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
QUESTIONS 1 of 2 1 2 Previous Next This is an AAOS Self Assessment Exam (SAE) question. Orthobullets was not involved in the editorial process and does not have the ability to alter the question. If you prefer to hide SAE questions, simply turn them off in your Learning Goals. (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? Tested Concept QID: 8663 Type & Select Correct Answer 1 Stretching the posterior capsule and pectoralis minor tendon 30% (73/243) 2 Stretching the posterior capsule and strengthening the subscapularis 49% (119/243) 3 Stretching the posterior capsule and using shoulder plyometrics 16% (39/243) 4 Stretching the anterior capsule and strengthening all components of the rotator cuff 2% (5/243) 5 Stretching the anterior capsule and improving pitching mechanics 2% (6/243) L 5 Question Complexity D Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 1 Review tested concept (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? Tested Concept QID: 1056 Type & Select Correct Answer 1 Isometric shoulder exercises 10% (106/1034) 2 Isokinetic shoulder exercises 6% (65/1034) 3 Closed chain shoulder exercises 14% (144/1034) 4 Coordination of scapular motion with trunk and hip movements 69% (712/1034) 5 Axial loading shoulder exercises 1% (6/1034) L 2 Question Complexity C Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 4 Review tested concept
All Videos (3) Podcasts (0) Login to View Community Videos Login to View Community Videos 2017 Orthopaedic Summit Evolving Techniques Rehab of Course! My Program for Scapular Dyskinesis: It Works! Patience, Ignore Everyone Else - W. Benjamin Kibler, MD Shoulder & Elbow - Scapulothoracic Dyskinesis 5/14/2018 524 views (4) Login to View Community Videos Login to View Community Videos 2016 Baseball Sports Medicine: Game Changing Concepts Scapular Muscle Training - Kevin E. Wilk, PT, DPT, FAPTA (BSM #14, 2016) Shoulder & Elbow - Scapulothoracic Dyskinesis 10/31/2017 184 views (2) Login to View Community Videos Login to View Community Videos Physical exam for scapular dyskinesia David Abbasi Shoulder & Elbow - Scapulothoracic Dyskinesis 1/29/2013 3092 views (6)