Neck Shoulder Exercise – Y Exercise To Stabilize Scapulo-Humeral Rhythm

Shoulder and neck problems often continue even after a reasonable period of rest and treatment like physical therapy, medications, injections and even surgery. Neck and shoulder pain is often related to an injury or structural problem found imaging studies. However, we often see pain problems are becoming more chronic and persistent.

This is the case with many neck conditions that result in painful neck and shoulders and the failure of measures to restore normal posture. This neck shoulder exercise works on restoring the proper functional status of the shoulder that is essential in dealing with chronic neck issues.

With a more functional approach, dealing with neck and shoulder pain shifts from a strictly structural focus from findings on MRI’s and x-rays to one based more on a functional type of pathology. This dysfunction can be the missing link in managing more persistent neck and shoulder pain that has not responded to traditional therapeutic measures. This includes assessing and correcting faulty motion patterns which can be the source of maintaining biomechanical overload.

It is possible to have shoulder or neck pain without any associated structural pathology as seen on imaging studies or to attribute these problems to be directly related to the condition. Many people display arthritis or other problems like a rotator cuff tear without any symptoms.

Functional pathology of the motor system is basically dysfunctional movement and the most important type of dysfunction is a faulty movement patterns. In the upper back, shoulder girdle or neck area the key faulty movement pattern is an abnormal scapulo-humeral rhythm. This causes the shoulder girdle to shrug up towards the ear(s) and results in increased neck and shoulder muscle tension, rounded shoulders, and forward head posture. This dysfunction can cause pain or decreased performance.

This is from a 2011 article in the Journal of Bodywork and Movement Therapies, by Craig Liebenson DC.

You can see this in the below picture which indicates a typical exercise done with resistance bands as we recommend with the neck rehab kit.

Overhead Pull Down (a) normal (b) abnormal (shrugged).

Once identified by a healthcare professional, this faulty scapulo-humeral motion pattern or shrugged shoulder(s) should be the first goal of treatment for pain, posture correction or physical training to affect better performance. A simple training method called the Y shoulder exercise can be used to both identify and correct dysfunctional in neck and shoulder movement patterns.

The Y neck shoulder exercise involves testing and training with the arms in an overhead position making a letter Y shape.

The Y exercise to restore shoulder and neck function utilizes an important method called shoulder packing or scapular setting. The key to the exercise is to pack the shoulder down and back. Imagine standing with one arm extended in front of you with your palm facing down. Now, push down as if pushing down on the top of a stick that is at chest height. Feel how your shoulder & shoulder blade muscles – in particular your latissimus dorsi muscle tighten as you push down on the stick. This feeling is the key to stabilizing or setting the scapula (shoulder blade).

– Stand facing a wall (about 1-2 inches away)
– Place palms on the wall
– Raise arms up in a Y position
– REACH up & shrug – Pack up. Shrug shoulders upwards ears until neck shortens
– ROLL back & down – Pack down (set scapula)
– Roll (turn) hands out
– Bring shoulders back & down until neck lengthens
– RAISE Arms Off Wall
– Tighten core
– Lift arms off the wall
– Feel mid-back – just below the shoulder blades working
– Note: Avoid lifting arms off wall by arching lower back into sway back
– Perform 10-12 slow repetitions

The Y Exercise – Shoulder Packing
(a) start position
(b) Pack up (reach up)
(c) Pack down (roll back & down)
(d) Lift off (raise off wall)
(e) Incorrect lift off with sway back.

This neck shoulder exercise should be evaluated and instructed by a health care professional. It can help with some neck and shoulder pain problems by helping to restore normal function to the related muscles. This can potentially benefit those who suffer from neck and shoulder pain due to overuse from work or athletics.

Another set of exercises was proven to reduce chronic neck/shoulder pain of non specific origin in a 2014 Journal of Occupational Rehabilitation. The target muscles are the lower trapezius and the serratus anterior.

The exercises were the the pree-up (chair) and pull-up plus (floor). In the beginning, 3 sets of 10 repetitions can be done, working up to 5 in the last weeks. The intervention was done over a 10 week period. You should modify this according to your condition, slow at first is the best advice. For example; the push up plus can be done to your preferred level and by holding the up position for 10 seconds, doing 5 repetitions. In the study, the exercises were done as a superset, where only a little rest is done between alternating the two.

A 2017 study in the Journal of Electromyography and Kinesiology found that neck muscle fatigue alters scapular and humeral kinematics indicating effects beyond the neck and into the motion of the shoulders. I highly recommend the neck rehab kit as a means to combat neck pain due to the shoulder strengthening methods included. Addressing scapulo-humeral rhythm is an often neglected aspect of addressing neck/shoulder pain. We present some options to address this here.

A 2019 study in Clinical Biomechanics found a relationship between neck pain and scapular dysfunction, indicating alterations in the 3-Dimensional scapular orientations in patients with chronic non-specific neck pain as compared with healthy controls. The authors of the study indicated, “Therefore, the scapular control may also be examined in patients with neck pain and it can be included in the rehabilitation program if needed.”