The role of the scapular girdle in early motor development

Early motor development is a complex and orchestrated process that depends on a multiplicity of neurophysiological, biomechanical, and environmental factors. Among the key structures involved in this process, the scapular girdle plays a crucial role in the maturation of postural and motor skills in the first months of life. Understanding the functional dynamics of the scapular girdle and its contribution to overall motor development allows not only better clinical observation but also the implementation of effective intervention strategies in both rehabilitative and preventive contexts.

The scapular girdle, also known as the shoulder girdle, is the osteoarticular and musculo-tendinous complex that connects the upper limbs to the trunk. Anatomically, it consists of two main bone structures: the clavicle and the scapula. These articulate respectively with the sternum (sternoclavicular joint) and with the humerus (glenohumeral joint), forming a suspended yet highly mobile structure, able to dynamically adapt to motor demands.

The mobility of the scapular girdle is made possible and finely regulated by a wide set of muscles, including the trapezius, rhomboids, serratus anterior, levator scapulae, and latissimus dorsi. This muscular system, in synergy with the central nervous system, enables not only refined movements of the upper limbs but also a fundamental contribution to postural control.
In newborns, the scapular girdle plays an essential role in the development of tonic-postural control. In the first months of life, the upper limb is still in the process of maturation, with predominantly reflex motor patterns and gross movements. The strengthening of the scapular muscles and the progressive stabilization of this structure allow better tonic organization of the trunk, thus facilitating the transition from passive postures to active and voluntary movements.

The scapular girdle therefore acts as a biomechanical and neurological bridge between the axial part of the body (trunk and head) and the upper extremities. This function is crucial for the acquisition of motor skills such as reaching (extending the arm to grasp objects), rolling, and later crawling and sitting independently.

Supine sleep and maturation of the shoulder girdle

Alongside these active motor dynamics, it is equally important to consider the role of rest in neuromotor development, particularly the supine position during sleep in the first year of life. Scientific evidence and recommendations from leading international pediatric societies (such as the AAP – American Academy of Pediatrics) emphasize the importance of infants sleeping and resting on their backs until at least 12 months of age.

This recommendation is not only a preventive measure against SIDS (Sudden Infant Death Syndrome), but also has significant implications for harmonious neuromotor development. Sleeping in a supine position ensures physiological relaxation of the scapular girdle, preventing the onset of muscular compensations and postural asymmetries caused by prolonged prone or lateral positioning. Moreover, the balanced distribution of body weight on the back during nighttime rest supports better modulation of basic postural tone and protects the musculoskeletal integrity of the scapulothoracic region.

The prone position as a biomechanical and neuromotor stimulus

The prone position represents a privileged context for the development of the scapular girdle. In the first months, when placed on their stomach, infants begin to lift their head and chest thanks to the activation of the extensor muscles of the neck and back. At this stage, the scapular girdle begins to stabilize through co-contraction of the scapular and thoracic muscles, allowing for progressive maturation of postural control of the cervical spine and upper trunk.

One of the most effective practices to actively stimulate these skills is tummy time, that is, the time infants spend daily in a prone position during wakefulness and under supervision. If introduced early (as early as the first weeks of life, in short sessions), this activity allows infants to actively explore their body and space, activating the posterior kinetic chains and promoting symmetrical development of the scapular, cervical, and dorsal musculature. Furthermore, tummy time stimulates proprioception, improves sensory integration, and helps prevent positional plagiocephaly. Over time, infants develop better scapulothoracic control and may begin to use their arms to support themselves, push, and move. This process typically emerges between the 3rd and 6th month of life, marking the transition from postural dependence to progressive motor autonomy.

These skills are fundamental for building the neuromotor foundations that will later enable rolling, crawling, and finally standing. Strengthening of the scapular girdle thus represents an indispensable biomechanical precursor for the evolution toward independent and functional mobility.

Strategies to support development

Supporting the development of the scapular girdle requires an integrated approach that considers targeted neuromotor stimulation, the quality of the surrounding environment, and respect for individual developmental milestones. It is essential that motor experiences offered to infants are calibrated to their level of neuromotor maturation, avoiding both excessive early stimulation and prolonged environmental passivity.

Among the most effective evidence-based strategies are:

A rich and varied motor environment

The quality of the environment is key to offering opportunities for spontaneous movement and self-exploration. It is important to provide safe surfaces, neither too hard nor too soft (such as play mats or activity rugs), that allow infants to perceive their bodies in relation to the support surface. Sensory objects (colorful, noisy, with different textures) should be placed to encourage reaching, rolling, and head rotation. The child’s continuous adaptation to these stimuli promotes sensory integration and intentional movement.

Tactile and proprioceptive interaction

Infant massage, as well as passive and active stimulation of the upper limbs, are valuable tools to foster body awareness, muscle tone development, and sensory regulation. When integrated into an empathetic relational context that respects the infant’s signals, these practices contribute to the consolidation of cortical body maps, enhancing motor response and the sense of security. Proprioceptive stimulation through gentle pressure, soft mobilizations, and postural variations further facilitates activation of the scapular and thoracic muscles.

Conscious use of ergonomic supports

In some stages, the use of ergonomic supports designed for physiological containment can help ensure optimal postural alignment and a safe transition to the prone position. When used correctly and temporarily, these devices can facilitate scapular girdle activation, offering infants a sense of safety and stability that promotes spontaneous movement.

A valid support for the safe and gradual introduction of tummy time is the Welcome Pod^®, an ergonomic device designed to respect the physiology of the newborn and accompany the first stages of motor development. The Welcome Pod provides gradual transition to the prone position, offering containment and support to immature body segments. Its design promotes alignment of the scapular and pelvic girdles, facilitating balanced muscular activation and reducing the onset of postural compensations.

Supporting proper scapular girdle development means creating the ideal environmental and relational conditions for spontaneous, respectful, and harmonious movement. Each proposal must be suited to the child’s developmental stage, respecting their timing, emerging skills, and fundamental need for affective relationships—the irreplaceable foundation for all motor and sensory learning.