Orthopedics

OSPI offers the top orthopedic surgeons in Gilbert AZ and the East Valley. Drs. Mahoney, Macqueen, Stewart and Clouse offer minimally invasive General, Sports and Joint Replacement expertise.

Physical Therapy

Whether you are pre or post-operative, OSPI’s East Valley physical therapy team works with you on both active and passive treatments. Your will be in the best hands with our licensed physical therapists!

Chiropractic

The Gilbert chiropractors at OSPI offer a plethora of nonoperative pain relief options such as manipulations, laser therapy, physiotherapy and electrical stimulation.

Family Practice

OSPI offers comprehensive family practice services including allergy testing, BHRT, medical weight loss, aesthetics and full check ups.

Medical Weight Loss

Patients routinely experience dramatic, healthy weight loss with the customized programs at OSPI. The programs combine nutrition, exercise and prescription weight loss options.

Performance Training

OSPI’s integrated team of healthcare providers work with both amateur and professional athletes to maximize one’s performance with sport specific programs.

Pain Management

OSPI’s Board Certified, Fellowship Trained pain doctor offers both medication management and interventional procedures with exceptional outcomes!

Scapular Dyskinesia

FAQS on Scapular Dyskinesia

 

Scapular dyskinesia is condition found in almost 70% patients suffering from shoulder injuries. A prominent cause of shoulder dysfunctions, the conditions needs to be accurately assessed and treated. Ignoring scapular dyskinesia may prove costly disturbing the scapulohumeral rhythm, rotator cuff functioning, and rotation of the shoulder.

What is scapular dyskinesia?

The word scapular dyskinesia is composed of two separate words, scapular meaning related to shoulder blade and dyskinesia indicating abnormality in performing movements. Thus, scapular dyskinesia refers to abnormality in the movement of the shoulder blade.

When throwing, the scapular muscles are subject to repeated changes as the arm takes different postures. This runs the risk of causing shoulder injury and impact the scapular position. The scapula fails to elevate the acromion properly. As a result, patients suffer from “drooping of the affected shoulder” and shoulder pain close to the collarbone. This abnormality in scapula function is characterized as scapular dyskinesia.

How does it occur?

The shoulder blade or scapula is responsible for rotation, elevation, tilting, and abduction of the shoulder. It holds the shoulder socket that fits into the humeral ball to make the shoulder joint. During rest, the shoulder blade should maintain the appropriate distance from the spine sitting at the right height on the trunk. During the arm movement, it should elevate, tilt back, rotate, and slid away to let the arm perform any task.

However, in patients with shoulder injuries, the scapula fails to elevate, tilt, slid, or rotate properly causing the joint to bear disproportionate stress. This abnormal deviation is characterized as scapular dyskinesis.

What are the symptoms of scapular dyskinesia?

Scapular dyskinesis is one of the four conditions that together called SICK scapula syndrome. Others are scapular malposition, Coracoid pain, and inferior medial border prominence. The disorder has the following symptoms.

  • Dropped shoulder appearance
  • Scapular pain
  • Middle scapular protrusion
  • Noticeable problem in scapular motion
  • Shoulder pain
  • Scapular jumping during arm movement
  • Pain in the upper arm
  • A feeling of tightened chest muscles
  • Worsening pain with weight lifting of chest training workouts

What causes scapular dyskinesia?

  • Shoulder disorders
  • Loss of muscular coordination
  • Shoulder injury and direct trauma
  • Overuse shoulder fatigue
  • Shoulder impingement
  • Osteo-ligamentous injury
  • Proprioceptive dysfunction
  • Injury to tissues around the shoulder socket
  • Intense, recurring overhead activity
  • Shoulder structural damage
  • Muscle strain
  • Unbalanced weight training
  • Rotator cuff injury

How is scapular dyskinesia diagnosed?

A detailed analysis of patient’s medical history and physical symptoms help assess the scapular dyskinesis accurately. Patients are asked about pain sensation, starting of the disorder, shoulder strength, stability, injury, and frequency of pain. The second stage involves performing a range of active and passive motions before the doctor.

Additional imaging tests are preferred to find out associated problems and causative factors. X-rays help find out any problems within the scapula while MRI and ultrasound tests are effective to identify injury to soft tissues, muscles, ligaments, etc. CT scan may be favored to create a detail picture.

What are the treatment methods available for scapular dyskinesia?

  • Medications: NSAID medications are prescribed to inhibit inflammation and pain in the shoulder.
  • Surgical Intervention: Surgery is preferred when there is an aggravated shoulder disorder leading to scapular dyskinesia. Repair and restructuring of muscles, and tendons are carried out to allow normal function of the scapula.
  • Physiotherapy: A range of physical therapy methods are resorted to encourage kinetic chain- based rehabilitation. It is useful in restoring normal muscular patterns and promoting pain-free shoulder movements.
  • Pain Management: Patients may use ice, do activity modification, change postures and positions that reduce stress on the shoulder. Elimination of repetitive stress helps regain muscle strength.
  • Scapula Stability Protocol: A flow of exercises and activities, this improves pain-free motions and helps achieve local muscle strength. Once the strength is restored, proprioreception exercises are resorted to enhance muscular integration and scapular coordination. When the scapular base stabilization is complete, stretching is done under expert supervision to activate rotator cuff muscles to their maximal strength.
  • Anesthetic injection: Anesthetic medication inhibits pain by numbing the inflamed area.
  • Corticosteroid injection: Steroid injected to the pain area successfully treats swelling and inflammation in the surrounding area and promotes smooth shoulder blade functions.

References

Kibler WB, McMullen J: Scapular dyskinesis and its relation to shoulder pain. J Am Acad Orthop Surg. 2003;11:142-151.Meredith A. Lazar, MD, et al. Snapping Scapula Syndrome. In Journal of Bone and Joint Surgery. September 2009. Vol. 91. No. 9. Pp. 2251-2262.

Philip McClure, et al. A Clinical Method for Identifying Scapular Dyskinesis, Part 1: Reliability. J Athl Train. 2009 Mar-Apr; 44(2): 160–164.

Cools AM, Dewitte V, Lanszweert F, et al. Rehabilitation of scapular muscle balance: which exercises to prescribe? Am J Sports Med. 2007;35:1744-1751.

Reinold MM, Escamilla R, Wilk KE. Current concepts in the scientific and clinical rationale behind exercises for glenohumeral and scapulothoracic musculature. J Orthop Sports Phys Ther 2009; 39(2):105-117.

Bertelli JA, Ghizoni MF. Long Thoracic Nerve: Anatomy and Functional Assessment. The Journal of Bone & Joint Surgery. 2005; 87:993-998

Burkhart SS, Morgan CD, Kibler WB. The disabled throwing shoulder: spectrum of pathology Part I: pathoanatomy and biomechanics. Arthroscopy 2003;19:404–20.

Kibler WB, Uhl TL, Madduz JW, Brooks PV, Zeller B, McMullen J. Qualitative clinical evaluation of scapular dysfunction: a reliability study. J Shoulder Elbow Surg. 2002;11(6):550-556.

Ludewig PM, Cook TM. Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Phys Ther 2000;80:276–91.

Postacchini R, Carbone S. Scapular dyskinesis: Diagnosis and treatment. OA Musculoskeletal Medicine 2013 Oct 18;1(2):20.

 

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