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THE FUNCTION OF THE SCAPULA STABILISERS
An ideal aligned scapula serves as a stable base for the muscles attached to it. This stable base optimizes the length tension relationship of the muscles attached to scapula and assures optimum muscle function. A stable scapula will enhance the muscle strength of Pectoralis minor elevating the upper ribs, when contracting from origin to insertion (Agur and Dalley 2009; Nijs et al. 2007; Kendal et al. 2005; Levangie and Norkin 2001). The ideal scapula position, resting or dynamic, orientates the glenoid to allow for optimum gleno-humeral function (Arlotta et al. 2011). Trapezius and Serratus anterior are the muscles responsible for this ideal, stable positioning of the scapula. First the anatomy and function of Trapezius will be discussed followed by the anatomy and function of Serratus anterior. Trapezius and Serratus anterior as a force couple will be discussed. Finally the role of Trapezius and Serratus anterior in the swim stroke will be discussed.
Retraining and strengthening of Serratus anterior
Ideal function of Serratus anterior is a crucial component in ideal positioning of the scapula, resting as well as dynamic. Serratus anterior upwardly rotates, posteriorly tips and protacts the scapula and prevents winging of the medial border of the scapula (Agur and Dalley 2009; Kendall et al. 2005; Ekstrom et al. 2004). The wall slide exercise, category one (Figure 21), had been proven to activate and strengthen Serratus anterior above 90° of humeral elevation (p<0.0001) (Hardwick et al. 2006). The amount of Serratus anterior activation increased as the amount of humeral elevation increased with the wall slide exercise (Table 3.10) (Hardwick et al. 2006). Although the scapular plane gleno-humeral elevation had even better activation of Serratus anterior, the wall slide was chosen for category one. The aim of category one was to retrain muscle recruitment and with the wall slide the swimmer had the ‘support’ of the wall for the upper limbs. While being supported, the swimmer could focus on the scapular position during the exercise. Minimal activation of Lattisimus dorsi occurred during the range of elevation with the wall slide exercise. The intervention group wore their elastic bands and they were instructed to breathe against the elastic band throughout the exercise, to facilitate lateral costal breathing. The control group was instructed to breathe throughout the exercise.
CHAPTER 1
INTRODUCTION
BACKGROUND
PROBLEM STATEMENT
RESEARCH QUESTION
HYPOTHESIS
AIM
IMPORTANCE AND SIGNIFICANCE OF THE PROPOSED STUDY
DELIMITATIONS
ASSUMPTIONS
DEFINITIONS
OUTLINE OF THESIS
SUMMARY
CHAPTER 2
LITERATURE REVIEW
INTRODUCTION
NORMAL BREATHING PATTERN
PECTORALIS MINOR
THE FUNCTION OF THE SCAPULA STABILISERS
RESTING POSITION OF THE SCAPULA
DYNAMIC CONTROL OF THE SCAPULA
CONCLUSION
CHAPTER 3
METHODOLOGY
INTRODUCTION
STUDY DESIGN
STUDY SETTING
STUDY POPULATION AND SAMPLING
DATA COLLECTION
ETHICAL CONSIDERATIONS
PILOT STUDY
THE INTERVENTION
DATA MANAGEMENT AND ANALYSIS
SUMMARY
CHAPTER 4
RESULTS
INTRODUCTION
PECTORALIS MINOR LENGTH
FORCE VITAL CAPACITY
MUSCLE FUNCTION
RESTING SCAPULA POSITION
DYNAMIC SCAPULA CONTROL
CONCLUSION
CHAPTER 5
DISCUSSION
CHAPTER 6
CONCLUSION
CHAPTER 7
RECOMMENDATIONS
REFERENCES
