Articles, Blog

Massage Tutorial: Lifting the Shoulder Blade

Hi, everyone. I’m Ian Harvey, massage therapist. This is Sam. Hi. Today we’re going to talk about how to lift
up the shoulder blade during a massage. How to mobilize it and how to work under it. First, we’ll start with four different ways
of lifting it up, then we’ll talk about why you might want to lift it, mobilize it and
work under it. Finally, we’ll talk about clients whose shoulder
blades don’t seem to want to move, and what to do in those situations. If you’d like to skip ahead, click on the
time codes down in the description. The first way, and my favorite way of introducing
this scapular mobilization is in the course of the rest of my massage. I don’t like to stop the massage, reposition
the body, and then do a different technique. I want it to flow. To do this, while I’m up here working in the
trapezius, I’m working with this shoulder blade, I can reach down, I’ll go into a lunge
here, connect to the side of the table and slip my hand under this acromioclavicular
joint. And just notice that having this little bit
of upward pressure here lifts this scapula up. This looks like like this under her shoulder
blade. I scoop my hand under and I press up using
my fingertips, but I’m not having to use my muscular effort because my knuckles are pressed
against the table and they are like a crowbar angling upwards. Angle that upwards, allow your hand to rest
and now that you’ve got this scapula popped up just a bit, everything that you do medial
to it is going to more easily interact with the medial border of this scapula. And if you press up even more, and you can
also press medially with this hand, you should pretty easily be able to go under the scapula
on some clients, on your more mobile clients. I’m keeping this inferior portion of the scapula
sandwiched between my fingers and my thumb and as I rock forward it can come up superiorly,
and you can make it circular. Just try not to drive this with the small
joints of your arms and your shoulders. Instead let this come from the rocking of
your body. Now if you’re not able easily leverage up
that shoulder with this hand, if that’s not comfortable for your unique body or if you
just like to bring the shoulder a little further up toward the ceiling, you can ask your client
to raise this shoulder up toward the ceiling just an inch or two and slip a towel under
there. Or any sort of slim bolster, I like a rolled
up or folded up hand towel. From here, you can use both hands. And this is a nice way of lifting that shoulder
up and then slowly coaxing it away from the surrounding musculature. We want these rhomboids and the trapezius
and the serratus anterior and all these muscles that are interconnected to form this web that
keeps this scapula in place, we want them to slowly give up their tone. We don’t want to try to pry this scapula away. And even if you’re not able to get completely
under the shoulder blade like this, you can still make progress toward that. And here you can do some things like using
your curled fingers to pull this shoulder blade outwards, and you can still do that
easy mobilization stuff but now you don’t have to be providing that upward lift. Instead this hand can just be depressing that
shoulder and then releasing to allow it to go back up toward the ear. The third way is probably what you learned
in massage school. And that’s to lift this arm up, place the
wrist in the small of the back and allow this elbow to drop. You’ll notice, of the three ways that I’ve
shown so far, this has produced the most dramatic lifting of this medial border of the scapula. It can indeed make it easiest to work under
it. What I don’t like about this is that it tends
to require the client to engage some of their shoulder muscles to keep this hand in place
and there are some ways around that. You can put a bolster right here, you can
apply some pressure using your own body. But I find that this tends to break the flow
and sometimes it’s a little extreme. For some clients this will be a little too
sharp, a little too intense because these muscles medial to the scapula are getting
a bit more of a stretch than they usually get, which isn’t in itself bad, just that
when you apply pressure as well, that can be a bit intense. Now I do like this third technique in the
side lying position. So Sam, go ahead and bring this left arm,
take this wrist and put it behind your back and let this shoulder be loosey goosey. And so now she’s not having to use her muscles
to keep this arm in place. And the weight of her own shoulder is going
to be helping me get under this shoulder blade. I’m not going to be able to get as much movement
out of this scapula as in some other positions but this is going to be a new sensation for
this shoulder blade and for this shoulder, because the arm is in this internally rotated
position. And keep in mind that you can use this hand
cupped around the acromioclavicular joint in order to mobilize this entire shoulder
girdle. And you can do some work from the other side
of the table using curled fingers and do some more specific work with this medial border
of the scapula. The fourth way is while the client is supine. I’m going to walk my way under her shoulder. To do that, I’m going to alternate hands,
one hand is going to allow some space for the other, it’ll walk in allowing space for
the other and again, I’m using my knuckles as a point of leverage. I’m not having to use my biceps or really
any muscular effort in order to create this shape. And then crowbar that shoulder up. Walking under the shoulder like this is a
good way of accessing that infraspinatus. I’m just doing some gentle circles here with
my fingertips. And you can walk even further until you are
medial to that scapula. At this point, I am curling my fingers and
I can pull toward myself. That allows me to get quite a ways under that
scapula, and I can do some gentle mobilizations here just by doing small circles. And I can slowly crawl my way out. And once again, my fingers look like this. I was hooking toward myself and pulling. It’s good to have short fingernails for this. Let’s talk about why we want to work under
the shoulder blades or to mobilize the shoulder blades. First let’s talk about why we wouldn’t want
to. I’m not doing this in order to stretch this
tissue. A lot of times people encounter a lot of tension
here, a lot of pain and they think, if I could just stretch this tissue out, it would feel
better. But if the issue is here, I’m thinking locally
and acting globally. I’m thinking of their rotator cuff, I’m thinking
of their pecs and I’m thinking of these nearby muscles as well the epicenter of the pain. Think of all these muscles that are pulling
this scapula forward and rolling those shoulders forward and work with those as well as this
painful area. I’m not trying to stretch this out. In fact I think that this area is often chronically
overstretched because people are working in front of themselves, they’re curled inward. Just keep those things in mind. I’m also not trying to unstick this shoulder
blade. I don’t think that this shoulder blade is
stuck in place in a structural way. This work may increase the blood supply to
the tissues deep to the scapula, it may promote the bursae that live under this scapula to
become more hydrated, but all of these effects are temporary and they will go away. And you could achieve the same things by doing
jumping jacks. I don’t think that we are ungluing this scapula. So why do I want to mobilize this scapula? Why do I want to lift it? Because I think it provides some interesting
novel stimulus that the client can’t get anywhere else. So by lifting this and by applying this stretch
outwards and by mobilizing it medially and superiorly and inferiorly, this is the only
time some of these stretch receptors in this local connective tissue and the local fascia
are going to be getting any of this interesting information. That’s us talking to the spinal reflexes,
but we’re also talking to the brain. We’re talking to the human. Where else can people learn so much about
their own body than through contact? There are a lot of people who don’t know what
their shoulder blade is and what it does, and we can describe it to them non-verbally. We can let them know that it has this medial
border, that it has this lateral border. And that it can float independently of the
ribcage. And that everything that it does affects the
rest of the shoulder and even down into the arm. Think of this as a mindfulness exercise for
your client. You’re telling them the story of this part
of their body. And that goes for everything else. We are making them mindful of how their neck
connects to this upper back. How their neck connects to their pecs. How their pecs connect to their shoulders. How this low back connects to the hips. By doing these interesting mobilizations,
by interacting with these tissues in new ways, we’re informing the client about their own
body. Now what about clients who aren’t this mobile? Who it’s very difficult to lift their scapula
up from their back? My advice is to think about 10 sessions rather
than one session. To introduce them to this medial scapula slowly
and gently. Their first session, second session, third
session and as you’re doing this you can try these different techniques to try to get that
shoulder blade to pop up just a little bit. But for many people this scapula is enmeshed
in a net of very tight muscle and one session isn’t going to be enough to get this to mobilize. For clients like this, just think of introducing
mobilization. And that might just mean getting this scapula
to glide along the ribcage. Rather than lifting it, rather than pulling
it in this direction or pushing it in this direction, just introducing this circular
movement. Introducing moves that bring the scapula up
toward the ear and that bring the shoulder down into depression. And communication. Some clients will have this scapula in a vise
grip and not even know it, and it might be within their power to let go of some of that
tension. You can say that like, “Sam, go ahead and
let this shoulder be loose, just let it flop around.” Sometimes just a little bit of communication
like that can be enough to get this scapula to move. As well as non-verbal communication like introducing
a little bit of jostling. Even if this doesn’t allow you to scoop this
scapula in the first session, maybe after three sessions of that gentle mobilization,
of that gentle communication, you’ll eventually be able to slide right under that scapula. But if your client’s shoulder blade won’t
come up at all, if you’re just able to introduce that movement and that’s all you’re still
able to do in 10 sessions, I say don’t count that as a failure. People are made differently. People carry their shoulders differently based
on how they live their lives and even how their body is built, how they’re put together. Even if you’re not able to do a lot of mobilization
here, just that little bit that you are able to do is going to be significant. It’s going to be more than they usually get
out of that shoulder blade movement. Alright y’all, if you have any tips of your
own, if you have any ways of working with those stubborn scapulae and make them a little
more mobile, please let me know about it in the comments. Consider subscribing and I’ll see you next

Tagged , , , , , , , , , , , , , , , , ,

27 thoughts on “Massage Tutorial: Lifting the Shoulder Blade

  1. I can offer this content for free thanks to the direct support of 159 wonderful Patreon supporters. If you find my videos useful and want to read more about it, click here: Oh, and I just hit 75,000 subscribers. How weird is that? Thanks everyone!

  2. I have a client that is very small so she has slit of visible bony structures. Thing is she want real deep pressure and always want me to work under her scapula. She says it hurts sometimes and feels like I'm hitting her bone. I know I'm definitely not. I try to use less pressure but then she asks for more. What technique shown here do you suggest?

  3. You can put your knee under the shoulder while they're prone and use it in the same manner you used the towel. Combine it with putting their arm behind the back and rhomboids should be able to relax almost completely. Your client already has scapular winging though so might just feel to her like you're trying for a shoulder dislocation.

  4. I'm not a massage therapist but I find your videos incredibly interesting. I also can't afford massages for my back pain, so watching these helps me live vicariously through your clients.

  5. I enjoy watching your videos! Thank u for sharing your knowledge and educating me as well as others on the anatomy and physiology of the muscles. Thank u, thank u!

  6. Thank you again for all the information, is helping me allot learning and getting much better with my style of massage. I would love to see more about agones, antagones, synergis. thank you again.

  7. Cant wait for next vid. I have a question ian one of my clients cant have any cream, oil or soap or anything similar on her skin. I was totally at a loss to how to massage. I felt so incompetent and amateurish. What a disaster, no myofacial work as it was impossible to glide . Has this ever happened to you.

  8. Thanks for great videos👍🏾congrats on 75000. Do u ever use small equipment such as TENS unit or ultra sound. I never noticed any being used.

  9. very nice perspective on things, and I must add you have a beautiful tone to aid all your great teachings, thank you.

  10. hello, i wanted to ask for an advice, since one of my friend is doing some muay thai + she has tendences to have a roundback forcing her scalpula out , she kinda has pain on her right and left shoulderblade, a bit lower from the trapeze. now i want to know how i can take off that pain and in what way should i massage her shoulders. she feels like its a "locked pain" like she stuck or something and it has to be released.

  11. Just stand near their head, bend over and use your left hand to hold their hand down. Elbow available for scapula work.

  12. Do this work for uneven shoulders? Or do you have any recommendations? Was told I don’t have scoliosis but I do have Klippel-Feil Syndrome still testing for other abnormalities and my shoulders are uneven and my small one hurts deep toward the bottom t5/t6 area

Leave a Reply

Your email address will not be published. Required fields are marked *