06/03/2026
If your patient can’t get their scapula to mid-axillary line during shoulder flexion and abduction, they’re either lacking mobility because the downward rotators are too stiff or short, lacking strength in the upward rotators, or a combination of both.
Most of the time it’s serratus anterior weakness coupled with stiffness in the rhomboids, levator scapulae, and lats. This pattern is a form of scapular dyskinesis and can cause impingement, and with time, glenohumeral joint instability.
And almost ALWAYS the serratus weakness and altered scapular position are secondary to deeper drivers in the viscera or CNS, courtesy of the shared nerve root at C5 to the phrenic nerve and the shared roots and branches to the accessory nerve and cervical plexus. This means any tension in the CNS or increased sensory activity in the visceral cavities often gets blurred with messaging to the serratus anterior and upper extremity musculature.
Which wreaks havoc on a joint like the scapulothoracic joint: one that is purely a musculoskeletal articulation.
This week’s episode of is the IG Live and I did yesterday! We talked all about this, armpits, and demoed a helpful exercise.
I also put my two favorite courses on sale as a surprise 🎉 Use code ARMPIT by Saturday 6/6 for 50% off Never Treat the Shoulder First or The Nerve Workshop. Comment SCAP and I’ll send you the link, or hit the link in bio!