Circus shoulders have to support, stabilize, develop and absorb forces all while functioning in an end range overhead position. One of the most challenging things as a clinician is trying to figure out exactly how to help artists achieve the balance needed to have their full range of motion and learn to control it in a way that serves them and their skill and performance goals.

Every once in a while, I notice a “trend” in what I am seeing and get excited thinking about why and want to share it with you. In the last few weeks, I have seen the same shoulder movement pattern in at least three patients with similar pain issues. But the neatest part and why I got excited this time is that these were folks across aerial, pole, and ground disciplines. All of these folks had pain in their shoulder with their arm overhead. All of these folks said they tried to “wrap their scapula” when they were engaging their shoulders… but what was happening?!? Why were they having trouble?!?

Let’s start at the beginning, what is scapular wrapping?

Scapular wrapping or “scap wrap” has become a shorthand for one component of shoulder engagement with the arm overhead. For the shoulder to work at its best the scapula (shoulder blade) needs to be muscularly supported on the ribcage in an upwardly rotated and posteriorly tilted position. This allows the humerus (arm) to line up as

The “scap wrap” part is when the scapula tips backwards and glides around the ribcage so that the bottom corner of the shoulder blade comes into the armpit.

If this is a new concept for you, test it out. Put one hand on your ribcage under your opposite side armpit, reach around as far as you are comfortable. Bring your other arm overhead but don’t think too hard… did you feel your scapula move under your first hand?

What was happening for these folks was a greater emphasis on the concept of “wrap” the protraction of the scapula, moving it around the ribcage, but they weren’t getting the posterior tilt component that brings the inferior angle around and points the joint (glenoid) upwards.

OK, so now you may be asking, how does that happen? Why and how can artists do this differently? Well, The cool thing about shoulders is that they have so many different ways of moving that allow us to have a really large range of motion. And, the cool thing about circus artists is that they are skilled at a wide variety of movement and creating shapes that open up the opportunity for all sorts of “interesting” patterns.

In the case of scapular motion, both the pectoralis muscles and the serratus anterior protract the scapula but only the serratus anterior tilts it backwards. The pectoralis minor and major will instead tilt the scapula forwards. Also related to hanging, the pectoralis major actually adducts the arm which can also mimic scapular wrapping (but that’s a story for another time…)

Here’s what it looks like:

Can you spot the difference? It’s subtle but it’s there. In the first photo, there is more pec muscle activity and the shoulder is a little more “closed” with less range of motion. 

This difference in muscle action changes how the scapula moves and stabilizes. Great, you may think, but why does this matter? 

Well, the ball and socket joint at the shoulder, made up of the glenoid and the humerus, is one of the most mobile in the body. So, if the shoulder blade isn’t moving well this mobile joint might just take up the slack increasing the pressure on the joint structures including the rotator cuff musculature. 

And what in the world do we do about it?!?

From handstand to hanging the concept is similar. We are looking for the same scapular and humeral position. Therefore, our beginning exercises can be the same as we introduce the movement patterns but the training for an aerialist and a ground acrobat will look different. 

Here are two of my favorite exercises for handstanders and long arm hangers! In each I am emphasizing the positioning and muscular performance to achieve the movement pattern I’m trying to get them to find and reinforce. The circus specific exercise just looks a little different depending on their goals.

The first exercise is one I work on with my handbalancers and artists who need to be able to push overhead. In the hands and knees position we can take a moment to find the desired shoulder blade position and I can help guide them if needed without knocking their handstand over.

Here, I spend a lot of time talking about where and how that push is created and maintaining length in the side body, or pressing their hips away from the wall and towards the back of the room… I try to have at least 3-5 ways to cue any movement to see how many ways I can connect with different folks and the way they think.

With hanging artists, I want them to be able to play with the different motions at the shoulder blade, again with less load so they can feel the variations. Here, I am emphasizing the humeral (not forearm) rotation and maintaining the arm by the ear as they perform that rotation. The temptation with these folks is to rotate and pull the arm out of the end range position which decreases their ability to achieve that scapular posterior tilt that we are looking for.

Give them a try on yourself, your patients, or your students! Let me know what you think!!!