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Scapular Dyskinesia: What is it and how to fix it?

Scapular dyskinesis
Scapular dyskinesis

Your shoulder blade is essential for movement and range of motion in your shoulders. Also called the scapula, your shoulder blades provide stability to your rotator cuff. If you sustain an injury to your soft tissue, muscle, or bone around your shoulder, it may impact your shoulder blade too. The shoulder joint is complex, and pain affects its use in daily activities, and sports is joint.
When your shoulder blades aren’t stable, you may experience a shoulder disorder called scapular dyskinesis. It is characterized as losing a normal range of motion in your shoulder blades. In some cases, it is a condition of its own. Other times, scapular dyskinesis is a symptom of another health condition or injury.
The scapula (or shoulder blade) moves with your arm. If it moves improperly (called dyskinesis), it places undue stress on the shoulder joints and can cause issues such as impingement, rotator cuff tendonitis, etc. As the arm is raised, an integrated motion between the scapula provides efficient function and joint stability.
Scapular dyskinesis is easily identified because it causes your shoulder blades to stick out abnormally during rest or activity. Scapular dyskinesis is also called winging because your shoulder blades stick out like wings on your back. Although the condition may not be painful, it can leave you at a greater risk of injury.

Scapular Dyskinesis's Connection To Pain

Does scapular dyskinesis cause pain/injury, or does pain/injury cause scapular dyskinesis? Both? Neither? Does the way you walk cause you to develop plantar heel pain, or does plantar heel pain (commonly referred to as plantar fasciitis) cause you to change the way you walk?
Is scapular dyskinesis a regular or even beneficial adaptation? Professional overhead athletes exhibit differences in their scapulohumeral mechanics compared to non-athletes, and differences exist between different types of overhead athletes. Additionally, a systematic review by Burn et al. 2016 concluded that the prevalence of scapular dyskinesis in overhead athletes was 61% compared to 33% in non-overhead athletes. Might it be an advantageous adaptation like the changes seen in the throwing arm of a baseball pitcher?
Results from the current study indicate that scapular dyskinesis may not be a relevant impairment for those with shoulder pain and may represent normal movement variability. Scapular dyskinesis is quite normal, and we cannot guess who has symptoms through observation alone, but does its presence increase your risk for injury?

Is It Possible?

Scapular Dyskinesis Symptoms

Common symptoms of Scapular Dyskinesis include shoulder pain and tenderness, snapping or popping of the shoulder, loss of strength, asymmetrical posture, scapular winging or instability of the shoulders. As soon as these symptoms arise, talk to your doctor to avoid further injury.

Typical scapular dyskinesis symptoms include:

  • Weakness in the arm on the affected side – including the arm feeling “dead” or “heavy.”
  • Pain and/or tenderness on and around the shoulder blade, particularly on the inner (medial) edge and at the top of the scapula
  • Limited range of motion (unable to raise the arm above shoulder height)
  • Unnatural “snapping” or “crunching” sound with shoulder rotation and movement
  • Visible “winging” (protrusion) of the shoulder blade
  • A drooped shoulder posture on the affected side
  • Fatigue with overhead or repetitive movements
Scapular dyskinesis

Best Scapular Dyskinesia Exercises

In this article, we’ll explain the best exercise for scapular Dyskinesia.
Scapular Dyskinesia can be one factor which leads to subacromial pain and should thus be assessed and treated to improve shoulder function.
If your patient experiences less pain with the scapular assistance test or the scapular retraction test, There is a good chance that he (she) might benefit from Scapular exercises.
The Y lift is a valuable exercise because it targets many different areas like the upper and the lower trapezius, which are both critical muscles in creating Lateral rotation of the Scapula.
At the same time, it produces a high force in the supraspinatus tendon Which is essential in controlling the humeral head and at last, it promotes thoracic extension, Which is essential for a complete shoulder range of motion. To perform this exercise, Lie on the bench in a prone position with the affected arm hanging over the table’s edge. Then lift the arm up and out to raise it above your head with your thumb pointing upwards to ensure external rotation. According to Ekstrom in 2003 and Reinold in 2007, an angle of 120 degrees provides the most muscular contraction of the supraspinatus and the lower and upper traps. Make sure to focus on a controlled eccentric movement.
Of course, this exercise can also be done with both arms simultaneously While you are in a prone position on a swiss ball, for example.
You can progress this exercise by using a small weight or a Thera-Band or cable pulley While you are performing the exercise in standing.

Treatment of Scapular Dyskinesis

Most abnormalities in scapular motion or position can be treated by physical therapy to relieve the symptoms associated with inflexibility or trigger points and to re-establish muscle strength and activation patterns. Surgical treatment is used to repair the source of the underlying abnormalities and often is an integral part of the treatment program. Bony abnormalities such as malunion of a clavicular fracture or an acromioclavicular joint separation may cause dyskinesis. More commonly, the source of muscle inhibition or imbalance is glenohumeral internal derangement, such as instability, labral tears, rotator cuff injury, or tendonitis. Scapular muscle rehabilitation may be initiated when structural problems or internal derangement have been corrected.

Most of the time, scapular dyskinesis is improved through physical therapy or rehabilitation with a qualified physical therapist or athletic trainer. Therapy usually lasts 4 to 8 weeks, depending on your injury. It includes exercises to help you gently restore your range of motion and strengthen the surrounding muscles. 

Remember that physical therapy only helps if you also cease the activity or motion that caused the injury in the first place. While you may be able to continue the activity in the future, it is essential to allow your body the chance to heal. ‌

Your physical therapy or rehabilitation is often accompanied by pain or anti-inflammatory medication to address your symptoms as you heal. Your doctor may also suggest using heat or ice to address pain.‌

At Sports & Spinal Solutions Clinic, we are trained to treat scapular dyskinesis. We provide chiropractic, massage therapy, acupuncture, physiotherapy, and rehabilitative exercise, under one roof. Utilizing these different services, we can help patients and clients reach the best outcomes and versions of themselves.

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