Written By: Chloe Wilson BSc (Hons) Physiotherapy
Scapular stabilization exercises are an important part of shoulder rehab.
Whether you have suffered an injury, your shoulder movement is limited or you have noticed that your shoulder blades stick out, known as winged scapula, shoulder blade exercises can make a big difference.
Here we are going to look at the best exercises for scapular stabilization, starting with how to set the shoulder blade in the correct position so you can get the most benefit from scapular strengthening exercises. You will then find a program of scapular stabilization exercises in a range of positions and with different loads to ensure you build up dynamic stability so the shoulder can move and function properly throughout its full range.
The shoulder blades aka scapula, are triangular shaped bones that sit flat on your upper back over your ribs. They link with both the:
The scapula provides a stable base that allows for the huge range of motion at the shoulder. Scapular stability depends on the co-ordinated activity of 17 muscles that work together to ensure correct positioning throughout the shoulder complex as the arm moves. This is known as scapulothoracic rhythm.
If there is weakness in these muscles, it affects the positioning and mechanics of the shoulder complex which can lead to pain, dysfunction and injury. One of the most common problems is “winging scapula” where the shoulder blades lifts away from the rib cage which results in abnormal shoulder biomechanics.
Scapular instability has been linked to around 68% of rotator cuff problems, 100% of shoulder joint instability problems and is a contributing factor in most shoulder injuries. This makes scapular stabilization exercises a really important part of shoulder rehab, but they are sadly often overlooked.
Here you will find a whole program of scapular stabilization exercises from beginners to advanced. There are 5 different groups to work through which get progressively harder.
A. Scapular Setting
B. Scapular Retraction Exercises
C. Wall Exercises For Scapular Stabilization
D. Resistance Band Scapular Strengthening
E. Advanced Scapular Stabilization Exercises
For scapular stabilization exercises to be effective, the shoulder blade needs to start in the right place so the best place to start is with scapula setting. This focuses on building up the strength and endurance of the lower trapezius muscles. Think of them like the shoulder blade’s anchor. As the arm moves, they hold the scapula in the right position and at the correct angle.
The scapular squeeze is the perfect place to start for setting the shoulder blade in the right starting position. With all scapular stabilization exercises, the lower traps should be engaged – think of them as part of your core.
Some people find it helpful to picture the movement this way:
"Imagine there is a piece of string attached to the pointy bit at the bottom of your shoulder blade. Now imagine that the string is being pulled diagonally downwards and backwards drawing the shoulder blade towards the opposite back pocket of your trousers. That’s the movement you are looking for."
Top Tips: a. To start with, just focus on getting the movement action correct. You want the combination of moving the shoulder blades back AND down to be one fluid movement.
b. Focus on using the muscles between the lower part of the shoulder blades rather than the top or middle so you are targeting the lower traps.
c. Try and keep the rest of your body relaxed, with your head resting on the towel, and avoid the temptation to hold your breath!
d. Some people find it easier to have their hands tucked under their hips rather than by their side
You need good strength and endurance in the lower traps to provide a stable base for your shoulder blades, so make sure you can do 4 repetitions, holding the position for 30 seconds each time before trying harder scapular stabilization exercises.
Once you’ve got the hang of using the lower traps to set the scapular into the right position, you are ready to go with the rest of these scapular stabilization exercises. Always start each one with a scapular squeeze to activate those lower traps.
Top Tip: If there is any discomfort in your lower back while you do these, clench your glutes to hold your spine in a more neutral position as you do these scapular stabilization exercises.
Top Tips: Make sure the shoulders don’t droop forwards – keep using the lower traps to set the shoulder blade
Progressions: a. Pulse the arm up and down while you hold the position
b. Hold a weight on your hand while you do the exercise (with or without the pulses). If you don’t have one, use a can e.g. of baked beans or tinned fruit
Top Tip: Make sure you keep drawing the shoulder blades downward and towards your spine throughout, don’t let the shoulder start to droop
Progressions: a. Pulse the arms up and down at the end range of the movement
b. Hold a weight/can in your hand
c. Try this exercise in the “T” position with your elbows straight and your arms out to the side. Make sure your thumbs point up towards the ceiling throughout.
Top Tip: Keep thinking about the area between the bottom of your shoulder blades – that is the area you should be using to maintain stability with these scapular stabilization exercises
Progressions: a. Pulse the arms up and down as you hold the position
b. Hold a weight/can in your hand
NOTE: If you have an injury in your shoulder such as impingement syndrome, a frozen shoulder or a rotator cuff tear, this exercise might be difficult. If so, skip it – you don’t want to aggravate things.
Once you are feeling confident with these scapular retraction exercises, you can make them harder by moving the shoulder through a greater range and taking it further away from your body. This is much more functional as scapular instability tends to cause most problems with activities such as lifting and racket sports, when the shoulder is moving through a large range of motion, away from the body.
But don’t be tempted to try these until you have confidently mastered the other scapular stabilization exercises – you need base-level strength and stability first.
Start out doing these without weights and once you feel confident, progress to holding a weight in your hand. Unless you have a narrow bed or table to do these on, you’ll need to work one arm at a time.
Lie face down, either resting your head on a towel or on your other hand, letting your arm hang down by your side. Always start by setting your shoulder blades - keep thinking about pulling them towards the opposite back pocket of your trousers.
Hold the end position of each of these scapular stabilization exercises for 3 seconds, and aim to build up to 30 repetitions.
If you have shoulder blade instability or winged scapula exercises against the wall can really help. Pushing against the wall while doing these scapular stabilization exercises helps to fix the shoulder blade in the right position making them a popular solution for how to fix winged scapula.
Progressions: a. Gradually increase the size of the circles
b. Vary the starting position of the ball e.g. change the height or move it sideways
Progression: Vary where on the wall you place your hands e.g. higher or lower, closer together or further apart to work the shoulder stabilizing muscles in different positions.
Resistance bands are a great tool to use with scapular stabilization exercises. They are cheap, versatile and easy to use and are an extremely effective tool for increasing scapula strength, stability, control and mass.
Now let’s look at some of the best exercises for scapular stabilization using a resistance band.
Progression: Add in some pulses as you hold the position
Variations: Change the height of the band by changing what you fix it to.
Progression: Pulse the arms in and out as you hold the position
Variations: You can bias different shoulder stabilization muscles by changing your hand position e.g. palm up, palm down, palm in, palm out.
The final stage with scapular stabilization exercises is to get the muscles working against your own body weight. Not only does the shoulder blade need to provide a stable base when the arm moves, it needs to do the same when using our whole body.
Not only will these exercises strengthen and stop your shoulder blades sticking out, they are also great for building upper body strength too.
Top Tips: Don’t let your lower back arch and maintain the scapular squeeze throughout
Progression: The further your feet start from the table, the harder the muscles will have to work
Top Tips: Keep your tummy muscles tight and don’t let your back arch
Progressions: a. Start in a plank position, on elbows and toes as shown
b. Start in a half press-up position, on hands and knees as shown
c. Start in a full press-up position, on hands and toes as shown
Alternately retract and protract the shoulder blades.
Top Tip: Keep your back and pelvis stable and straight throughout
Progression: Hold a weight in each hand as you do this exercise
The scapular stabilization exercises will help you build up shoulder blade strength and stability and are a great way to fix a winged scapular.
Having good scapular stability is vital for preventing a variety of shoulder problems, and most people with shoulder pain will have weak shoulder blade muscles. Winged scapula are often linked with frozen shoulders, shoulder impingement syndrome and rotator cuff tears.
Scapular stabilization exercises should be incorporated in most shoulder rehab programmes alongside rotator cuff strengthening work and shoulder mobility exercises. It often takes 1-2 months of doing daily scapular stabilization exercises to notice a real difference, so stick with it - it will be worth it!
Page Last Updated: 28/09/2021
Next Review Due: 28/09/2023
1. Archives of Physical Medicine and Rehabilitation. Effects of Scapular Stabilization Exercise Training on Scapular Kinematics, Disability, and Pain in Subacromial Impingement: A Randomized Controlled Trial. Elif Turgut, PT, PhD,a Irem Duzgun, PT, PhD,a Gul Baltaci, PT, PhDb. 2017
2. Physical Therapy & Rehabilitation Journal. Critical and Theoretical Perspective on Scapular Stabilization: What Does It Really Mean, and Are We on the Right Track? Kevin J. McQuade, John Borstad, Anamaria Siriani de Oliveira. August 2016