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Review
. 2015 Oct;7(4):289-97.
doi: 10.1177/1758573215595949. Epub 2015 Jul 16.

Scapular dyskinesis: the surgeon's perspective

Simon J Roche  1 , Lennard Funk  2 , Aaron Sciascia  3 , W Ben Kibler  3
Affiliations
Review

Scapular dyskinesis: the surgeon's perspective

Simon J Roche et al. Shoulder Elbow. 2015 Oct.

Abstract

The scapula fulfils many roles to facilitate optimal function of the shoulder. Normal function of the shoulder joint requires a scapula that can be properly aligned in multiple planes of motion of the upper extremity. Scapular dyskinesis, meaning abnormal motion of the scapula during shoulder movement, is a clinical finding commonly encountered by shoulder surgeons. It is best considered an impairment of optimal shoulder function. As such, it may be the underlying cause or the accompanying result of many forms of shoulder pain and dysfunction. The present review looks at the causes and treatment options for this indicator of shoulder pathology and aims to provide an overview of the management of disorders of the scapula.

Keywords: Dyskinesis; instability; scapula.

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Figures

Figure 1.
Figure 1.
Combined translational movements of the scapula in three planes lead to protraction and retraction around the thorax.
Figure 2.
Figure 2.
Prime movers and stabilizers of the scapula: upper and lower trapezius with serratus anterior.
Figure 3.
Figure 3.
Force couples for scapula motion: in early elevation (a, b), the upper and lower trapezius and serratus anterior muscles have long lever arms, being effective rotators and stabilizers. With higher arm elevation (c), the upper trapezius moment arm is shorter, whereas the lower trapezius and serratus anterior moment arms remain long, continuing to rotate the scapula. With maximum arm elevation (d), the lower trapezius maintains scapula position and the instant centre of rotation moves from the medial border of the spine to the acromioclavicular joint (adapted from Bagg SD, Forrest W)..
Figure 4.
Figure 4.
Scapula assistance test: the scapula is stabilized with one hand and the other hand ‘assists’ the scapula through its correct motion plane.
Figure 5.
Figure 5.
Scapula retraction test: the examiner stabilizes the medial border of the scapula as the arm is elevated. Relief of impingement symptoms is a positive test.
Figure 6.
Figure 6.
Scapula retraction test with resistance. (a) the examiner performs a traditional ‘empty can’ test. (b) The examiner stabilizes the medial border of the scapula and repeats the test. If the impingement symptoms are relieved, the test is positive.
Figure 7.
Figure 7.
Lateral scapula slide test. (a) Initial position with arm at side. (b) Second position, arms on hips. (c) Third position with arms at 90° and internal rotation.
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References

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