The Shoulder Girdle: How It Functions & How It Can Effect Shoulder Pain

The shoulder girdle consists of the collar bone and the shoulder blade. They form a “u” shaped structure that has only one joint attaching it to the torso (the sternal clavicular joint) at either side of the top of the breast bone. It is this structure and it’s relative skeletal freedom from the torso which allows us to have so much freedom of movement in the shoulder joint.

The shoulder girdle is attached to the torso through various muscles. At the front of the body the pectoralis major and pectoralis minor. On the back it is attached to the torso by the upper/middle/lower trapezius, levator scapula and rhomboid major and minor and latissimus dorsi. The serratus anterior attaches to the bottom corner of the shoulder blade and wraps around the body to attach to the ribs at the front of the torso.

Ideally the muscles at the front of the torso are balanced out by the muscles at the back of the torso so the shoulder girdle is in a neutral position, with the shoulder joint being aligned at the sides of the torso & the shoulder blade laying flat on the back over the back of the rib cage. This positions allows for the greatest range of movement in the shoulder joint.

With the focus in today’s society requiring so much time working at a desk/computer and with the trend leading to a more sedentary lifestyle, the balance between the muscles of the front of the shoulder girdle and the back of the shoulder girdle is often compromised. Generally the pectoralis major becomes short and tight as we hold our arms forward of our bodies to accommodate typing on a keyboard much of the day, add to this time spent driving to and from work.

This constant forward carriage is caused by the tightening of the pectoral muscles leading to the muscles of the back of the shoulder girdle becoming excessively long and tense as they try to accommodate the forward carriage of the shoulders. The middle and lower trapezius muscles lengthen allowing  the shoulder blade to be pulled from the middle of your torso to the sides while the upper trapezius shortens drawing the shoulder blade higher on the ribcage then is normal. This often leads to pain and tension in the rhomboids (between the shoulder blades) and in the levator scapula (up the back of the neck) as well into the upper shoulders.

In addition to the pain caused as a direct result of this forward carriage of the shoulder girdle, there can be secondary pain in the shoulder as the alignment of shoulder joint is compromised.

To correct the alignment of the shoulder girdle you must first find out what is causing it. In general, it is a short tight pectoralis major. If this is the case the first corse of action is to stretch out the pectoralis.

In addition to stretching you will also want to do focused strengthening of the middle and lower trapezius muscles.