Scapular Dyskinesis

Scapular dyskinesis refers to altered positioning and movement patterns of the scapula (shoulder blade) during upper extremity motion. This condition represents a significant clinical finding in various shoulder pathologies and can affect both athletes and the general population.

Anatomical Context

The scapula serves as a crucial link in the kinetic chain of upper body movement, connecting the arm to the thorax. Normal scapular function depends on:

• Proper muscular coordination of the scapulothoracic muscles
• Intact neuromuscular control
• Balanced activation of the following muscle groups:
  • Trapezius
  • Serratus Anterior
  • Rhomboids
  • Rotator Cuff

Clinical Presentation

Common signs and symptoms include:

1. Visible winging or prominence of the medial border
2. Early scapular elevation during arm raising
3. Rapid downward rotation during arm lowering
4. Associated shoulder pain and dysfunction

Classification

Clinicians typically recognize three primary patterns:

1. Type I: Inferior angle prominence
2. Type II: Medial border prominence
3. Type III: Superior border prominence

Causes and Risk Factors

Several factors can contribute to scapular dyskinesis:

• Posture abnormalities
• Muscle Imbalance
• Nerve Injury
• Sports Overuse
• Thoracic Spine dysfunction

Assessment

Evaluation typically includes:

1. Visual observation
2. Scapular Assistance Test
3. Dynamic Movement Assessment
4. Muscle Strength Testing

Treatment Approaches

Management typically involves:

Conservative Treatment

• Physical Therapy focusing on:
  • Scapular stabilization exercises
  • Posture Correction
  • Motor Control training
  • Soft Tissue Mobilization

Advanced Interventions

• Dry Needling
• Kinesio Taping
• Manual Therapy techniques

Prevention

Preventive strategies include:

1. Proper Exercise Form
2. Regular Strength Training of stabilizer muscles
3. Workplace Ergonomics modifications
4. Sport-specific technique training

Impact on Performance

Scapular dyskinesis can significantly affect:

• Athletic performance in Overhead Sports
• Daily activities requiring arm elevation
• Shoulder Function and stability
• Risk of developing secondary conditions

Prognosis

With appropriate intervention, most patients show improvement in:

• Scapular positioning
• Movement patterns
• Pain Management
• Functional capacity

The condition requires ongoing monitoring and maintenance exercises to prevent recurrence.