foreign
ERS we're back working on the winged scapula if you missed part one go back and watch that
because that's it that's a little bit more information plus the supine uh position and
now we are doing the sideline and the prom position so now that he's sidelined you need
to make sure that his leg is being supported with a bolster in its neck you want to make
sure the cervicals are you know supported so the main focus of this video is to work on the uh
serratus anterior which is the main muscle for a wing scapula so what you want to do is you want
to open up the arm you know and expose this area and we already kind of warmed it up from when we
did the supine but I want to do a little bit of the skin rolling remember skin rolling is done
before you apply any oil or anything like that and just maybe even some sea bowing
to warm up the tissue once the tissue is warmed up then you can start
using some oil some airflow arrange petrissage and this is the one that you can tell that it
was a little bit more wink because it was more separate from the from the midline of the body
this was like over a little bit over three inches from the spinous processes and the
serratus anterior originates from ribs two three four five six seven eight nine and it
inserts on the front part of the scapula here so we really can't get to it you know this is
kind of like the medial part of the scapula that you can get some of the rhomboids there but you
want to make sure and warm up this muscle and I love the sideline position because
you really expose the serratus anterior and all the origins here on the anterior part
so you want to make sure and warm it up and remember there are three main trigger points
for the serratus and one is like right underneath you know the uh the armpit and another one reverse
like right around here and another one might refer down the arm too so there's a trigger points here
and if you're gonna if he does have a trigger point we're going to use our
trigger point tool which I know he had one somewhere around here when he was supine
right there okay right there's one and you want to hold it gently you never want to take the
pressure above a five because it might be too much then you over stimulate the nervous system
and remember relaxation begins with the nervous system so you want to relax the
nervous system not make it worse and of course you ask your client always to take
a deep breath you can hold it up to 90 seconds and then just kind of soothe it afterwards
you can go back to it from a different angle like we we approached it from the Supine position now
I'm approaching it from the sideline position and you can also approach it from the prone position
so you're you're getting to the same trigger point from three different different places because the
tissue Falls differently from different positions so you can do some ringing here
also of the serratus now once you've moved it and you've warmed it up and you can also you know
um use this tool to relax some of the tissue here
and if you can I'm not big enough but if you if you can you know hold at
your waist this arm at your waist and then move it
you know at the same time that you're doing this that that will be great but like I said
I'm really short I'm only 4 11 so it's kind of hard for me to do some of these movements now
once you've warmed it up now you can get ready to do some of the movements of the scapula so you're
going to let his arm Bend a little bit bend it so it really shows the you know the scapula here
you can even see a little bit of the hollow part here so then you're gonna uh hold his arm right
like right at the medial part of the scapula and you're going to try to you're going to elevate
and retract you know and then retract protract retract and protract you're going to kind of
hook actually would have been better if I would have done it before the oil so but these are
the movements so you go protract the scapula out then retract and then Elevate and depress
Elevate and depress these are the movements of the scapula so you want to
protract right like from the rhomboids too that's the what the rhomboids move the scapula
they're protract and then Elevate from the levator and the upper trap and then depress okay so those
are the movements that you can do with your client and try to move that scapula as much as
you can to try to get some movement also you I'm doing this like trying to grasp the scapula here
I'm going like anterior because this is another good way to even get to the subscapularis so
the subscapularis and the serratus are like almost right next to each other the serratus
sits against the ribs and the subscapularis is on the anterior part of the scapula so they're
very close together in proximity but they're in the front part the anterior part of the scapula
so this movement I'm just trying to grab the edges of it and like I said the whole point is to loosen
that scapula to move it as much as possible so that you can get rid of that Wing scapula
and this is another way that this isn't your this is your broken wrist yeah yeah it is okay
I don't want to grab the wrist and okay there's another way to stretch do a good stretch
you always want to assist I'm going to sit down here so I can really work in detail
with some of the trigger points so I'm going to get my tool here and just go back again
and work some of the trigger points going back to the same trigger point
I hold it there he breathes for in a few seconds
I usually move it around in a circular motion and I move you know like all around like in
a diameter of about an inch just to make sure that I'm getting all the fibers that
are you know associated with that and also the bevel tool here in between the
ribs this is another great way to go from the ins from the origins of the serratus
I'm going in between each rib
this is also very good to work on people that have hard time breathing because these this is a main
muscle too to open up your rib cage along with the intercostals so this tool is also used for this
and if you can grasp from the uh from the spinous processes out
try to hook your fingers in between here you're also working the rhomboids
the insertion of the rhomboids and see these two I put this on yeah there you go try to hook from
here so you're already working the rhomboids and you're also working the serratus posterior
Superior because it's below the trapezius below the rhomboids so you're working that muscle too
and while you're here you can also work the levator
originates here in the transverse processes
c23 and 4 so you want to make sure and work this area here
and uh upper trap and the insertion of the levator is right here too
so these are the muscles that move the scapula remember it's the rhomboids minor major serratus
uh levator upper trap and middle trap and lower traps all that all three of all three parts of
the fibers move the scapula and the PEC minor so there's six muscles that move the scapula even
though 17 actually more like 20 insertive you count some of the I hyoid muscles but
17 to 20 muscles attach on the scapula but only six move the scapula so anyway now we're going
to turn him prone and remember that the trapezius is like from T12 covers just a
little bit of the scapula and it goes all the way to the chromium process and then here also
by the occipital Ridge so you want a massage all these muscle attachments here and also
the levator remember the levator elevates along with the upper fibers of the trapezius foreign
I'm doing this clasping up you can get to the origin
and the insertion of the levator I'm I'm pushing up on the scapula so I can
really get to the anterior part of the scapula right there with insertion of the levator is
a good way to get to the elevator sometimes it's a little stringy and also grasping the upper trap
and now you want to work on the rhomboids
the origins of the rhomboid miners from C7 to T1 and then the major is from t22
T5 so it looks the fibers go this way so you want to go to the origins and it inserts right here
and then below that you have the serratus posterior Superior
below the the most superficial is the traps then the rhomboids then the serratus posterior Superior
okay and another one that you can do is open up and expose the serratus anterior right here
and go down like all I'm doing is going down
and then you go Superior to some long strokes all the way all the way up to the chromium process
just trying to relax that serratus as much as you can
another movement too that you can do is from the opposite side of
the table I will go to this side and do the raking here on the serratus remember
the serratus originates on the anterior part from ribs two three four five six seven eight
and some people all the way to nine so you want to do some raking
and the whole point is just to release this muscle and you know sometimes the long thoracic
nerve which passes through the it innervates the serratus anterior sometimes you know of is
trapped and it causes a freezing of the muscle or tingling or lack of movement so you want to make
sure and warm up the serratus anterior which is the main one for um Frozen I mean enough yeah for
the wing scapula so now that you're here you know you want to again you want to grab the scapula I'm
going to the inferior border of the scapula and just pushing it up and I'm also grasping
at the Superior part of the scapula and just trying to get some movement here of the scapula
so I'm elevating and then I Elevate with this one and then I depress by pushing it back down
and I'm using my body weight kind of to sit down because that way I can get some more movement
on his scapula
it's all about creating and loosening up loosening
up the fascia all around that scapula all those six muscles that move the scapula
and I really like this one the best where you just let the arm hang down and you know go
back and you swarm it out because this is kind of cold so warm up this tool and go all the way down
you're going even over the infraspinatus
Terry's major in teres minor the the rotator cuff muscles you know they all attach on the
scapula but they don't move the scapula you've got your teres um major and teres minor and
supraspinatus infraspinatus all those muscles but they don't move the scapula they just attach on
the scapula so make sure you know the difference we're working on the muscles that attach and
move the scapula which there's only six of them so that's what we're trying to do here
and again you always want to assist the arm and bringing it back and reaching closure
with your client you know after you beat them up whoops after you've beat them up and gone to do
some deep work you want to go back and do some soothing work my work is mainly neuromuscular
you know addressing the trigger points oh the one another one of the trigger points here for the uh
serratus is along this area here usually where the insertion is of the rhomboids tube so you want to
make sure and check this point here so you make sure that they don't have a trigger point there
but if you address the trigger points and that's a movement it should really help somebody with
wing scapula so we have part one where I do a little bit more explanation and show you how to
measure to see if they have the wing scapula so make sure to go back and watch part one
and the part two is the prone and the sideline so until the next time create a great day foreign
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