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Scapular Dyskinesis and Its Relation to Shoulder Pain

Dr. Kibler is Medical Director, Lexington Sports Medicine Center, Lexington, KY. Mr. McMullen is Manager, Sports Medicine and Physical Therapy, Lexington Sports Medicine Center.

Reprint requests: Dr. Kibler, 1221 South. Broadway, Lexington, KY 40504.

Scapular dyskinesis is an alteration in the normal position or motion of the scapula during coupled scapulohumeral movements. It occurs in a large number of injuries involving the shoulder joint and often is caused by injuries that result in the inhibition or disorganization of activation patterns in scapular stabilizing muscles. It may increase the functional deficit associated with shoulder injury by altering the normal scapular role during coupled scapulohumeral motions. Scapular dyskinesis appears to be a nonspecific response to shoulder dysfunction because no specific pattern of dyskinesis is associated with a specific shoulder diagnosis. It should be suspected in patients with shoulder injury and can be identified and classified by specific physical examination. Treatment of scapular dyskinesis is directed at managing underlying causes and restoring normal scapular muscle activation patterns by kinetic chain–based rehabilitation protocols.

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