Scapular Dyskinesia

What is Scapular Dyskinesia?

Scapular dyskinesia (SD) refers to improper movement of the shoulder blade (scapula) during activity. You move your arm. This can cause pain, weakness, and difficulty moving your shoulder. The scapula is essential for smooth shoulder movement and helps transfer force from your body to your arm.

Sometimes people have SD without any symptoms, but often it is linked to shoulder pain and problems.

Why is the Scapula Important?

The scapula has several key jobs:

• It acts as the rotation centre for your upper arm bone (humerus).
• It anchors your arm to your chest.
• It keeps other bones from getting in the way when you lift your arm.
• It helps transfer forces from your core muscles to your arm, enabling strong and smooth movement.

To do this, the scapula moves in many directions (up, down, forward, backward, tilting and rotating). Muscles like the trapezius and serratus anterior control these movements.

What Causes Scapular Dyskinesia?

SD can have many causes, often grouped as:

• Shoulder problems: Injuries or conditions like rotator cuff tears, shoulder impingement, or acromioclavicular joint injuries often disturb scapular movement.
• Neck issues: Muscle imbalances, nerve compression, or neck pain can affect how the scapula moves.
• Poor posture: Rounded shoulders or a hunched upper back (thoracic kyphosis) can change the scapula’s resting position and movement.

Athletes participating in overhead sports (such as swimming, tennis, and volleyball) and individuals with desk jobs who use computers for extended periods are at a higher risk.

How is Scapular Dyskinesia Diagnosed?

There is no single test for SD, so doctors use several methods:

• Watching your scapula move during arm lifts and other movements to spot abnormal patterns, such as winging or shrugging.
• Manual tests where the examiner helps move or stabilise your scapula to see if this reduces pain or improves strength.
• Checking related areas like your neck, shoulder joints, and muscles to rule out other problems.

In the future, technology such as 3D motion analysis and AI may help diagnose SD more precisely.

How is Scapular Dyskinesia Treated?

Conservative (Non-Surgical) Treatment

Treatment aims to restore normal scapula movement through:

• Stretching tight muscles, such as the chest muscles and the back of the shoulder, can help improve flexibility.
• Strengthening weak muscles, especially the serratus anterior and trapezius, to support proper scapula control.
• A typical program has three stages:
  • Learning to control scapular muscles and improve posture consciously.
  • Building strength and control for everyday activities.
  • Sport- or job-specific strengthening to maintain shoulder health.

Physical therapy typically lasts about 12 weeks, with a longer duration for athletes.

Surgical Treatment

Surgery is rare and is only recommended if a related structural problem necessitates it.

Clinical Key Points

• SD means abnormal movement or position of the shoulder blade.
• It is common in shoulder injuries and among athletes who perform overhead activities.
• Diagnosis depends on clinical observation and manual tests.
• Treatment primarily involves physiotherapy, including stretching and strengthening exercises.
• Good posture and muscle control are key to recovery and prevention.
• Surgery is rarely needed unless there is an underlying injury.

Patient FAQs

1. What symptoms does Scapular Dyskinesia cause?

You may experience shoulder pain, weakness, difficulty lifting your arm, or notice your shoulder blade protruding (winging).

2. Can poor posture cause SD?

Yes, slouched shoulders or a hunched upper back can change scapula position and movement.

3. How long does treatment take?

Typically, around 12 weeks of guided physiotherapy; however, some athletes may require a longer duration.

4. Can I prevent SD?

Yes, by maintaining good posture, avoiding repetitive overhead activities without rest, and doing regular strengthening and stretching exercises.

5. Is surgery needed for SD?

Rarely. Surgery is usually only for other shoulder injuries causing scapular problems.

6. Can SD cause other shoulder problems?

Yes, it often occurs with conditions like shoulder impingement, rotator cuff injuries, or joint instability.

Call to Action

If you experience shoulder pain, weakness, or notice abnormal movement of your shoulder blades, consult your healthcare provider for an assessment.

For advice on exercises and managing scapular dyskinesia, visit www.TheArmDoc.co.uk
Call: 020 3384 5588
Email: Info@TheArmDoc.co.uk

Disclaimer

This information is for educational purposes and does not replace medical advice. Always consult a healthcare professional for a diagnosis and treatment tailored to your specific needs.