then it shortens the lever arm of all of the rotator cuff muscles. The labrum acts as a suction cup holding the shoulder in place. Muscles exert force distal to proximal so they pull the shoulder towards the socket, which is the labrum. The rotator cuff muscles all attach from the scapula to the shoulder. ![]() Now here is how this relates to the rotator cuff. If this is the case, we will see possible winging out of the scapula. We usually see weakness in the serratus anterior and or lower trap. The upper and lower traps, and the serratus anterior. There is a force couple between 3 muscles for scapular elevation. Now, lets go back to the scapula elevating and upward rotating. What happens if they don’t do their job? That’s right, narrowing of the subacromial space=impingement=ouch. ![]() Their job is to prevent upward migration of the humeral head. They insert on the lesser and greater tubercles of the humerus. The rotator cuff muscles, teres minor, subscapularis, supraspinatus, infraspinatus all originate on the scapula. It also leads to decrease performance, ie having a really hard time with snatch or OHS. Narrowing of this space leads to impingement-or any shoulder –it is:). The scapula must elevate from 0-90 deg shoulder flexion and upward rotate 60-180 degrees to maintain space between the ac joint and the shoulder as the arm goes over head. Clavicular elevation for the first 90 deg of shoulder flexion/abduction, and then clavicular posterior rotation from 90-180 degrees. Without getting too complicated, there are 3 main osteokinematic movements(bone movements you can see) that you need to be aware of. To better understand why this is important we need an anatomy and biomechanical review of the shoulder. For just about every shoulder issue out there, physical therapy will start scapular strengthening as soon as possible. Everyone with shoulder problems has some form of scapular dyskinesia. Not everyone that suffers from this has any symptoms of shoulder problems. Scapular dyskinesia is improper or inadequate movement of the scapula. ![]() We do this to activate and strengthen the scapular musculature, which in turn helps correct what is called scapular dyskinesia. We do an exercise known as YTA’s for 3×10 usually before we do overhead movements. At Outlier CrossFit in San Diego, as well as Crossfit Coronado, we have been using crossover symmetry bands in our warm ups. ![]()
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