099. Upper traps - are they really a bad guy with Jo Gibson

03/13/20 • 19 min

Patients with shoulder pain, rotator cuff tears and nerve injuries can often be seen shrugging their shoulder while they lift their arm, appearing to overuse their upper fibres of trapezius. Surface EMG research has shown increased activity in UFT in shoulder pain and whiplash patients. To add to this, patients get sore upper traps, and can be adamant that they need regular massage of their upper fibres of trapezius (UFT).

We seem to have plenty of evidence that we need to decrease UFT muscle activity, and help this by providing exercises to target the middle and lower traps.

Is this really the case? Are the upper traps really a bad guy, or a victim caught in the spotlight? Do we need to decrease upper traps muscle activity to help our patients shoulder or neck pain? Or perhaps counter-intuitively, do we need to strengthen upper traps and help them to work together with the surrounding muscles?

In this podcast, Jo Gibson (Clinical Specialist Physio) explores the evidence around the upper fibres of trapezius, and implications on your clinical practice. You’ll discover:

What are the myths around upper traps?
Are upper fibres of trapezius a bad guy or a victim?
Why do upper traps sometimes seem to be overactive?
Should we aim to increase the activity in middle and lower traps?
What information does surface EMG really provide?
Can taping of the scapula change recruitment of the trapezius?
Should we strengthen UFT?
Why is initial activation of the UFT important in shoulder elevation movements?
Why should patients with rotator cuff tears or stiff & painful shoulders use upper traps more with their movements?
How can we incorporate UFT strengthening into our shoulder strengthening?
What exercises can we use to strengthen UFT without increasing activity in levator scapulae?
Why is UFT strengthening important in ACJ injury rehab?
In gym goers, what scapula setting errors are commonly used?
How do nerve injuries that affect the upper traps impact movement?
Do trigger points or soreness indicate that our patients need massage or exercises to decrease UFT activity?

Download this episode now to improve your treatment of shoulder and neck pain.

Podcast handout

Free video series “Frozen shoulder assessment & treatment” with Jo Gibson

Shoulder: Steps to Success online course with Jo Gibson

Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess

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Articles associated with this episode:

Download the podcast handout to receive the articles associated with this podcast.
Lee JH, Cynn HS, Choi WJ...

We seem to have plenty of evidence that we need to decrease UFT muscle activity, and help this by providing exercises to target the middle and lower traps.

In this podcast, Jo Gibson (Clinical Specialist Physio) explores the evidence around the upper fibres of trapezius, and implications on your clinical practice. You’ll discover:

What are the myths around upper traps?
Are upper fibres of trapezius a bad guy or a victim?
Why do upper traps sometimes seem to be overactive?
Should we aim to increase the activity in middle and lower traps?
What information does surface EMG really provide?
Can taping of the scapula change recruitment of the trapezius?
Should we strengthen UFT?
Why is initial activation of the UFT important in shoulder elevation movements?
Why should patients with rotator cuff tears or stiff & painful shoulders use upper traps more with their movements?
How can we incorporate UFT strengthening into our shoulder strengthening?
What exercises can we use to strengthen UFT without increasing activity in levator scapulae?
Why is UFT strengthening important in ACJ injury rehab?
In gym goers, what scapula setting errors are commonly used?
How do nerve injuries that affect the upper traps impact movement?
Do trigger points or soreness indicate that our patients need massage or exercises to decrease UFT activity?

Download this episode now to improve your treatment of shoulder and neck pain.

Podcast handout

Free video series “Frozen shoulder assessment & treatment” with Jo Gibson

Shoulder: Steps to Success online course with Jo Gibson

Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess

Links associated with this episode:

Articles associated with this episode:

Download the podcast handout to receive the articles associated with this podcast.
Lee JH, Cynn HS, Choi WJ...

Previous Episode

098. How to use strength training in your treatment with David Joyce

Strength training can be used in your treatment and rehab programs to improve your patients strength, load capacity, function & pain, so they can get back into work and the activities they enjoy. In your athletic patients, strength training can be used to help restore power and speed, which are vital for sporting performance.

Would you like to include more strength training in your treatment, but aren’t completely sure about the most effective ways to build strength? Which exercises can you use? How many sets and reps should your patients perform? Will 3 sets of 10 reps build strength effectively? What is power training, when should you focus on improving power, and how can you incorporate power training?

In this podcast with David Joyce - Sports Physiotherapist, S&C expert and co-author of High performance training for sports, and Sports injury prevention and rehabilitation, you will discover:

How to use strength training with your patients
The most effective ways to help your patients develop strength
Set and rep ranges for strength improvements
Recent developments in S&C
What is power & power training, and how does this compare to strength?
When should your patients work on improving power vs strength
How to improve power using different areas on the force/velocity curve
Power development using bodyweight and barbell exercises
Calf strengthening
How to incorporate velocity/explosiveness training
When are higher reps useful?
Does endurance training with higher reps carryover to improved running or cycling
When your patients are performing deadlifts or squats, what elements should you monitor?
Do biomechanics in a deadlift or squat matter?
What rest periods should be used to help develop strength, while maintaining an efficient training routine
What is strength training vs conditioning?
How can patients perform conditioning for improved fitness?
Should conditioning be incorporated into strength training sessions for maximum improvements in strength?
Should exercises and sets be performed to temporary muscular failure (when the bar is unable to be lifted for another repetition)?
Resources to help improve your strength & conditioning

Dr Claire Minshull also presented two online courses for Clinical Edge members to further develop your strength & conditioning skills and confidence. You can get access to these online courses with your free trial membership.

CLICK HERE to get access to these online courses on strength & conditioning for youths and adolescents with Dr Jon Oliver with your free trial membership

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Next Episode

100. 5 practical strategies to improve your clinical reasoning & treatment results with David Toomey, Jordan Craig & Simon Olivotto

100 Physio Edge podcast episodes since I discovered a love of podcasts, and created the Physio Edge podcast to help Physio’s, Physical Therapists and other health professionals in their clinical practice with practical information from the leaders in different musculoskeletal and sports injuries. I really enjoy recording each podcast, helping you with your clinical challenges and hearing how the podcast has helped you with your patients.

While recording each of these podcasts, I’ve noticed that one area Physiotherapy experts & leaders have in common is their well developed clinical reasoning. They use effective & efficient clinical problem solving to assess and treat their patients. How can you improve your clinical reasoning to more effectively assess and treat your patients?

In this podcast with the new Clinical Edge Senior Physio education & presentation team - David Toomey (NZ based Musculoskeletal Physio), Jordan Craig (APA Titled Musculoskeletal & Sports Physio) and Simon Olivotto (Specialist Musculoskeletal Physiotherapist, FACP), you’ll explore:

Five practical strategies you can use immediately to improve your clinical reasoning and treatment results.
Clinical reasoning - what is it and how will it help you with your patients?
How to effectively & efficiently assess and treat in short treatment sessions
How to create a rehabilitation or training plan for a patient to suit their individual needs.
Low back pain patients - How to use clinical reasoning to target your questioning, objective assessment and treatment to your patients needs

Download this podcast now to improve your clinical reasoning and treatment results with these five practical strategies.

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