Scapular Dyskinesis

Scapular dyskinesis is a muscle-related condition that results in the malposition of a shoulder blade (scapula). It can cause shoulder pain and arm weakness. Left untreated, scapular dyskinesis can throw the ball-and-socket joint of your shoulder out of alignment, leading to soft tissue damage and other problems

The majority of athletes with shoulder injuries typically also have scapular dyskinesis.

What Is Scapular Dyskinesis?

Scapular dyskinesis is considered a type of overuse syndrome in which repetitive strain weakens, tightens, or causes the detachment of muscles that connect to the shoulder blade. A muscle or nerve injury can also lead to this type of muscle failure.

There are more than a dozen different muscles that attach to the shoulder blade, including the deltoids, biceps, latissimus dorsi, and the muscles of the rotator cuff.

When certain muscles become impaired or ineffectual, you may be unable to carry out simple arm movements, such as reaching overhead. In addition, because the muscle groups attached to the shoulder blade exert varying degrees of pull on the bone, depending on muscle health and strength, the position of your shoulder blade may begin to shift. This malpositioning of the shoulder blade – scapular dyskinesis – is present when the shoulder is at rest, as well as during arm movement.

Symptoms of Scapular Dyskinesis

The most common signs and symptoms of scapular dyskinesis include:

• Shoulder pain or tenderness
• Arm weakness and fatigue
• Restricted movement with the affected arm
• Noticeable protrusion of the shoulder blade, called “winging” of the scapula

Diagnosis & Treatment of Scapular Dyskinesis

Your physician may notice the tell-tale signs of scapular dyskinesis with a physical exam alone. When looking at your back, one shoulder blade will be noticeably more prominent than the other – especially as you move your arms away from the body.

Specific tests your orthopedic shoulder specialist may perform include:

• Scapular assistance test (SAT) involves gently pushing on your scapula to assist as you are asked to elevate your arm. If this allows greater arm movement without pain, it may indicate scapular dyskinesis and a problem with your muscles.
• Scapular retraction test (SRT) is a similar type of hands-on gentle manipulation of the scapula. This time, you are asked to resist the force applied by your provider while your arm is held out at shoulder height.

In most cases of scapular dyskinesis, nonsurgical treatment options alone can improve your condition. If other conditions are present, such as a rotator cuff tear, chronic shoulder instability, or an AC joint injury, your doctor may recommend surgery to repair these problems before being able to address the scapular dyskinesis.

Physical Therapy to Get Your Scapula Back in Place

Physical therapy is the standard remedy for scapular dyskinesis. It is important that your orthopedic physician and physical therapy team work together to design a comprehensive regimen that can improve scapular control, depending on the affected muscles in your case.

Your therapeutic plan may include exercises to strengthen specific muscles, balance your upper body strength, stretch tight muscles, and improve your posture. In addition to alleviating symptoms of scapula dyskinesis, effective PT can improve the stability of your shoulder and provide you with a program to help you prevent it from recurring in the future.

Scapular Dyskinesis Treatment in Knoxville and Athens, TN

Are you an athlete experiencing shoulder pain? You may also have a muscle-related condition called scapula dyskinesis. To be properly evaluated and treated for this condition that impairs the position of your shoulder blade, call orthopedic specialist Dr. David Hovis at The Shoulder Institute at ORTHOKnox at (865) 251-3030.