Current concepts scapular dyskinesis pdf

Current concepts for shoulder training in the overhead athle. It is best considered an impairment of optimal shoulder function. Jul 16, 2015 the scapular assistance test sat and scapular retraction test srt help evaluate the degree to which scapular dyskinesis, when corrected, may alter the patients symptoms. The main cause is muscle imbalance, between the trapezius, rhomboids, and pectoralis minor. Current tests and measures, while proven to be reliable, have not altogether shown strong validity by demonstrating correlation with biomechanical motion, symptoms, pathology, or outcomes.

Name 4 direct factors contributing to rom shift or deficit. Although it occurs in a large number of shoulder injuries, it appears that scapular dyskinesis is a nonspecific response to a painful condition in the shoulder rather than a specific response to certain glenohumeral pathology. The scapular muscles play a vital role during the overhead throwing motion. Juulkristensen b, hilt k, enoch f, remvig l, sjogaard g. Scapular dyskinesis, meaning abnormal motion of the scapula during shoulder movement, is a clinical finding commonly encountered by shoulder surgeons. Shoulder instability represents a spectrum of disorders resulting in shoulder dysfunction, including subluxation, dislocation, and symptomatic laxity. A common contributor, seen in 68100% of shoulder injuries, is scapular dyskinesis.

The scapula serves many roles in order for proper shoulder function to occur. Lesions in throwers will be presented in the mayjune issue. Ben kibler, md aaron sciascia, ms, atc, nasmpes, ns shoulder center of kentucky 700 bobolink dr lexington, ky 40504. The relationship between breathing pattern disorders and. Deficits in hip abductor or extensor strength, deficits in hip rotation flexibility, or core strength weakness have been identified in 50% of slap injuries. These roles include providing synchronous scapular rotation during humeral motion, serving as a stable base for rotator cuff activation and functioning as a link in the kinetic chain. Treatment is based on rehabilitation, using numerous exercises for activating scapulothoracic muscles. This will usually bring out any weakness in the muscles and display any resulting scapular dyskinesis abnormal scapular motion. The notion that an unstable scapula is related to shoulder dysfunction and pathology is well accepted. Oct 28, 2011 sports physiotherapists regularly assess and rehabilitate shoulder dysfunctions and pathologies. Although it occurs in a large number of shoulder injuries, it appears that scapular dyskinesis is a nonspecifi c response to a painful condition in the shoulder rather than a specifi c response to certain glenohumeral pathology. The sick scapula, scapular dyskinesis, the kinetic chain, and rehabilitation stephen s. Scapular dyskinesis identified during active motion did not result in different 3d scapular orientation or acromiohumeral distance during active arm elevation in static positions.

Dynamic scapular motions may be evaluated by having the patient move the arms in ascent and descent 35 times. Scapular dyskinesia, the forgotten culprit of shoulder pain. Clinical observation is the most pragmatic method for assessing dyskinesis yielding interrater agreement of 79% and sensitivity of 76%. The reliability measurements of lateral scapular slide test at. Recommendations for appropriate clinical measures include. The scapular assistance test sat and scapular retraction test srt help evaluate the degree to which scapular dyskinesis, when corrected, may alter the patients symptoms. The scapular dyskinesis is an alteration of the normal scapular kinematics as part of scapulohumeral rhythm, which has been shown to be a nonspecific response to a. Patients with symptomatic sd show an altered scapular orientation. Sports physiotherapists regularly assess and rehabilitate shoulder dysfunctions and pathologies. Scapular dyskinesis or scapular dysfunction refers to the abnormal mobility or function of the scapula shoulder blade. Statistical analysis was performed by applying the shapirowilks test, which found that dscapular data were parametric. Scapular dyskinesis is quite frequent and can lead to shoulder pain.

Motion in forward flexion is most likely to demonstrate medial border prominence. Clinical implications of scapular dyskinesis in shoulder injury. A current concept of scapular dyskinesia and scapular algorithm. We present a case of a young male patient with dyskinesis due to axonal involvement of the long thoracic nerve and paresis of the anterior. These roles include providing synchronous scapular rotation. Mar 15, 2020 scapular dyskinesis scapular dyskinesis alteration of motion is a term that denotes loss of control of normal scapular motion, physiology or mechanics. Abstract despite the essential role played by the scapula in shoulder function, current concepts in shoulder training and treatment regularly neglect its contribution. Evaluation of clinical assessment methods for scapular dyskinesis.

A current concept of scapular dyskinesia and scapular. When the normal 3d scapular movements are disrupted by abnormal scapular musclefiring patterns, fatigue, or injury, it has been hypothesized that the shoulder complex functions less efficiently, leading to injuries to the shoulder, including the glenohumeral joint. Contrast temporalbased and criteriabased protocols. Scapular dyskinesis is the term used to describe loss of normal scapular physiology, biomechanics, and kinetics. Overview and benefits the kinesis trilogy program is a time efficient, high intensity total body workout specifically designed for personal training. A comprehensive approach to nonoperative rotator cuff.

The disabled throwing shoulder marianjoy medical library. In all overhead sports, the athletes shoulder is predisposed to the development of multiple common biomechanical adaptations, including acquired glenohumeral instability, range of motion deficits, specifically a loss of internal rotation, muscle imbalances with a lack of scapular retraction strength, and resulting scapular dyskinesis 6,17,18,20,35,48. Assessment and management of scapular dyskinesis 2015 wfatt world congress t. The sat evaluates scapular contributions to impingement and rotator cuff strength whereas the srt can be used for evaluation in cases of labral symptoms and rotator cuff. Accurate and comprehensive assessment of scapular dyskinesis is essential to identify alterations in normal. The shoulder complex relies heavily on the scapular stabilizers to maintain optimal scapular position throughout movement. As a sports physiotherapists it is important to evaluate the contributing factors to shoulder pathology. Shoulder instability, dysfunction and scapular dyskinesis. Current concepts in the assessment and rehabilitation of the. Scapular dyskinesis sd is currently defined as an alteration of normal scapular kinematics. This altered scapular positionmovement has been termed scapular dyskinesis. The sick scapula, scapular dyskinesis, the kinetic chain, and rehabilitation will be presented in the julyaugust issue. Scapular positioning in athletes shoulder physical therapy ceu. Scapular dyskinesis can decrease function of the shoulder complex and increase the risk for injury.

In these cases, rehabilitation is the best treatment. Assessment of scapular dyskinesis the sports physiotherapist. Dyskinesia in the overhead throwing athlete 43 kibler wb, sciascia ad, uhl tl, et al. Aug 01, 2016 the notion that an unstable scapula is related to shoulder dysfunction and pathology is well accepted. These roles include providing synchronous scapular rotation during humeral. This altered scapular position movement has been termed scapular dyskinesis.

Kibler scapular dyskinesis free download as pdf file. The program is based on a unique threefold training. Luckily, proper attention to the scapular stabilizers can prevent and help correct scapular dyskinesis. The protocol is both chronologically more information. The inability to achieve proper scapular alignment and coordinated motion during activity is described as scapular dyskinesis. Scapular dyskinesis in trapezius myalgia and intraexaminer reproducibility of clinical tests. T he medical communitys fascination with the disabled throwing shoulder derives from the pub. Furthermore, current concepts of rehabilitation dealing. This highly mobile and versatile joint is one of the most common reasons people visit their health care dysinesis information.

Scapular dyskinesis has multiple causative factors, both proximally muscle weaknessimbalance, nerve injury and distally acromioclavicular joint injury, superior. To appraise the literature and understand the current concepts in evaluation of scapular dyskinesis, clinical implications and factors influencing abnormal kinematic alterations and relevant strategies for management. Current methods for assessing scapula dyskinesis involve clinical observations, threedimensional kinematics and threedimensional wing computer tomography. Each role is vital to proper arm function and can only occur when the anatomy around the shoulder is uncompromised. Scapular dyskinesis scapular dyskinesis alteration of motion is a term that denotes loss of control of normal scapular motion, physiology or mechanics. Scapular dyskinesis and its relation to shoulder pain. Scapular dyskinesis in young, asymptomatic elite swimmers. Nov 15, 2019 current concepts scapular dyskinesis pdf dyskinesis is present in a high percentage of most shoulder the concepts regarding how to evaluate and treat scapular dys kinesis are. However, few studies report the results of the rehabilitative therapy. Current concepts in the scientific and clinical rationale. Nov 12, 2019 dyskinesia in the overhead throwing athlete 43 kibler wb, sciascia ad, uhl tl, et al. Treatment of scapular dyskinesis the sports physiotherapist. The initial postulate that both would have a significant association was confirmed, because this work has confirmed the influence of positioning alteration of the scapula when associated with shoulder pain in sedentary young adults.