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Published on: February 10, 2015
Scapular involvement in impingement: signs and symptoms
1Lexington Clinic, Sports Medicine Center, Lexington, Kentucky, USA.
Instructional Course Lectures
|September 9, 2006
Summary
Shoulder impingement is often linked to scapular dyskinesis, a disruption in normal scapular motion. Identifying and addressing the causes of scapular dyskinesis is key to improving shoulder function and treating impingement.
Area of Science:
- Orthopedics
- Sports Medicine
- Biomechanics
Background:
- Normal scapular motion is crucial for efficient shoulder function and scapulohumeral rhythm.
- Shoulder impingement syndrome frequently involves disrupted scapular movement, known as scapular dyskinesis.
- Scapular dyskinesis presents as impaired control of scapular external rotation and retraction, affecting shoulder mechanics.
Purpose of the Study:
- To elucidate the relationship between scapular dyskinesis and shoulder impingement.
- To detail the pathomechanical consequences of scapular dyskinesis on shoulder function.
- To differentiate between proximal (muscular) and distal (joint-related) causative factors of scapular dyskinesis.
Main Methods:
- Review of literature on scapular motion, shoulder impingement, and scapular dyskinesis.
- Analysis of the pathophysiological and pathomechanical alterations associated with scapular dyskinesis.
- Categorization of causative factors into proximal (muscular) and distal (joint derangements).
Main Results:
- Scapular dyskinesis leads to altered scapular rotation, glenoid antetilting, and reduced rotator cuff activation.
- These alterations exacerbate dysfunction in patients with shoulder impingement.
- Proximal factors (muscle-related) are typically responsive to rehabilitation, while distal factors often necessitate surgical intervention.
Conclusions:
- Scapular dyskinesis is a significant contributor to shoulder impingement dysfunction.
- Physical examination for scapular dyskinesis can identify causative factors.
- Tailored treatment strategies, including rehabilitation or surgery, based on identified factors are essential for effective management.
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