Scapular dyskinesis

Question 1

What is scapular dyskinesis?

Answer 1

Abnormal movement of the scapula during movement. Biomechanical alterations may contribute to altered scapular movement and positioning include soft tissue tightness, altered muscle activity or strength imbalance

Question 2

Common causes

Answer 2

• Shoulder impingement syndrome
• Non-traumatic shoulder instability
• Multidirectional shoulder joint instability
• Insidious onset neck pain and whiplash-associated disorders
• Rotator cuff tendinopathy and rotator cuff tears

Question 3

Signs and symptoms Type 1 Infers-medial scapular boarder prominence

Answer 3

• Evident in cocking position of overhead sports
• Tightness in the anterior side of shoulder
• Weakness of lower trapezius and serrates anterior muscles

Question 4

Signs and symptoms Type 2 Medial boarder prominence

Answer 4

• Patten is winging of the entire medial boarder of the scapula at rest
• Becomes more prominent in cocking position after repetitive levation of upper limb
• Caused by fatigue of scapula stabilising muscles

Question 5

Signs and symptoms Type 3 Supero-medial boarder prominence

Answer 5

Displayed as a prominence of superior medial boarder of scapula, often associated with impingement and rotator cuff injury

Question 6

Treatment

Answer 6

• MET and STR to pec minor and major
• Effleurage and Trp to lower traps due to poor activation and inhibition
• MET, STR and Tops to upper traps and levator scapula due to over activity and facilitation
• Tops and MET to subscapukaris

Question 7

Post care advice

Answer 7

• Avoid aggravating movements and exercises
• Modify training load and volume
• Stretching and self fascial release of pec major and minor
• Activation and strengthening exercises for serrates anterior and lower trapezius
• Mobalisation and foam rolling of the thoracic spine

Question 8

Special tests

Answer 8

• Painful arc
• Empty can
• Speed’s test
• Neer’s test
• Hawkins Kennedy
• Apley’s scratch test