Scapular Dyskinesis | Winging (Myths Busted | Evidence Based)

Get our programs here: https://store.e3rehab.com/collections/programs

Everything you need to know about scapular dyskinesis and winging!

Blog: https://e3rehab.com/blog/scapulardyskinesis (all references can be found here!)

Introduction (0:00)

Anatomy (0:36)

Scapulohumeral Rhythm (1:30)

The scapulohumeral rhythm was first described by Codman in 1934, but it was widely popularized as a term by Inman and colleagues in 1944. The scapulohumeral rhythm refers to the four joints working together to produce motion at the shoulder. Using roentgenography (x-ray image) and the insertion of bone pins into a single subject, Inman determined that the normal scapulohumeral rhythm consists of a 2:1 ratio of movement between the glenohumeral and scapulothoracic joints. For example, to achieve 180 degrees of abduction, 120 degrees would come from the glenohumeral joint and 60 degrees from the scapulothoracic joint. However, there are a lot of individual factors that affect the scapulohumeral rhythm: plane of motion, age, fatigue, gender, athlete vs non-athlete, type of athlete, dominant vs non-dominant hand, loaded vs unloaded, etc.!

Scapular Dyskinesis (3:35)

Relationship with Pain (5:14)

So now that I’ve defined scapular dyskinesis and what we’re looking for, we have to determine if it’s actually a problem. I like to think of the chicken or egg scenario. Is scapular dyskinesis the cause of pain? Or is the effect of pain? Is it both? Or is it neither? Well, that same study by Tate et al in 2009 looked at the relationship between pain and scapular dyskinesis in overhead athletes and concluded that “The presence of shoulder symptoms was not different between the normal and obvious dyskinesis volunteers.” and that there was “no relationship between the presence of pain and scapular dyskinesis in these athletes.”

One of my favorite studies on the topic is by Plummer et al in 2017. They concluded that “the occurrence of scapular dyskinesis is not influenced by the presence of shoulder pain” and “may represent normal movement variability.” Here’s the kicker in this study, though. They found that if you are unblinded, meaning that you know someone has shoulder pain prior to observing their shoulder motion, you’re more likely to rate them as having scapular dyskinesis. So if you’re trained to find faults, you’re going to find them even if they don’t exist.

A different way of thinking about scapular dyskinesis is that it might actually be a beneficial adaptation. It’s prevalent in up to 61% of overhead athletes compared to 33% in non-overhead athletes and different overhead athletes demonstrate different scapular kinematics. It’s possible that it’s part of what makes them good at what they do, kinda like the changes in the shoulder of a baseball pitcher.

Predicting Future Injury (6:59)
Traditional Rehabilitation (8:16)
Practical Recommendations (9:45)

-----
Disclaimer: The information presented is not intended as medical advice or to be a substitute for medical counseling but intended for entertainment purposes only. If you are experiencing pain, please seek the appropriate healthcare professional.

Видео Scapular Dyskinesis | Winging (Myths Busted | Evidence Based) канала E3 Rehab