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Scapular Dyskinesis Its Relation To Shoulder Pain
Scapular Dyskinesis Its Relation To Shoulder Pain
ARTICLE INCLUDES
Normal scapular function
Scapular Dyskinesis
Methods of classification
Evaluation techniques
SCAPULAR DYSKINESIS
It is defined as observable alterations in the position
SCAPULAR EVALUATION
SHOULD INCLUDE
Postural evaluation
Resting Scapular Evaluation
Dynamic Evaluation of scapular motion
Corrective measures
POSTERIOR ASPECT
FIRSTLY SCAPULA SHOULD BE EVALUATED IN
STATIC POSITION AS IN LONG-STANDING
SCAPULAR DYSKINESIS,RESTING WINGING
MAY BE SEEN
DYNAMIC EVALUATION
Should be examined in both elevating &
TYPE I
PROMINENCE OF
INFERIOR MEDIAL
SCAPULAR BORDER
ABNORMAL
ROTATION AROUND
TRANSVERSE AXIS
INDICATES
WEAKNESS OF
LOWER TRAP, LAT
DORSI, SERR ANT
OR
TIGHT PECT
MINOR,MAJOR
TYPE II
CLASSIC WINGING
PROMINENCE OF
ENTIRE MEDIAL
SCAPULAR BORDER
ABNORMALROTATIO
N AROUND
VERTICAL AXIS
INDICATES
WEAKNESS OF SERR
ANT,RHOMBOIDS,AL
L FIBERS OF TRAP
TYPE III
PROMINENCE OF
SUPERIOR MEDIAL
SCAPULAR BORDER
WITH SUPEROR
TRANSLATION OF
ENTIRE SCAPULA
INDICATES
OVERACTIVITY OF
LEVATOR SCAPULAE
& IMBALANCE OF
UPPER & LOWER
TRAP FORCE
COUPLE
TESTS PERFORMED TO
INDICATE WEAKNESS OF
SCAPULAR
MUSCLES
Isometric scapular pinch test
Wall push- ups
Lateral scapular slide test
Scapular assistance test
Scapular retraction test
ISOMETRIC SCAPULAR
PINCH TEST
Scapula can be normally held in retraction
LATERAL SCAPULAR
SLIDE
TEST
Inferior medial
angle of scapula is palpated &
marked on both the sides
The reference point on the spine is nearest spinous
process,which is marked
Distance is measured on both the sides in three
different positions,At resting position
With hands on hips, with fingers anterior &thumb posterior
With the arms at 90 degrees with internal rotation
abnormality
LATERAL SCAPULAR
SLIDE TEST
SCAPULAR ASSISTANCE
TEST
During abduction or
forward elevation,
assistance is provided by
manually stabilizing the
scapula and rotating
inferior border of scapula
as the arm moves
This proc simulates force
couple activity of serratus
ant and lower trap
Elimination or modification
of symptoms indicate
these muscles should be
major focus in rehab.
SCAPULAR RETRACTION
TEST
The examiner
Weeks (estimate)
Muscular Flexibility
Massage
Modalities (eg, ultrasound, electronic stimulation)
Stretching (eg, active-assisted, passive, PNF)
Corner stretches (pectoralis minor)
Towel roll stretches (pectoralis minor)
Levator scapulae stretches
Sleeper position stretches (shoulder ER)
1-3
1-3
1-5
1, 2
1-3
1-8
1-3
1-3
1-3
1-3
1, 2
1, 2
1, 2
2
1, 2
2
3-5
5-8
2-5
2-5
3-5
2-6
3-8
4-8
3-6
6-8
5-8
6-10
6-10
PRESENTATION ACKNOWLEDGEMENT: