Shoulder blade exercises aim to improve how the shoulder blade (scapula) moves and sits against the rib cage, so the shoulder has a steady base and the upper back muscles share the load. They suit most people with shoulder pain when reaching or lifting, aching between the shoulder blades from desk work, and many with a snapping or slightly winging shoulder blade. Control often improves within 3 to 4 weeks. Strength and endurance usually take 6 to 12 weeks.
This is general information. A physical therapist who has examined your shoulder and upper back can set the exact exercises and dose for you.
Key takeaways
- The shoulder blade is the base: it turns and tilts on the rib cage so the arm can lift fully.
- Three stages: find the position, build control, then build strength.
- Key muscles: serratus anterior holds the blade against the ribs; the lower trapezius draws it down and turns it as the arm lifts.
- The pain rule: discomfort up to about 3 out of 10 that settles by the next morning is usually acceptable.
- Timeline: control often improves within 3 to 4 weeks; strength and endurance usually take 6 to 12 weeks.
Before you start
Get assessed by a physical therapist or doctor first if you have:
- Sudden winging: a shoulder blade that started to stick out after an illness, injury or surgery, especially with weakness lifting the arm.
- A recent injury: a fall or a heavy lift followed by pain or weakness.
- Pain with breathing: sharp upper back pain when you breathe in deeply.
- Numbness or tingling: in the arm or hand.
Mild discomfort up to about 3 out of 10 that settles within an hour or by the next morning is usually acceptable. Sharp pain, or pain that is worse the next day, means ease back.
Stage 1: find the position
The anatomy of the upper back and shoulder blade shows how about 17 muscles attach to each blade. Stage 1 teaches you to feel where it sits and move it without the top of the shoulder taking over. It often lasts 1 to 2 weeks.
Shoulder blade setting
Sit or stand tall with your arms by your sides. Gently draw the shoulder blades back and slightly down, about a quarter of the way, as if sliding them into your back pockets. Hold, breathing normally.
- Dose: 10 holds of 10 seconds, 3 times a day.
- You should feel: light work below and between the shoulder blades.
- Common mistake: squeezing hard or arching the lower back.
Wall slide
Stand facing a wall with your forearms on it, elbows at shoulder height and shoulder width apart. Lean gently into the wall and slide your forearms up as far as is comfortable, letting the shoulder blades turn and move around the ribs. Slide back down.
- Dose: 2 sets of 10, once or twice a day.
- You should feel: work along the side of the ribs, below the armpit.
- Common mistake: shrugging the shoulders toward the ears as the arms go up.
Stage 2: build control
Move on once you can set the shoulder blade easily and wall slides feel smooth. Stage 2 often runs from about week 2 to week 6.
Band row
Anchor a resistance band at chest height. Pull your elbows back past your sides, letting the shoulder blades draw back and down at the end. Return slowly.
- Dose: 3 sets of 12 to 15, every other day.
- You should feel: work between and below the shoulder blades.
- Common mistake: pulling with the arms alone while the shoulder blades stay still.
Serratus punch
Lie on your back holding a light weight with your arm straight up toward the ceiling. Without bending the elbow, push the weight further toward the ceiling so the shoulder blade lifts off the floor, then let it settle back.
- Dose: 3 sets of 12 to 15, every other day.
- You should feel: work along the side of the ribs.
- Common mistake: bending the elbow, which turns it into an arm exercise.
Wall push-up plus
Stand at arm’s length from a wall with your hands on it at shoulder height. Do a wall push-up, then at the top push a little further so the upper back rounds slightly and the shoulder blades spread apart.
- Dose: 3 sets of 10, every other day.
- You should feel: work along the side of the ribs and the front of the chest.
- Common mistake: letting the shoulder blades lift away from the ribs at the bottom.
Stage 3: build strength
Stage 3 usually starts around week 4 to 6, once stage 2 feels steady. It works the lower trapezius in positions closer to overhead.
Prone Y and T
Lie face down with your forehead on a folded towel. With thumbs pointing up, lift both arms into a Y shape, slightly above shoulder height. Lower, then lift them straight out to the sides into a T.
- Dose: 2 to 3 sets of 8 to 10 of each, every other day, without weight at first.
- You should feel: work below and between the shoulder blades.
- Common mistake: lifting the head or shrugging the shoulders.
Wall lift-off
Stand facing a wall with your forearms on it in a Y shape above your head. Draw the shoulder blades slightly down, then lift both hands an inch off the wall and hold.
- Dose: 3 sets of 8 holds of 3 to 5 seconds, every other day.
- You should feel: work low down between the shoulder blades.
- Common mistake: arching the lower back to get the hands off the wall.
How to progress
- Stage 1 to 2: when setting is easy and wall slides feel smooth, often after 1 to 2 weeks.
- Stage 2 to 3: when 3 sets of each stage 2 exercise feel steady with no rise in pain the next morning.
- Adding load: increase resistance or holds one exercise at a time.
- Overall: control often improves within 3 to 4 weeks; strength and endurance usually take 6 to 12 weeks.
When to stop and get checked
Stop the exercise that is aggravating things and get assessed by a physical therapist or doctor if pain keeps rising over 2 weeks despite a lower dose, winging becomes more obvious, or nothing has improved after about 6 weeks. With a winged shoulder blade, ask whether a nerve or the muscles are the main reason.
Where else this could be coming from
- Pain between the blades: pain between the shoulder blades can come from muscles, rib joints, the neck or, less often, organs.
- A snapping blade: a snapping shoulder blade grinds or clunks over the ribs, often with a tender spot near the inner edge.
- The neck: shoulder blade pain that comes from the neck often changes with neck movement and may come with arm tingling.
- A rib joint: rib joint pain tends to be sharp beside the spine and catch with twisting or a deep breath.
- Pain on breathing: upper back pain when breathing has causes inside and outside the chest.
- Where exactly it hurts: shoulder blade pain by location narrows down the likely sources.
A shoulder moves well when its base moves well.
Call your local emergency number or go to the emergency department if
- Chest symptoms: pain between or under the shoulder blades comes with chest pain or pressure, breathlessness, sweating or nausea.
- Sudden tearing pain: severe, sudden pain between the shoulder blades that feels like tearing or ripping.
See a doctor today if
- Breathing and fever: upper back pain comes with fever, a cough or sharp pain on every breath.
- New weakness: the arm suddenly becomes weak, or the shoulder blade suddenly sticks out after an injury.
Get it checked soon if
- Winging that stays: the shoulder blade sticks out more than the other side for more than 2 weeks.
- Night pain: upper back pain at night does not ease with changing position.
- Tingling or numbness: you notice it in the arm or hand.
- No progress: nothing has improved after about 6 weeks of consistent exercise.
More on this area: neck and shoulder exercises.
Train the base, and the arm above it has more to work from.
Written by Louise Yow, Neck & Shoulder Physio.