Shoulder Rehab

Shoulder pain is very common among active individuals.  Although there are many different causes of shoulder pain, many studies have been published in recent years that link scapular (shoulder blade) position and the activity patterns of the muscles around the scapula to many types of shoulder injury. Among the evidence is the consistent finding of delayed lower trapezius activity in dysfunctional shoulders.

Lower Trapezius Exercises

A 2009 study published in the Journal of Orthopaedic and Sports Physical Therapy used EMG analysis to examine muscular timing in the trapezius muscles during various exercises. The results of the study indicate that the prone extension exercise and the prone horizontal abduction (with external rotation) both promote early firing of the middle and lower trapezius muscles (when compared to the other muscles that move the shoulder).  This is a good thing for those of you who might be confused…in other words, many shoulders have weakness in this area and we now have scientific evidence as to the best way to strengthen these muscles.

Shoulder Exercises – Lower Trapezius

In the prone extension exercise, you simply lie on your stomach (on a bench) with your shoulders flexed to ninety degrees. You then extend your shoulders to achieve the end-position pictured below. (Don’t use a stick as pictured below…it is recommended to use dumbbells).

Person performing shoulder extensions

In the second exercise, you start in the same starting position as the first exercise, but you bring your arms out to the side (as pictured below).  Finish the exercise with your thumbs pointing up to the ceiling.

Person performing shoulder extensions

Shoulder Pain Treatment

As always, we do our best to bring you the most current and accurate information both in our clinic and on our website.  References are provided below.  If you’re experiencing shoulder pain, we suggest that you have your condition examined by one of our doctors; jumping into a strengthening program without being diagnosed is not recommended.  Most cases of shoulder pain not only benefit from strengthening the right areas but also require focused treatment at the dysfunctional structures.  Laser therapy is one of our popular treatment methods for shoulder pain and can be applied by either our physiotherapists or our chiropractors.  For more information, call 905.220.7858 or email us at


Cools AM, Dewitte V, Lanszweert F et al. Rehabilitation of scapular muscle balance: which exercises to prescribe? The American Journal of Sports Medicine 2007; 35(10): 1744-1751.

De Mey K, Cagnie B, Van De Velde A et al. Trapezius muscle timing during selected shoulder rehabilitation exercises. Journal of Orthopaedic and Sports Physical Therapy 2009; 39(10): 743-752.

Hirashima M, Kadota H, Saraurai S et al. Sequential muscle activity and its functional role in the upper extremity and trunk during overarm throwing. Journal of Sports Science 2002; 20: 310-310.