Scapular Dyskinesis
Scapular dyskinesis or scapular dysfunction consists of an altered scapular position and motion pattern. This occurs from muscular imbalance, a lack of coordination or injury to the area. Most shoulder injuries have an underlying scapular dysfunction as well. (1-3)
Scapular dyskinesis is often asymptomatic initially until another shoulder injury occurs. If scapular dysfunction is symptomatic, individuals describe pain on the front or top and back side of the shoulder. Scapular dysfunction often gets worse the longer an activity goes on. Sometimes there are shoulder range of motion limitations. Scapular dyskinesis is often part of upper crossed syndrome.
Treatment consists of restoring mobility to tight tissues while strengthening weak ones. Manual release techniques are often used to enhance lengthening of tissues. Exercises focus on dynamic stabilization as well as endurance of stabilization. Manipulation can be used to restore mobility of the scapulo/thoracic joint. (4,5)
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Borstad JD, Ludewig PM. The effect of long versus short pectoralis minor resting length on scapular kinematics in healthy individuals. J Orthop Sports Phys Ther 2005;35:227–38.
McQuade KJ, Dawson JD, Smidt GL. Scapulothoracic muscle fatique associated with alterations in scapulohumeral rhythm kinematics during maximum resistive shoulder elevation. Journal of Orthopaedic and Sports Physical Therapy. 1998;28(2):74-80.
Kibler WB, Sciascia AD. Current concepts: scapular dyskinesis. Br J Sports Med 2010;44:300–5.
Bergman GJD, Winters JC, et al. Manipulative Therapy in Addition to Usual Medical Care for Patients with Shoulder Dysfunction and Pain. Ann Int Med 2004 141:432-43.
Winters et al. Comparison of Physiotherapy, Manipulation and Corticosteroid Injection for Treating Shoulder Complaints in General Practice. BMJ 1997