Current concepts scapular dyskinesis pdf

Clinical implications of scapular dyskinesis in shoulder injury. Current concepts in the scientific and clinical rationale. Scapular dyskinesis sd is currently defined as an alteration of normal scapular kinematics. 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 disabled throwing shoulder marianjoy medical library. The sick scapula, scapular dyskinesis, the kinetic. 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. This altered scapular positionmovement has been termed scapular dyskinesis. Scapular dyskinesis can decrease function of the shoulder complex and increase the risk for injury. Dyskinesia in the overhead throwing athlete 43 kibler wb, sciascia ad, uhl tl, et al. This will usually bring out any weakness in the muscles and display any resulting scapular dyskinesis abnormal scapular motion. Current concepts in the assessment and rehabilitation of the. This highly mobile and versatile joint is one of the most common reasons people visit their health care dysinesis information.

Evaluation of clinical assessment methods for scapular dyskinesis. Kibler scapular dyskinesis free download as pdf file. As a sports physiotherapists it is important to evaluate the contributing factors to shoulder pathology. Shoulder instability represents a spectrum of disorders resulting in shoulder dysfunction, including subluxation, dislocation, and symptomatic laxity. Name 4 direct factors contributing to rom shift or deficit. In these cases, rehabilitation is the best treatment. Patients with symptomatic sd show an altered scapular orientation. Treatment is based on rehabilitation, using numerous exercises for activating scapulothoracic muscles. Contrast temporalbased and criteriabased protocols. 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 dyskinesia, the forgotten culprit of shoulder pain. A current concept of scapular dyskinesia and scapular. Scapular dyskinesis and its relation to shoulder pain. Assessment and management of scapular dyskinesis 2015 wfatt world congress t. Dynamic scapular motions may be evaluated by having the patient move the arms in ascent and descent 35 times. The scapula serves many roles in order for proper shoulder function to occur. 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. A common contributor, seen in 68100% of shoulder injuries, is scapular dyskinesis. Ben kibler, md aaron sciascia, ms, atc, nasmpes, ns shoulder center of kentucky 700 bobolink dr lexington, ky 40504. 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.

It is best considered an impairment of optimal shoulder function. Current concepts for shoulder training in the overhead athle. Scapular dyskinesis in trapezius myalgia and intraexaminer reproducibility of clinical tests. These roles include providing synchronous scapular rotation. Scapular dyskinesis has multiple causative factors, both proximally muscle weaknessimbalance, nerve injury and distally acromioclavicular joint injury, superior.

Shoulder instability, dysfunction and scapular dyskinesis. However, few studies report the results of the rehabilitative therapy. Abstract despite the essential role played by the scapula in shoulder function, current concepts in shoulder training and treatment regularly neglect its contribution. The scapular muscles play a vital role during the overhead throwing motion. The protocol is both chronologically more information. Motion in forward flexion is most likely to demonstrate medial border prominence. Assessment of scapular dyskinesis the sports physiotherapist. The notion that an unstable scapula is related to shoulder dysfunction and pathology is well accepted. Scapular dyskinesis, meaning abnormal motion of the scapula during shoulder movement, is a clinical finding commonly encountered by shoulder surgeons.

Lesions in throwers will be presented in the mayjune issue. Scapular dyskinesis in young, asymptomatic elite swimmers. This altered scapular position movement has been termed scapular dyskinesis. 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 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. 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.

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. T he medical communitys fascination with the disabled throwing shoulder derives from the pub. 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. 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. Scapular dyskinesis is the term used to describe loss of normal scapular physiology, biomechanics, and kinetics. Nov 12, 2019 dyskinesia in the overhead throwing athlete 43 kibler wb, sciascia ad, uhl tl, et al. 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. A comprehensive approach to nonoperative rotator cuff. Deficits in hip abductor or extensor strength, deficits in hip rotation flexibility, or core strength weakness have been identified in 50% of slap injuries. A current concept of scapular dyskinesia and scapular algorithm. Furthermore, current concepts of rehabilitation dealing.

The program is based on a unique threefold training. The reliability measurements of lateral scapular slide test at. Scapular dyskinesis or scapular dysfunction refers to the abnormal mobility or function of the scapula shoulder blade. Clinical observation is the most pragmatic method for assessing dyskinesis yielding interrater agreement of 79% and sensitivity of 76%. The relationship between breathing pattern disorders and. Aug 01, 2016 the notion that an unstable scapula is related to shoulder dysfunction and pathology is well accepted. The sick scapula, scapular dyskinesis, the kinetic chain, and rehabilitation stephen s. Luckily, proper attention to the scapular stabilizers can prevent and help correct scapular dyskinesis. Overview and benefits the kinesis trilogy program is a time efficient, high intensity total body workout specifically designed for personal training. 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 is quite frequent and can lead to shoulder pain. Current methods for assessing scapula dyskinesis involve clinical observations, threedimensional kinematics and threedimensional wing computer tomography.

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. The main cause is muscle imbalance, between the trapezius, rhomboids, and pectoralis minor. Sports physiotherapists regularly assess and rehabilitate shoulder dysfunctions and pathologies. Recommendations for appropriate clinical measures include. 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. Juulkristensen b, hilt k, enoch f, remvig l, sjogaard g. The sick scapula, scapular dyskinesis, the kinetic chain, and rehabilitation will be presented in the julyaugust issue. Statistical analysis was performed by applying the shapirowilks test, which found that dscapular data were parametric. These roles include providing synchronous scapular rotation during humeral. Accurate and comprehensive assessment of scapular dyskinesis is essential to identify alterations in normal. 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. Scapular dyskinesis identified during active motion did not result in different 3d scapular orientation or acromiohumeral distance during active arm elevation in static positions.