Q: I noticed you mentioned breathing patterns as a potential issue that a good PT should address. Tony briefly explained how this relates to overall shoulder function in his Limiting Factors article if I remember correctly, and it seems to be a subject that’s been popping up quite a bit recently.

Would it be possible for you elaborate on this even further? Even just throwing out some random thoughts you may have on the topic would be great

A: Think of what happens when air enters the chest: the shoulders rise. Most people are extremely tight in levator scapulae already – so elevating the rib cage, clavicle, and scapulae further is only going to exaggerate things. Learn to breath into the belly, and you can put levator scapulae on slack a bit more.

The fundamental problem is that levator scapulae is a downward rotator of the scapula – and when it’s tight, it makes it difficult to get appropriate upward rotation to allow for safe overhead motion. This compromises the space through which the rotator cuff tendons pass. Gray Cook’s Secrets of the Shoulder delves into this in some detail.

Eric Cressey

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