scapular dyskinesis

scapular dyskinesis

collective term referring to scapular movement that is dysfunctional
Note: should compare side to side

causes of scapular dyskinesis

1. muscle weakness/imbalance
2. nerve injury
3. AC joint injury
4. superior labral tear
5. RC injury

type I scapular dyskinesis

scapular anterior tip
-inf angle prominent
-weak: lower trap, lat dorsi, serratus ant
-tight: pec min/mj

type II scapular dyskinesis

scapular winging
-medial border prominent
-SLAP lesion, long thoracic n. lesion
-weak serratus ant, rhomboids, u/m/l trap
-tight humeral rotators

type III scapular dyskinesis

elevated scapula
-superior border elevated
-overactive levator scap and upper trap
-imbalance upper/lower trap (maybe)
-often seen with impingement and RC lesions
Note: dominant side may just be more depressed

type IV scapular dyskinesis

normal motion

what to watch for during AROM shoulder flex/abd

symmetry?
1. premature or excessive elevation/protraction
2. nonsmooth motion during elevation/lowering
3. rapid downward rotation during arm lowering
4. medial border winging/infangle tipping are post displaced from thorax

corrective maneuvers/special tests for scapular dyskinesis

scapular assist test
scapular retraction test

scapular assist test

assist scapular upward rotation and post tilt (using hand on sup and inf angles)
[+] = relief of painful arc with active elevation

scpaular retraction test

MMT of supraspinatus or special tests for labral injury, then stabilize scapula in retracted position
[+] supraspinatus MMT stronger or symptoms from labral injury relieved
Note: not diagnostic, but pos result indicates scapular dyskinesis and need for scapular m. rehab