summary Scapulothoracic dyskinesis is a rare condition characterized by abnormal scapula motion leading to shoulder impingement and dysfunction. Diagnosis is clinical with presence of scapulothoracic crepitus with a low and protracted scapulaand symptoms being relieved with scapula stabilization. Treatment involves NSAIDs and physical therapy with emphasis on periscapular muscle and rotator cuff strengthening. Epidemiology Demographics seen in athletes (baseball pitchers) Etiology Pathophysiology causes are multifactorial including neurologic injury pathologic thoracic spine kyphosis periscapular muscle fatigue poor throwing mechanics secondary to pain (shoulder, neck) 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? QID: 8663 Type & Select Correct Answer 1 Stretching the posterior capsule and pectoralis minor tendon 29% (115/394) 2 Stretching the posterior capsule and strengthening the subscapularis 46% (182/394) 3 Stretching the posterior capsule and using shoulder plyometrics 19% (74/394) 4 Stretching the anterior capsule and strengthening all components of the rotator cuff 4% (14/394) 5 Stretching the anterior capsule and improving pitching mechanics 2% (8/394) L 5 Question Complexity E Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 1 Review Tested Concept Review Full Topic (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? QID: 1056 Type & Select Correct Answer 1 Isometric shoulder exercises 10% (124/1212) 2 Isokinetic shoulder exercises 6% (73/1212) 3 Closed chain shoulder exercises 15% (179/1212) 4 Coordination of scapular motion with trunk and hip movements 68% (828/1212) 5 Axial loading shoulder exercises 0% (6/1212) L 2 Question Complexity D Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 4 Review Tested Concept Review Full Topic
All Videos (4) Podcasts (0) Login to View Community Videos Login to View Community Videos Cleveland Combined Hand Fellowship Lecture Series 2019-2020 Scapulothoracic Dysfunction - Austin Pitcher, MD Austin Pitcher Shoulder & Elbow - Scapulothoracic Dyskinesis 9/16/2020 52 views 5.0 (2) 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 B 5/14/2018 560 views 5.0 (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 B 10/31/2017 225 views 5.0 (2) See More See Less