The Hand-Scapula Relationship

The scapular-humeral rhythm affects the entire arm down to the hand. When the arms picks up an object, the scapula acts like a crane or lever on the back to move the arm in space.

The upward and downward positions of the scapula can be confusing movements  to visualize. They refer to the placement of the shoulder blade on the ribs in movement.

Upward rotation of the scapula refers to the healthy movement of the scapula following the lift of the arm.  When done correctly, the scapula glides down the back, widens and shapes the ribcage. The tip of the scapula  should follow the direction of the hand as it moves up in space. The inferior border of the scapula (the lower  tip of the shoulder blade) moves forward toward the armpit and the scapula revolves slightly around the  ribs to help move the arm forward. The gliding action brings an easeful depression of the shoulder blade.

Downward rotation of the shoulder blade follows the movement of the arm as it reaches backwards. The superior border of the scapula moves up over the shoulder as the arm extends backwards. You may notice some clients whose scapulae are stuck in downward rotation. Posture, tension around the shoulder girdles and weakness are all possible reasons for this.