Scapular Dyskinesia

Scapular Dyskinesis

By Cody Suder, SPT, CSCS

  • The scapula is a bone on the back side of your shoulder, commonly referred to as the shoulder blade. It serves as an attachment for many muscles that contribute to the shoulder, upper arm, thorax, neck, and chest.
  • Scapular (shoulder blade)Dyskinesis appears to be a nonspecific response to shoulder dysfunction. With scapular dyskinesis, cases may be result of loss of muscular coordination, leading to abnormal scapulohumeral rhythm and various other shoulder pathologies as a result.
  • Scapular dyskinesis can result in inhibition or disorganization of activation patterns in scapular stabilizing muscles.

Types of Scapular Diskenisis:

  • Type I (Scapular tilt): Type I is characterized by prominence of the inferior medial scapular border.
  • Type II (Scapular winging):is the prominence of just the medial border of the scapula.
  • Type III (Scapular Shrugging): associated with shoulder impingement and rotator cuff injury and displays prominence of the superior medial border.

Muscles Involved:

  • Scapular Upward Elevation: This movement occurs during arm elevation, such as moving the arm forward or to the side(flexion and abduction). Muscles involved include upper trapezius, lower trapezius, and serratus anterior.
  • Scapular Downward Elevation: This movement occurs during lowering phase of elevated arm movements (adduction and extension). Muscles involved include levator scapulae, latissimus dorsi, pectoralis minor, and rhomboids.
  • Scapular Protraction: This movement occurs during pushing activities, such as performing a push-up or closing your car door. The main scapular protractor is the serratus anterior.
  • Scapular Retraction: This movement occurs while performing pulling activities, such as performing a row or closing a door. Scapular retractors include the trapezius(middle and lower fibers) and the rhomboids.

Is your scapular dyskinesis causing shoulder dysfunction? If so: what can you do on your own?

  • Stretching muscles that attach to your scapula.
    • Pec Stretch (doorway stretch)
    • Posterior shoulder stretches (arm cross body)
    • Upper trapezius stretch (ear to shoulder)
  • Strengthening muscles that attach to your scapula.
    • External rotation: keeping elbows at side and flexed to 90 degrees, rotate arms to the side.
    • Scapular retraction: pinching your scapula together as if to pin a tennis ball in the middle of your back.
    • Serratus Punches/ push-up plus: while lying on your back push your arm up to the sky as if to reach for something above you. OR, while performing a pushup, at the top of the motion try and push your back to the ceiling.
  • What can your Physical Therapist do for you?
    • Provide manual mobilization (specific joint techniques) that allow for more efficient and normalized movement patterns.
    • Provide specific strengthening and stretching exercises to pinpoint your specific dysfunction and return to prior level of pain free functioning.
    • Implement modalities, such as electrical stimulation, ultrasound, heat and ice, that require skilled intervention to help relieve pain, normalize tissue, and speed recovery processes.
    • Provide you with home exercise programs that allow you to minimize future problems and provide you with your own self-care and independence.

 

 

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