Scapular Stabilization

As I promised in an earlier blog, an important topic to cover for injury prevention is the musculature of the upper back. I refer to these muscles as a child's 'shock absorbers'. The repetitive load that is transferred to the dominant arm can cause micro-trauma over time. When a child 'plays up' or practices constantly with older children they are exposed to even greater stress on this kinetic chain. Inflexibility and muscle strength imbalances in the shoulder causes a 'rolling forward' of the shoulders and a posture that is a precursor to injury. Combined with weak posterior musculature, this posture (more common in growing boys than girls) can lead to a breakdown somewhere in the chain (wrist, elbow, shoulder).

The key to your child's health is striking a balance between participation and prevention. Remember that prior to puberty, changes in strength are mainly due to neurological adaptations. In the absence of hormones these changes are hard to maintain. "If you don't use it-you lose it." Prevention is a daily task and the scapular stabilizers are the most important muscle group to attend to.

A quick check to see if your child has proper 'shock absorbers' can be done by having them stand shirtless facing away from you. Have them hold a small soup can in each hand and make a Y with their arms. Inspect whether their scapula 'wing out'. Most young children have winging scapula so don't panic.



The long bone of the arm (humerus) is held in place by two major muscle groups. The rotator cuff is made up of four muscles that originate on the scapula and attach on the humerus. The scap stabilizers (trapezius, serratus and rhomboids) originate on the spine and attach to the scapula. Together these muscles keep the humerus centered in the shoulder joint and provide stability during movement. As stated earlier, the combination of weak posterior musculature, anterior inflexibility and the overuse nature of the sport has created a 'perfect storm' of circumstances that often lead to injury.

The exercises in the video below can be done daily. Light resistance tubing or dumbbells should be used and the athlete should complete 3 sets of 12-15 repetitions. For the mat and ball exercises, sets of 10-20 reps can be done. This routine should be completed after playing tennis and should only take 10-15 minutes. It can be done in conjunction with daily core strengthening as a part of the 'homework' program.