Shoulder-blade: the core of all movements of the upper limb

THE CERVICAL TRACT
The cervical tract of the vertebral column bears a double function: it supports and coordinates the movements of the head and plays a fundamental role in the postural control of the upper limbs. From a dynamic point of view, it represents one of the components of the kinetic chain* of the upper limbs.
Moreover, from the cervical column start and end:

1. innervations
2. arterial and venous circulation
3. lymphatic circulation
4. energetic circulation (meridians)

of the upper limbs.

It is easy to understand the importance of any action on the cervical column when facing most pathologies affecting the upper limbs; at the same time, all issues related to the cervical column can involve upper limbs in many ways and in different points.

* KINETIC CHAIN – concept. Every movement involves different districts or segments of the body that intervene together in the execution of that particular action. That's why, in case of pathologies located in a certain district, it is good not to act directly on the specific area, but on the whole kinetic chain involved. In our example: cervical>fingers; hand>cervical.

SHOULDER-BLADES
Shoulder-blades play a fundamental part in the kinetic chain of upper limbs.
Shoulder-blades are the core of all movements involving the upper limbs.
A common mistake is to use shoulders (scapulae-humeral articulation) to produce the impulse for upper limbs movements: this generates a very wrong postural habit.

1. The movement starts from the hub (the core) and not from the periphery. Let's take the wheel as an example: if we started a circular movement form the hands, it would be like applying a force on the circumference of the wheel, causing a great waste of energy; if the movement starts from the center (shoulder-blades) a small central impulse is sufficient to generate a big force on the periphery, saving quite a bit of energy (and effort).

2. Movements are bigger, in all directions.

3. Movements have an economical advantage because deeper, tougher and more specific muscles are used, while superficial and peripheral muscles of the upper limbs stay relaxed.

4. The scapulae-humeral articulation works in a correct way, leaving the humeral head free to rotate inside the acetabulum.

Warning: shoulder-blades movement cannot involve the vertebral column; the scapular track is completely independent. If movements are executed correctly, deeper muscles are at work, following their main direction (horizontal or vertical).
 

Upper limbs' pathologies
Tensions and wrong postures on cervical and scapulae-humeral levels can cause problems not only in affected areas, but can produce consequences that may affect the entire limb (for example the carpal tunnel). In these cases, if one does not intervene directly on the cause, the treatment is destined to give no result.
Problems located in the shoulder's articulation can be due to acute reasons (mostly traumas). An example of a chronic pathology is the so called 'scapulae-humeral periarthritis'. Arthritis phenomena can be caused by a consistent incorrect posture or by the repetition of wrong movements, even small ones (but prolonged in time), involving either shoulders or shoulder-blades (like may occur to housewives).
The elbow can be affected by acute pathologies (traumas) or by movement that generate an overload of the articulation (tennis elbow).
Wrist and fingers are affected by local pathologies with scarce relations to postural dynamics, unless when they are the secondary consequence of chain events caused by altered issues in the upper body (neck, shoulders, and see above).

Correzione dei problemi degli arti superiori
External treatment: acupuncture, massage (Tui Na), osteopathy, etc.
The patient can actively help by:

• Correcting bad habits and wrong attitudes;

• Learning and using proper dynamics;

The regular practice of specific exercises aimed at maintaining correct postures: this helps correcting eventual wrong habits and solving physical issues.
Basic exercises of qigong and Chinese martial arts can be particularly useful.