Scapular instability. The scapulothoracic joint

Scapular instability may be the result of a variety of casues of which the clinician should be made aware. Work-up should include an initial radiographic evaluation and may require more in-depth investigation. Treatment should be prescribed dependent on the underlying diagnosis. In most cases, instability about the scapula can be treated with a careful plan of exercises to strengthen the involved musculature. It may take upwards of 12 to 18 months to achieve adequate results. Nonoperative failures may need to be treated with surgical techniques including nerve dissection and reconstruction with muscle flaps.