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Yoga shoptalk, January, 2002

Question: Many students have difficulty lowering the shoulders when the arms are lifted overhead, both in a standing position and in the down facing dog. Will strengthening the rhomboid muscles help correct this? If so, what are the best exercises for accomplishing that objective, and if not, what is the best remedy?

Answer: This is a very complex question, and one has to dive deeply into the anatomical relationships of the upper extremity and torso to answer it. I’ll refer you to chapter eight of Anatomy of Hatha Yoga for anatomical drawings and more details. Here we can only provide a summary that is derived from that chapter. We’ll concentrate on the down facing dog, realizing that the same principles apply to lifting the arms overhead, as well as to the proper accomplishment of many inverted postures.

The scapula is the key to understanding the upper extremity and to answering your question, because the scapula provides the foundation for movements of the arms. It is supported and stabilized by five muscles on each side of the body, the trapezius, the rhomboid muscles, the levator scapulae, the pectoralis minor, and the serratus anterior.

The serratus anterior muscle takes origin from a broad area on the front of the chest, runs laterally around the rib cage, passes underneath the scapula to insert on its medial border, and acts to abduct it, that is, to pull it laterally. One more scapular supporting muscle, the pectoralis minor, also takes origin from the front side of the chest, but this one inserts on the acromion of the scapula, and from that position pulls it forward. The rhomboids and the levator scapulae, on the other hand, stabilize the scapulae posteriorly. The rhomboid muscles adduct the scapula, pulling its medial border toward the midline from its origin on the thoracic spine, and the levator scapulae elevates the scapula, as its name implies, pulling on its upper border from an origin on the transverse processes of C1–4. The rhomboids also act as synergists with the levator scapulae to aid elevation of the scapula, which is obvious from even one glance at those muscles in an anatomical atlas. The most superficial muscle that supports the scapula is the trapezius, so-named because the two trapezius muscles viewed together from the rear form a trapezoid. Each muscle is flat and triangular-shaped, takes origin medially from a line that runs from the skull to T12, and inserts on the clavicle and the spine of the scapula, the hard bony ridge you can feel on your upper back. Depending on which fibers of the muscle are active, the trapezius exerts traction to pull the scapula up, down, medially, or all three at the same time.

These five muscles not only stabilize the scapula, making a dependable foundation for movements of the arms, they move the scapula around on the surface of the back. The scapula can be moved laterally (the serratus anterior) and medially (the rhomboids); it can be elevated (the levator scapulae and the rhomboids) or depressed (the lower fibers of the trapezius); and its pointed lower angle can be rotated out and upward (the trapezius and serratus anterior) or in and downward (the rhomboids, pectoralis minor, and levator scapulae). All of these movements are crucial to movements of the arms in standing, inverted, and semi-inverted postures such as the down facing dog.

To check for yourself how the scapula works, ask someone who is slender, lightly muscled, and flexible to stand with their arms hanging alongside their thighs. Then trace the borders of both scapulae visually and by feel. The medial borders for each of these triangular bones are parallel to one another, an inch or so to either side of the midline, and the lateral borders angle up and laterally. The prominent bony landmark on top is the scapular spine. Next, while feeling the inferior angle of each scapula (its lowermost tip), ask your subject to slowly lift both hands overhead. Notice that as the arms are lifted each scapula rotates on an axis that runs roughly through the middle of the scapular spine, and from that axis you can feel that the inferior angle is carried in an arc out and up. This is called upward rotation. If this movement is constrained it will be difficult to do all postures that require an overhead stretch. Now ask your subject to lower both arms, spread the tops of the shoulders, and at the same time pull the inferior angles of the scapulae toward the midline of the body. This is the opposite movement, namely rotation of the inferior angle of the scapula down and medially, or downward rotation.

Other movements are self-explanatory. Still feeling the scapulae, ask your subject to do shoulder rotations. Watching carefully, notice that lifting the shoulders elevates the scapulae, pulling the shoulders downward depresses them, pulling the shoulders to the rear adducts them, and pulling the shoulders forward abducts them.

In the down facing dog the arms end up flexed 180 degrees overhead, or even a little more, and this movement is accompanied by about 60 degrees of upward rotation of the scapulae. And since the scapulae are supporting much of the weight of the upraised body, the five muscular attachments between it and torso must all be actively engaged. Allowing them to relax will cause adduction and elevation of the scapulae, as well as an unsightly jamming of the shoulders toward the floor. To counteract this tendency, instructors usually urge students to press the hands strongly against the floor, lift the buttocks, flatten the back, and press the shoulders toward the feet. They may not recognize it, but those adjustments also abduct and depress the scapulae as well as hold them isometrically in their upwardly rotated positions, and this happens to be exactly what is needed for the down facing dog.

Textbooks usually discuss movements of the arm in reference to muscles that insert on the humerus, but in the down-facing dog the arm is relatively fixed and acts as an origin instead of an insertion. The teres major muscle, for example, is ordinarily listed as an arm extensor, taking origin from the lateral border of the scapula and inserting on the humerus. But in the down-facing dog the teres major acts to abduct the scapula laterally and rotate it upward from a stabilized arm instead of acting as an arm extensor from a fixed scapula.

The well-known and important rotator cuff muscles, which include the teres minor, the supraspinatus, the infraspinatus, and the subscapularis, are also important in the down-facing dog. Their role is to stabilize the head of the humerus in the glenoid cavity. Without them, the action of other powerful muscles such as the pectoralis major ("pecs")and latissimus dorsi ("lats")would quickly dislocate the shoulder. With their origins and insertions reversed, the rotator cuff muscles abduct the scapulae from fixed arm positions while taking nothing away from their classic role in stabilizing the head of the humerus in the glenoid cavity. The subscapularis muscle has a slightly different action from the other three rotator cuff muscles. Since it attaches to the front of the humerus rather than to its posterior side, it also acts to pull the scapula anteriorly as well as abducting it laterally, which assists in keeping it flat against the chest wall.

In the down-facing dog one other muscle, the serratus anterior, is especially important for pulling the medial border of the scapula laterally, not from the arm, but from the front of the chest, and this action is especially helpful because it slides the scapula directly against the chest wall rather than pulling it to the side. And since the serratus anterior attaches near the inferior angle of the scapula, it is positioned to powerfully assist upward rotation by pulling the inferior angle of the scapula laterally.

Now you should be able to complete the answer to your own question. All of the aforementioned muscles are important in pulling the shoulders downward in the down facing dog and in lifting the arms overhead. But the rhomboids are important not as agonists and synergists but as antagonists, because they have exactly the opposite roles (elevation, adduction, and downward rotation of the scapulae) from what we are looking for, which is depression, abduction, and upward rotation. So if you strengthen the rhomboids in isolation, you will be headed in exactly the wrong direction.

The other component of your question is how to remedy this common complaint, and the answer is to strengthen the muscles generally that support the scapulae and upper extremities. Although several useful exercises are mentioned in chapter eight of Anatomy of Hatha Yoga, one of the best and simplest is to first come into the basic down-facing dog and then slowly lower the shoulders, slide your nose forward close to the floor, straighten the knees, and hold the posture isometrically in whatever position is especially difficult for you. Finally, let the elbows swing out, and (with considerable relief, at least for most of us) extend the elbows slowly into a simple upward-facing dog supported between the hands and the flexed toes.