Current concepts scapular dyskinesis pdf

Current concepts in the scientific and clinical rationale. Clinical implications of scapular dyskinesis in shoulder injury. 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. Scapular positioning in athletes shoulder physical therapy ceu. Abstract despite the essential role played by the scapula in shoulder function, current concepts in shoulder training and treatment regularly neglect its contribution. Patients with symptomatic sd show an altered scapular orientation. A common contributor, seen in 68100% of shoulder injuries, is scapular dyskinesis. Overview and benefits the kinesis trilogy program is a time efficient, high intensity total body workout specifically designed for personal training. Aug 01, 2016 the notion that an unstable scapula is related to shoulder dysfunction and pathology is well accepted.

However, few studies report the results of the rehabilitative therapy. Scapular dyskinesia, the forgotten culprit of shoulder pain. 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. Each role is vital to proper arm function and can only occur when the anatomy around the shoulder is uncompromised. Current methods for assessing scapula dyskinesis involve clinical observations, threedimensional kinematics and threedimensional wing computer tomography. 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. Treatment is based on rehabilitation, using numerous exercises for activating scapulothoracic muscles. Recommendations for appropriate clinical measures include.

The sick scapula, scapular dyskinesis, the kinetic. Evaluation of clinical assessment methods for scapular dyskinesis. 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. Scapular dyskinesis identified during active motion did not result in different 3d scapular orientation or acromiohumeral distance during active arm elevation in static positions.

Scapular dyskinesis in young, asymptomatic elite swimmers. This will usually bring out any weakness in the muscles and display any resulting scapular dyskinesis abnormal scapular motion. Shoulder instability represents a spectrum of disorders resulting in shoulder dysfunction, including subluxation, dislocation, and symptomatic laxity. 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. This altered scapular position movement has been termed scapular dyskinesis. 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. The notion that an unstable scapula is related to shoulder dysfunction and pathology is well accepted. Deficits in hip abductor or extensor strength, deficits in hip rotation flexibility, or core strength weakness have been identified in 50% of slap injuries. 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. The scapula serves many roles in order for proper shoulder function to occur. Nov 12, 2019 dyskinesia in the overhead throwing athlete 43 kibler wb, sciascia ad, uhl tl, et al. Name 4 direct factors contributing to rom shift or deficit.

T he medical communitys fascination with the disabled throwing shoulder derives from the pub. Shoulder instability, dysfunction and scapular dyskinesis. Assessment and management of scapular dyskinesis 2015 wfatt world congress t. The main cause is muscle imbalance, between the trapezius, rhomboids, and pectoralis minor. 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. Furthermore, current concepts of rehabilitation dealing. Luckily, proper attention to the scapular stabilizers can prevent and help correct scapular dyskinesis. These roles include providing synchronous scapular rotation during humeral. The protocol is both chronologically more information. The disabled throwing shoulder marianjoy medical library.

Scapular dyskinesis and its relation to shoulder pain. It is best considered an impairment of optimal shoulder function. Contrast temporalbased and criteriabased protocols. Juulkristensen b, hilt k, enoch f, remvig l, sjogaard g. Oct 28, 2011 sports physiotherapists regularly assess and rehabilitate shoulder dysfunctions and pathologies. 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. Statistical analysis was performed by applying the shapirowilks test, which found that dscapular data were parametric. Accurate and comprehensive assessment of scapular dyskinesis is essential to identify alterations in normal. Scapular dyskinesis has multiple causative factors, both proximally muscle weaknessimbalance, nerve injury and distally acromioclavicular joint injury, superior. In these cases, rehabilitation is the best treatment. As a sports physiotherapists it is important to evaluate the contributing factors to shoulder pathology. A current concept of scapular dyskinesia and scapular. Scapular dyskinesis sd is currently defined as an alteration of normal scapular kinematics.

Scapular dyskinesis in trapezius myalgia and intraexaminer reproducibility of clinical tests. 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. 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. A comprehensive approach to nonoperative rotator cuff. The sick scapula, scapular dyskinesis, the kinetic chain, and rehabilitation stephen s. Scapular dyskinesis can decrease function of the shoulder complex and increase the risk for injury.

Current concepts in the assessment and rehabilitation of the. The program is based on a unique threefold training. The scapular muscles play a vital role during the overhead throwing motion. The reliability measurements of lateral scapular slide test at. The shoulder complex relies heavily on the scapular stabilizers to maintain optimal scapular position throughout movement. Scapular dyskinesis is quite frequent and can lead to shoulder pain. A current concept of scapular dyskinesia and scapular algorithm.

This highly mobile and versatile joint is one of the most common reasons people visit their health care dysinesis information. Lesions in throwers will be presented in the mayjune issue. 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. Scapular dyskinesis is the term used to describe loss of normal scapular physiology, biomechanics, and kinetics. This altered scapular positionmovement has been termed scapular dyskinesis. Assessment of scapular dyskinesis the sports physiotherapist. 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. Scapular dyskinesis scapular dyskinesis alteration of motion is a term that denotes loss of control of normal scapular motion, physiology or mechanics. Motion in forward flexion is most likely to demonstrate medial border prominence. Kibler scapular dyskinesis free download as pdf file.

Scapular dyskinesis or scapular dysfunction refers to the abnormal mobility or function of the scapula shoulder blade. 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. 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. 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. These roles include providing synchronous scapular rotation. The sick scapula, scapular dyskinesis, the kinetic chain, and rehabilitation will be presented in the julyaugust issue. Scapular dyskinesis, meaning abnormal motion of the scapula during shoulder movement, is a clinical finding commonly encountered by shoulder surgeons. The inability to achieve proper scapular alignment and coordinated motion during activity is described as scapular dyskinesis. Dynamic scapular motions may be evaluated by having the patient move the arms in ascent and descent 35 times. Sports physiotherapists regularly assess and rehabilitate shoulder dysfunctions and pathologies. Dyskinesia in the overhead throwing athlete 43 kibler wb, sciascia ad, uhl tl, et al.