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46 m a s s a g e & b o d y w o r k m a y / j u n e 2 0 1 8 nerves, and blood vessels critical to the health and function of the upper extremity. Specifically, the supraspinatus maneuvers the humeral head inferiorly as prime mover muscles such as the deltoid move the shoulder through abduction. When the supraspinatus contracts, it levers the proximal end of the humerus downward as the distal end rises upward. Ideally, this occurs in tandem with activation of the deltoid muscle during shoulder abduction. Subtle depression of the humeral head during shoulder abduction positions the humeral head centrally within the glenoid fossa, preventing contact or impingement on the acromion process. By maintaining adequate space and optimal mechanics throughout the full range of shoulder abduction, the supraspinatus prevents compression and excessive friction that is damaging to surrounding soft tissues. The location of the supraspinatus tendon deep to the acromion process makes this structure particularly vulnerable to tendinitis, impingement, and tearing. Excessive friction and trauma to this muscle is common and debilitating to the function of the entire shoulder. Additionally, bony anomalies such as an excessively angled or "hooked" acromion, and postural deviations such as a forward head or rounded shoulders, can inhibit activation of the rotator cuff and encourage shoulder impingement syndromes. Establishing and maintaining proper posture and a strong, healthy supraspinatus in conjunction with the other rotator cuff muscles is essential to optimal shoulder function. Christy Cael is a licensed massage therapist and certified strength and conditioning specialist. Her private practice focuses on injury treatment, biomechanical analysis, craniosacral therapy, and massage for clients with neurological issues. She is the author of Functional Anatomy: Musculoskeletal Anatomy, Kinesiology, and Palpation for Manual Therapists (Lippincott Williams & Wilkins, 2009). Contact her at christy_cael@hotmail.com. FUNCTIONAL ANATOMY Client Homework: Shoulder Depression Stretch 1. Stand or sit up straight with the head facing forward. 2. Keep your neck elongated and your back straight as you reach back and clasp your hands behind your back, palms together. Grasp a towel if you are unable to clasp your hands. 3. Gently squeeze your shoulder blades together and straighten your arms. 4. Take several deep breaths and push your shoulders down as you exhale. 5. Maintaining a long neck and straight back, slowly rotate your head from side to side. Editor's note: The Client Homework element in Functional Anatomy is intended as a take-home resource for clients experiencing issues with the profiled muscle. The stretches identified in Functional Anatomy should not be performed within massage sessions or progressed by massage therapists, in order to comply with state laws and maintain scope of practice. Palpating Supraspinatus Positioning: client prone with arm at side. 1. Palpate the spine of the scapula with your thumb. 2. Move your thumb superiorly above the spine to locate the supraspinous fossa. 3. Locate the muscle belly in the supraspinous fossa. 4. Follow the muscle belly to the acromion process, then locate the tendon laterally between the lateral acromion and greater tubercle of the humerus. 5. Resist as the client initiates shoulder abduction to ensure proper location.