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Use an Exercise Ball to Improve Scapular Stability.

In order to perform any functional movement we need a stable base of support. In university they drilled into our heads "you must have stability before you can have mobility". This principle applies to the shoulder girdle as well. Lack of stability in the shoulder blade is often the cause of shoulder injuries such as bursitis, impingement, and rotator cuff tendonitis and tendinosis in the long term. Rather than creating movement, stabilizers control and slow down movement. Too much movement at the scapulothoracic joint causes one to lose control over what is occurring at the shoulder, leading to injury.

In a recent study muscle activity measured in the serratus anterior, upper, middle, and lower trapezius, and latissimus dorsi, with electromyograpy (EMG) has shown that exercises on the ball increase activity in the scapular stabilizing muscles. (1)
In this study 10 healthy men in their 20's were examined while performing the following exercises:

A. Standard push-up plus on a stable chair
B. Knee push-up plus on a stable chair
C. Standard push-up plus on an exercise ball
D. Knee push-up plus on an exercise ball

Results show that activity in these stabilizing muscles is occurring to a lesser degree in B. Kneeling pushup plus on a chair, suggesting if you are just beginning this exercise or are recovering from an injury, this is a good place to start.

If you are a throwing athlete, weight lifter, or have already been doing a lot of stability work and are looking for something more advanced, C. Standard push-up plus on the exercise ball recruited the greatest scapular stabilizing activity and put the greatest demand on the scapular stabilizing musculature.


kneeling push-up plus start position kneelin pushup plus on ball
Illustration of the kneeling push-up plus using the exercise ball. After extending your arms, push further so that your shoulder blades come forward for the "plus" part of the exercise.


Standard push-up plus on exercise ball start Standard push-up plus on the exercise ball
Illustration of the standard push-up plus using the exercise ball. After pushing up and extending the arms, push further to bring scapulae forward using serratus anterior for the "plus" part of the exercise.

For other scapular stabilizing exercises try the following:
Beginner
    Static

Leaning Straight (standing plank on the ball)
Leaning Up
Leaning Down
Single Arm Lean (standing plank with one arm)
Knee Plank on Ball

Intermediate
   Static

Kneeling Side Plank
Standing Ball Plank on wall
Standing Plank on Ball
   Dynamic
Wax on/Wax off
Pushup on the Wall

Advanced
   Static

Ball Plank Heel Raise
Pike on the Ball

   Dynamic
Kneeling Rolling Plank
Kneeling Rolling Side Plank
Ball Walkout
One Sided Walkout


1. SH Seo, IH Jeon, YH Cho, HG Lee, YT Hwang, JH Jang. Surface EMG during the Push-up plus Exercise on a Stable Support or Swiss Ball: Scapular Stabilizer Muscle Exercise.
J Phys Ther Sci 2013 Jul;25(7):833-7