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Knowing levator scapulae, rhomboids, upper trapezius, and pectoralis minor release and lengthening techniques can reduce shoulder pain, neck pain, scapulothoracic pain, etc. and improve fitness performance.

Scapula Muscles: Release and Lengthening

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I have almost completed my CPT certification and am half-way through the Human Movement certification to inform my massage practice. The different modalities of reading, watching audiovisual materials, and attending live or recorded webinars have been important to my learning style and for review.

Brookbush Institute has the most detailed, specific and effective tools for online learning for movement and/or bodywork professionals. I love the combination of the videos as well as the text available online.

I recently completed the CPT course. It was demanding yet practical. I would highly recommend it for anyone wanting an education about human movement.

I have my personal trainer certificate through here and am almost finished my human movement specialist certification. Overall, the education that Brookbush has packaged together for clinicians and trainers is invaluable. I am a physio assistant so coming from more of a rehab background I appreciate that this education has been beneficial both as a trainer and in a rehab setting. I love that I have been able to do all learning at my own pace and able to work around my schedule. Thank you for setting up this platform! Highly recommend :)

I have been a massage therapist for 10 yrs and I feel like all the “pieces” I’ve learned throughout the yrs have been put into place and can see the full picture. I am also a member to tons of great content since I love to learn! I plan to get my CPT through them as well.

I have been following Brent Brookbush for nearly a decade- back when I was a personal Trainer and now as a Physical Therapist. BBI is an incredible resource for any movement nerds and corrective exercise specialists! The information is thorough with multiple real world applications. I am looking forward to an in-person Manual Therapist course the second they do one a little bit closer to Virginia ;)

I have taken both the Human Movement Specialist and Certified Personal Trainer certificate programs and have found the value in understanding the how and ways the body moves and functions and from evidence, non-biased, outcome, conceptual, theoretical, and practical approach to helping my clients/patients look better, feel better, and move better.

Over the last years I've returned time and again to Brookbush Institute for stellar coursework as I've worked toward a Human Movement Specialist certification. (I'm currently ACE CPT, and in training with Anatomy Trains for Structural Integration Manual Therapy.) Every Brookbush Institute module is fantastic and each one includes detailed informational videos, written descriptions of how to-do, and, more importantly, why to-do!

I am a 70 yr old chiropractor and no other healthcare provider was able to come up with an exercise protocol particular to my structural and balances and muscle deficits and keep me in the game. And as for continuing education on human skeletal movement, the website is phenomenal full of great exercises for particular mechanical dysfunction.

The H.M.S. is the most valuable certificate I have earned and was a fraction of the the cost of my others. Define the best bang for your buck!

Brookbush is the most efficient Personal Training Certification I have ever come across. All the lessons are well thought out and very straight to the point.

I am getting my Master's degree in Kinesiology, and I would like to say that I have benefited greatly from the rich, comprehensive, well-documented scientific content of Brookbush Institute that links theory to practical applications. Proudly I've got my CPT certificate, and I am on my way to get my HMS certificate.

Having courses count towards different certifications makes it so users can transition seamlessly from one certification to another. In my case, going from earning the BI CPT to earning the BI HMS was an easy decision and I am proud to have earned both certifications. I have also had the pleasure of going to a Live HMS workshop that was well taught by Instructor Boettcher and that was excellent to see how the methods and techniques are implemented.



I have been a member of BBI for years and every course I have taken has been incredibly informative. I learn more from these courses than I do at local CEU courses for my PTA license. I also earned my CPT and HMS certifications through the platform. It was so convenient and the content was top notch! Forever member.

We learn principles in academia, we learn cool new modalities via whatever specialty certification, but BBI really concentrates on the nuances of passive treatment and they do a fantastic job. The format in which BBI instructs soft tissue specialists (DPTs, Chiros, ATs) like myself feels like almost like an apprenticeship. You get a thoroughly detailed explanation of the “why’s”, and a visual comprehension of how to apply. Personally, I believe application is where the good and the great are distinguished.

Brookbush has been incredibly helpful since I was in massage school and now as I’m in my career! I run my own practice and it gives me the resources I need to not only improve what I already know, but also help me navigate better, more efficient ways of treatment.

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Challenging concepts are explained in very understandable terms without dumbing down the material, and I find this program to be superior in quality to other personal training programs.

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Human Movement Specialist

This course describes scapula muscle release and lengthening, commonly referred to as scapula muscle foam rolling, scapula muscle release with ball, neck, and shoulder stretching, and scapular mobility techniques. Although terms like tight muscle, muscle tightness, tight traps, tight neck, or tight rhomboids are commonly used, it may be more accurate to label these muscles as prone to over-activity (e.g. hypertonic, phasic). Performing downward rotator and anterior tipper release and lengthening techniques to increase mobility prior to activation, integration, and strengthening techniques may significantly enhance rehabilitation and performance programs. In practice, the release of the levator scapulae, rhomboids, pectoralis minor, and potentially the upper trapezius, mobilizing the shoulder joint, and integrating a child's pose stretch (rhomboid stretch), crucifixion stretch (pectoralis minor stretch), and/or open books (active stretch), is likely to improve shoulder and scapulothoracic mobility and improve the effectiveness of exercises like wall angels, wall slide, ITY’s, cobras, etc. Scapular anterior tipper and downward rotator over-activity have been correlated with altered upper extremity alignment, rounded shoulder posture, shoulder medial rotation syndrome, upper cross syndrome, forward head posture, loss of scapular muscle strength, loss of rotator cuff strength and stability, shoulder pain, neck pain, scapulothoracic pain, AC/SC joint pain, an increased risk of future injury, and a loss of sports performance. Sports medicine professionals (personal trainers, fitness instructors, physical therapists, massage therapists, chiropractors, occupational therapists, athletic trainers, etc.) should add these exercises to their repertoire to improve the outcomes of their integrated exercise programs and therapeutic (rehabilitation) interventions.

Following release techniques, but before lengthening techniques, it may be beneficial to perform 

Self-administered Joint Mobilization Techniques: Upper Body

Thoracic Spine Posterior to Anterior Mobilization

Dr. Brent Brookbush demonstrating a pectoralis minor self-administered release technique

Course Description: Scapula Muscle Release and Lengthening

Introduction

For a complete review of origin, insertion, innervation, action, integrated function, 

, motor behavior, subsystem involvement, and trigger points, please check out the Functional Anatomy & Human Movement Science of the:

 does not contribute to scapular motion, it often exhibits behavior similar to the 

 - an increase in activity that may alter osteokinematics and arthrokinematics, contributing to commonly seen restrictions in shoulder/scapular motion. Further, the self-administered release technique for the 

 is similar to the techniques used for the 

. For these reasons, and because it is not included in any other Brookbush Institute articles, release and lengthening of the 

Introduction to Scapula Muscles Release and Lengthening

Signs of over-activity and adaptive Shortening:

 Downward rotators and anterior tippers short and over-active

: Downward rotators, anterior tippers, shoulder internal rotators, and posterior deltoid short and over-active

A demonstration of arms fall during an overhead squat assessment

 < 100 - 110° Internal rotators of the shoulder short and over-active, and potentially anterior tippers of the scapula short and over-active

: < 180º Internal rotators of the shoulder short and over-active, and potentially downward rotators and anterior tippers of the scapula short and over-active

 – Top arm restricted may be indicative of downward rotator and anterior tipper over-activity

Signs of Over-activity and Adaptive Shortening

Optimizing Motion (Best Practice)

Maintaining optimal length and activity of the downward rotators and anterior tippers of the scapula is likely dependent on not only optimal soft tissue 

 but optimal arthrokinematic motion and activity of functional 

. When addressing scapular dysfunction, consideration of the quality of movement of the thoracic spine and shoulder (at the very least) is also necessary.

Thoracic Spine Mobilization (Posterior to Anterior Mobilization)

Thoracic Spine Rotational Mobilization and Stabilization

Optimizing Motion to Prevent Shoulder and Neck Pain

Research Corner

Several texts have noted the propensity of the muscles addressed in this article to become over-active and short (1-5). Further, many of these texts recommend techniques similar to those described in this article (1-4). Recently, more research has been done to investigate the relative activity of muscles as it relates to upper body movement impairment. Scapular kinematics have been of particular focus, as several studies have correlated a change in scapular motion with the commonly reported anterior shoulder pain/shoulder impingement syndrome (6-10). Further, studies have shown that forward head posture and rounded shoulder posture immediately change scapular muscle activity and scapular kinematics during overhead tasks (11-12), and that cervical dysfunction and even elbow and forearm dysfunction may result in changes in scapular muscle recruitment (13-15). Interventions including release and exercise have been shown to be effective for improving kinematics, posture, and muscle activity (16-18). In a study by Wong et al., release of the pectoralis minor decreased rounded shoulder posture, and although self-administered techniques were not included in this study, it is evidence that release techniques are beneficial (16). In studies, by Wang et al. and Cools et al., it was found that exercise selection had an effect on muscle recruitment, and that exercise does improve the strength and endurance of scapular muscles (17-18). To date, more research is desperately needed on the effectiveness of mobility techniques (release, mobilization, and lengthening) for improving scapular kinematics and muscle recruitment.

To date, research on self-administered release techniques for the upper body have not been done; however, studies using these techniques on lower extremity muscles have shown promising results. This includes a perceived decrease in muscle soreness and better performance and recovery in subsequent bouts of intense exercise when foam rolling was done immediately after training (20-22), an increase in range of motion without a decrease in force production (23-24), and several studies have shown release and stretching is more effective for increasing ROM than either technique alone (25-27).

An image depicting the muscles on the posterior side of the body, including the trapezius, rhomboids, levator scapulae, and latissimus dorsi 

Research Corner: Scapula Muscles Release

Techniques and Progressions

Levator Scapulae Stretch: Static --> Active

Pectoralis Major, Pectoralis Minor, and Subscapularis Stretch: Static –> Active –> Dynamic

Latissimus Dorsi and Teres Major, and Rhomboid Stretch (Child’s Pose with Modification): Static –> Active –> Dynamic

Dr. Brent Brookbush performing a stretch of the pectoralis muscles

Techniques & Progressions for the Scapula Muscles Release and Stretching

Release Techniques

Levator Scapulae (Self-Administered) Static Release

Levator Scapulae (Self-administered) Active Release

Levator Scapulae

Supraspinatus (Self-administered) Static Release

Supraspinatus

Upper Trapezius (Self-Administered) Static Release

Upper Trapezius

Rhomboid (Self-Administered) Static Release

Rhomboid

Pectoralis Minor (Self-Administered) Static Release

Pectoralis Minor

Stretching Techniques

Levator Scapulae Static Stretch

Upper Trap Static Stretch

Crucifixion/Cross Stretch

Pectoralis Major Wall Stretch

Active Pectoralis Major, Pectoralis Minor, and Subscapularis Stretch

Dynamic Pectoralis Major, Pectoralis Minor, and Subscapularis Stretch

Pectoralis Major, Pectoralis Minor, and Subscapularis

Latissimus Dorsi, Erector Spinae, Quadratus Lumborum and Rhomboids Static Stretch (Child’s Pose)

Latissimus Dorsi and Rhomboids Active Stretch (Child’s Pose)

Latissimus Dorsi and Rhomboids Dynamic Stretch

Latissimus Dorsi

Manual Lengthening Techniques

Pectoralis Minor Manual Stretch

Sample Mobility Program and Progressions

Perform each technique with accuracy (ex. hold until release for static techniques, 10-15 repetitions for active techniques at a 2:2:2 count, etc.). Progress the flexibility routine as trigger points are reduced, techniques are mastered, and optimal flexibility is attained (generally over the course of weeks). This can be accomplished by adding additional release techniques, and/or replacing static stretches with active and eventually dynamic stretches.

Crucifixion Stretch (Pectoralis major and minor, and subscapularis)

Child’s Pose (Latissimus Dorsi, Teres Minor)

Activate and Integrate under-active structures specifically – 

Sample Scapula Muscle Mobility Program and Progressions

Phillip Page, Clare Frank, Robert Lardner, 

Assessment and Treatment of Muscle Imbalance: The Janda Approach

NASM Essentials of Corrective Exercise Training

Diagnoses and Treatment of Movement Impairment Syndromes,

Scovazzo, M.L., Browne, A., Pink, M., Jobe, F.W., and Kerrigan, J. (1991). The painful shoulder during freestyle swimming: An electromyographic cinematographic analysis of twelve muscles. 

Ludewig P.M., Cook, T.M. (2000) Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. 

Cools, A.M., Witvrouw, E.E., Declercq, G.A., Danneels, L.A., Cambier, D.C. (2003) Scapular muscle recruitment patterns: Trapezius muscle latency with and without impingement symptoms. 

Fayad F, Roby-Brami A, Yazbeck C, Hanneton S, Lefevre-Colau MM, Gautheron V, Poiraudeau S, Revel M. (2008). “Three-dimensional scapular kinematics and scapulohumeral rhythm in patients with glenohumeral osteoarthritis or frozen shoulder.” 2008 

Lawrence, R. L., Braman, J. P., Laprade, R. F., & Ludewig, P. M. (2014). Comparison of 3-dimensional shoulder complex kinematics in individuals with and without shoulder pain, part 1: sternoclavicular, acromioclavicular, and scapulothoracic joints. 

journal of orthopaedic & sports physical therapy

Kwon JW, Son SM, Lee NK. (2015). Changes in upper-extremity muscle activities due to head position in subjects with a forward head posture and rounded shoulders. 

Thigpen CA, Padua DA, Michener LA, Guskiewicz K, Giuliani C, Keener JD, Stergiou N. (2010). Head and shoulder posture affect scapular mechanics and muscle activity in overhead tasks. 

Journal of Electromyography and Kinesiology

Helgadottir, H., Kristjansson, E., Einarsson, E., Karduna, A., & Jonsson, H. (2011). Altered activity of the serratus anterior during unilateral arm elevation in patients with cervical disorders. 

Journal of electromyography and kinesiology

Ayhan, C., Camci, E., & Baltaci, G. (2015). Distal radius fractures result in alterations in scapular kinematics: A three-dimensional motion analysis. 

Day, J. M., Bush, H., Nitz, A. J., & Uhl, T. L. (2015). Scapular Muscle Performance in Individuals With Lateral Epicondylalgia. 

Journal of Orthopaedic & Sports Physical Therapy

Wong CK, Coleman D, diPersia V, Song J, Wright D. (2010). The effects of manual treatment on rounded-shoulder posture, and associated muscle strength. 

Wang, C., McClure, P., Pratt, N., Nobilini, R. 

Stretching and Strengthening Exercises: Their Effect on Three-Dimensional Scapular Kinematics

. Arch Phys Med Rehabil. 1999 vol. 80, 923-929

Cools, A.M., Dewitte, V., Lanszweert, F., Notebaert, D., Roets, A., Soetens, B., Cagnie, B., Witvrouw, E.E. (2007) Rehabilitation of Scapular Muscle Balance. Which Exercises to Prescribe? 

Healey, K.C., Hatfield, D.L., Blanpied, P., Dorfman, L.R., and Riebe, D. (2014). The effects of myofascial release with foam rolling on performance. Journal of Strength and Conditioning Research. 28(1). 61–68

Pearcy, G.E.P., Bradbury-Squires, D.J., Kawamoto, J., Drinkwater, E.J., Behm, D.G., Button, D.C. (2015) Foam rolling for delayed-onset muscle soreness and recovery of dynamic performance measures. Journal of Athletic Training. 50(1): 5-13

Macdonald, G.Z., Button, D.C., Drinkwater, E.J., Behm, D.G. (2014) Foam rolling as a recovery tool after an intense bout of physical activity. 

Sullivan, K.M., Silvey, D.B.J., Button, D.C., Behm, D.G. (2013). Roller-massager application to the hamstrings increases sit-and-reach range of motion within five to ten seconds without performance impairments. 

International Journal of Sports Physical Therapy

Halperin, I., Aboodarda, S.J., Button, D.C., Andersen, L.L., Behm, D.G. (2014). Roller massager improves range of motion of plantar flexor muscles without subsequent decreases in force parameters. 

The International Journal of Sports Physical Therapy. 9(1):

Mohr, A. R., Long, B. C., & Goad, C. L. (forthcoming 2014). Foam Rolling and Static Stretching on Passive Hip Flexion Range of Motion. 

Skarabot, J., Beardsley, B., Stim, I. (2015). Comparing the effects of self-myofascial release with static stretching on ankle range of motion in adolescent athletes. 

International Journal of Sports Phyiscal Therapy.

Renan-Ordine, R., Alburquerque-Sedin, F., De Souza, E.P.R., Cleland, J.A., Fernandez-De-La-Penas, C. (2011) Effectiveness of myofascial trigger point manual therapy combined with a self-stretching protocol for the management of plantar heel pain: A randomized controlled trial. Journal of Orthopaedic & Sports Medicine

David G. Simons, Janet Travell, Lois S. Simons, 

Travell & Simons’ Myofascial Pain and Dysfunction, The Trigger Point Manual, Volume 1. Upper Half of Body: Second Edition

Bibliography

Questions, comments, and criticisms are welcomed and encouraged

Scapula Muscles: Release and Lengthening

Related Courses:

Course Description: Scapula Muscle Release and Lengthening

Introduction to Scapula Muscles Release and Lengthening

Signs of Over-activity and Adaptive Shortening

Optimizing Motion to Prevent Shoulder and Neck Pain

Research Corner: Scapula Muscles Release

Techniques & Progressions for the Scapula Muscles Release and Stretching

Release Techniques

Levator Scapulae
2 Sub Sections

Supraspinatus
1 Sub Section

Upper Trapezius
1 Sub Section

Rhomboid
1 Sub Section

Pectoralis Minor
1 Sub Section

Stretching Techniques

Levator Scapulae
1 Sub Section

Upper Trapezius
1 Sub Section

Pectoralis Major, Pectoralis Minor, and Subscapularis
4 Sub Sections

Latissimus Dorsi
3 Sub Sections

Manual Lengthening Techniques

Pectoralis Minor
1 Sub Section

Sample Scapula Muscle Mobility Program and Progressions

Bibliography

Related Courses:

Comments

Guest

Scapula Muscles: Release and Lengthening

Related Courses:

Course Description: Scapula Muscle Release and Lengthening

Introduction to Scapula Muscles Release and Lengthening

Signs of Over-activity and Adaptive Shortening

Optimizing Motion to Prevent Shoulder and Neck Pain

Research Corner: Scapula Muscles Release

Techniques & Progressions for the Scapula Muscles Release and Stretching

Release Techniques

Levator Scapulae2 Sub Sections

Supraspinatus1 Sub Section

Upper Trapezius1 Sub Section

Rhomboid1 Sub Section

Pectoralis Minor1 Sub Section

Stretching Techniques

Levator Scapulae1 Sub Section

Upper Trapezius1 Sub Section

Pectoralis Major, Pectoralis Minor, and Subscapularis4 Sub Sections

Latissimus Dorsi3 Sub Sections

Manual Lengthening Techniques

Pectoralis Minor1 Sub Section

Sample Scapula Muscle Mobility Program and Progressions

Bibliography

Related Courses:

Comments

Guest

Levator Scapulae
2 Sub Sections

Supraspinatus
1 Sub Section

Upper Trapezius
1 Sub Section

Rhomboid
1 Sub Section

Pectoralis Minor
1 Sub Section

Levator Scapulae
1 Sub Section

Upper Trapezius
1 Sub Section

Pectoralis Major, Pectoralis Minor, and Subscapularis
4 Sub Sections

Latissimus Dorsi
3 Sub Sections

Pectoralis Minor
1 Sub Section