Scapular kinematics and task specificity: The effect of load direction

Our current understanding of healthy scapula motion is mainly based on studying the shoulder when it is generating an abduction torque against gravity. However, the shoulder can perform diverse tasks beyond abduction. In particular, little attention has been given to how scapula motion contributes to concentric adduction despite its involvement in high-demand tasks such as rock climbing and wheelchair transfers. Investigating scapular kinematics during concentrically loaded arm-lowering can provide insight into the mechanical demands underlying healthy scapula motion. In this study, we combined biplanar videoradiography and optical motion capture with a controllable cable machine to compare the three-dimensional humerothoracic, glenohumeral, and scapulothoracic kinematics between a weighted pull-down task (involving concentric shoulder adduction) and a weighted press-up task (involving concentric shoulder abduction) in ten healthy adults. We observed significantly more scapulothoracic upward rotation and less glenohumeral abduction during concentric adduction than concentric abduction. Our findings indicate that scapula upward rotation is not simply a function of overall humerothoracic elevation, but instead varies in a load-specific manner - potentially to orient the glenoid in a way that facilitates glenohumeral joint stability. We also observed substantial inter-individual variability in scapular kinematics within a task, and in how individuals responded to the different tasks. Our findings help provide a more well-rounded understanding of healthy scapular kinematics such that we can better identify and treat unhealthy motion (i.e., dyskinesis). Our findings can also inform musculoskeletal models that simulate scapulothoracic kinematics.