Updated: 6/11/2018

Scapulothoracic Dyskinesis

Topic
Review Topic
0
0
Questions
2
0
0
Evidence
2
0
0
Videos
3
https://upload.orthobullets.com/topic/3134/images/protractionwalltest.jpg
https://upload.orthobullets.com/topic/3134/images/topicimage.jpg
Introduction
  • Description
    • Scapulothoracic dyskinesis is a condition characterized by abnormal scapula motion leading to shoulder impingement and dysfunction
      • causes are multifactorial including
        • neurologic injury
        • pathologic thoracic spine kyphosis
        • periscapular muscle fatigue
        • poor throwing mechanics
        • secondary to pain (shoulder, neck)
      • also known as SICK scapula
  • Epidemiology
    • demographics
      • seen in athletes
  • Pathoanatomy
    • pathoanatomy
      • scapulothoracic power imbalance leads to protraction of scapula
        • leads to alteration of mechanics at glenohumeral joint
          • excessive stress placed on anterior capsule of shoulder and posterosuperior labrum
      • athletes have increased risk of injuring
        • labrum
        • rotator cuff
        • capsule
Anatomy
  • Scapulothoracic joint anatomy 
Presentation
  • Symptoms
    • shoulder pain and dysfunction worse with arm elevation
    • loss of throwing velocity
  • Physical exam 
    • scapulothoracic crepitus
    • affected scapula may be lower and protracted 
    • symptoms relieved with scapula stabilization
Imaging
  • Radiographs
    • recommended views
      • complete shoulder series
    • findings
      • usually unremarkable
Treatment
  • Nonoperative
    • NSAIDs, PT, local injections
      • indications
        • main treatment
      • technique
        • physical therapy with emphasis on   
          • core strengthening
          • scapular stabilizers, serratus anterior, trapezius
          • rotator cuff muscles 
          • teaching proper core mechanics in throwers 
 

Please rate topic.

Average 3.4 of 22 Ratings

Thank you for rating! Please vote below and help us build the most advanced adaptive learning platform in medicine

The complexity of this topic is appropriate for?
How important is this topic for board examinations?
How important is this topic for clinical practice?
Questions (2)

(SAE07SM.1) A 22-year-old college baseball pitcher reports the recent onset of anterior and posterosuperior shoulder pain in his throwing shoulder. Examination shows a 15-degree loss of internal rotation, tenderness over the coracoid, and a positive relocation test. Radiographs are normal, and an MRI scan without contrast shows no definitive lesions. A rehabilitation program is prescribed. Which of the following regimens should be initially employed? Review Topic

QID: 8663
1

Stretching the posterior capsule and pectoralis minor tendon

22%

(18/80)

2

Stretching the posterior capsule and strengthening the subscapularis

49%

(39/80)

3

Stretching the posterior capsule and using shoulder plyometrics

24%

(19/80)

4

Stretching the anterior capsule and strengthening all components of the rotator cuff

2%

(2/80)

5

Stretching the anterior capsule and improving pitching mechanics

1%

(1/80)

ML 5

Select Answer to see Preferred Response

PREFERRED RESPONSE 1

(OBQ05.170) A 23-year-old professional pitcher complains of posterior shoulder pain. Physical exam is notable for scapular dyskinesis. No intra-articular pathology is found on shoulder MRI. Which of the following should be emphasized in the initial stages of rehabilitation? Review Topic

QID: 1056
1

Isometric shoulder exercises

11%

(66/593)

2

Isokinetic shoulder exercises

7%

(40/593)

3

Closed chain shoulder exercises

14%

(83/593)

4

Coordination of scapular motion with trunk and hip movements

67%

(399/593)

5

Axial loading shoulder exercises

1%

(4/593)

ML 2

Select Answer to see Preferred Response

PREFERRED RESPONSE 4
ARTICLES (2)
VIDEOS (3)
Topic COMMENTS (3)
Private Note