The shoulder blades or scapulae have muscles that extend to the neck, thoracic spine, ribs and shoulder. The shoulder blades, therefore, can influence these other regions. Having control/mobility over the scapula would thus be a potential area to work on if you are having problems in these other areas.
I often have my athletes and my desk athlete’s perform scapular circles if they have any problems in these regions. They are easy to do and can be done anywhere.
Shoulder blade / scapular circles (CARs)
Shoulder blade circles/scapular circles (CARs) can and should be performed with the arms in any position.
To show the movement of the shoulder blade I will perform this movement, in the video, with my arms out in front of me. I will only move one arm so you can see how much the shoulder blade contributes to the movement. Keep in mind you can perform this exercise with both shoulders simultaneously.
I often start my athletes off with their hands resting on their laps. This tends to be the easiest way to start. As they get more accustom to controlling the movement of the shoulder blade the arm can be placed in different positions.
start by pulling the shoulder blades together. Once you’ve hit your max then keep the shoulder blades and raise them up as high as you can. Once you have reached your max then round/reach the shoulder blades forward as far as you can, keeping the should blades up. then when you reach the end point keep it there and drop the shoulder blade down.
Perform this movement slowly.
Take about 30 to 60 seconds to complete one circle.
A number of years ago i wrote a post looking into the research of whether or not there is any harm in cracking your knuckles. An update on the subject is needed since knowledge can change over 6 years.
Chronic Cracking of your Knuckles and Arthritis
There isn’t much more research in chronic knuckle cracking and arthritis since I last posted. Two new papers were found during my search on this topic.
This study took 28 people who could recall whether or not they had or had not cracked their knuckles when they were younger. X-rays were taken of the hand. 28 school children were surveyed to determine the prevalence of knuckle cracking in children. One of the 15 knuckle crackers had radiographic signs of arthritis where as 5 of the 13 non-knuckle crackers had signs of arthritis. “The chief morbid consequence of knuckle cracking would appear to be its annoying effect on the observer.”
This study took 300 people 74 of which were admitted knuckle crackers (amount of cracking per day was not indicated) for 18 to 60 years and 226 non-knuckle crackers. Six-four (64%) percent of knuckle crackers had an increase in hand swelling where as 5.75% had hand swelling (this was statistically significant). Comparing grip strength, the habitual knuckle crackers’ strength was significantly less than the non-knuckle crackers ( 210 (50) mmHg v 280 mmHg). The knuckle crackers were also more often manual labourers with higher incomes who frequently smoked, drank alcohol, and bit their nails. The signs of osteoarthritis (Heberden and Bouchard’s nodes) were similar between the groups.
In this study the authors sent out questionnaires to 319 participants. The questionnaires asked which fingers were cracked, how frequently, for how many years they cracked their knuckles, if there were any other risk factors for osteoarthritis and if they worked in manual labour for over 5 years. They received 215 surveys. Based on these questionnaires they determined there were no differences between controls and those with osteoarthritis based on number of years they cracked their knuckles, the frequency of cracking or working manual labour. They concluded, that there is no association between knuckle cracking and the prevalence of osteoarthritis of the hand.
When compared with subjects who are not habitual knuckle crackers, do habitual knuckle crackers have greater QuickDASH scores (a questionnaire for disability of the arm, shoulder and hand), swelling, weakness, joint laxity, or range of motion? The authors found there are no differences in QuickDASH scores, laxity and grip strength Range of motion comparisons between subjects with a history of habitual knuckle cracking versus subjects without such a history only yielded increased ROM in joints that cracked during manipulation.
Thirty-five habitual knuckle crackers (cracking their joints ≥5 times/day) Cartilage thickness was measured with ultrasound and grip strength was measured. Grip strength was similar between groups Habitual knuckle crackers had thicker cartilage. Increased thickness may be an indication of edema of the cartilage which may be an early stage of OA.
Download the in depth summary on knuckle cracking from the link below.
The evidence hasn’t changed much. Currently there is no difference in the degree of arthritis and being a chronic knuckle cracker. Cartilage damage could be occurring in those who chronically crack their knuckles but more research is needed.
I would also like to point out that many findings on MRI are non-symptomatic. Approximately, thirty percent of 30 year olds, 40% of 40 year olds have disc herniations, 50% in 50 year olds, etc, have disc herniations. This doesn’t mean that those disc herniations are surgical by any means.
Conservative care is the first way to go when it comes to disc herniations:
Continuing to be active. Walking is often tolerated by many.
Discovering what movements or positions help reduce the intensity, size of area of pain is often helped so can control the pain
Discovering what movements/positions make things worse so you don’t continue to aggravate the problem.
Joint mobilizations and chiropractic manipulations/adjustments
Progressively loading the back/neck as tolerated at the appropriate time during the healing process
A patient may be considered a candidate for spinal surgery if, after an adequate course of conservative care:
Back and leg pain limits normal activity or affects quality of life