Upload
victoria-conley
View
255
Download
0
Embed Size (px)
Citation preview
Scapular Dyskinesis
Normal Anatomy
• The scapular makes up most of the joints in the shoulder girdle
• Articulates with thorax• Provides an attachment
for stabilising muscles of the glenohumeral joint
Scapular Movements- Elevation and Depression
Scapular Movements- Upward and Downward Rotation
Scapular Movements- Anterior and Posterior Tilting
Scapular Movements- Protraction and Retraction
Pathology
• Alteration in movement of the scapular during shoulder motion
• A ‘Cause’ and/or ‘Effect’ of most shoulder pathologies
Causes
1. Posture2. Nerve Palsy3. Soft Tissue Mobility4. Muscle Weakness
Classification
• Type 1- Inferior Angle Winging– Increased anterior tilt– Lower trapz weakness– Increased thoracic
kyphosis, tight pec minor, short head of biceps
Classification
• Type 2- Medial Border Winging– Increased internal
rotation– Serratus Anterior
weakness
Classification
• Type 3- Superior Medial Border Winging– Shrugging with arm
elevation
Associated Pathologies
• External Impingement• Internal Impingement• Rotator Cuff Tears• SLAP Lesions• Shoulder Instability
Objective
• Observation• Flexion or abduction
with a small weight• Watch for– Winging– Lack of co-ordination or
control– Fast downward rotation
with eccentric lowering
Objective
• Scapular Assistance Test• Manually assist scapular
upward rotation• Change in symptoms?
Objective
• Scapular Repositioning Test
• Manually assist scapular external rotation and posteriorly tilt
• Change in symptoms?
Conservative - Management
• Based on the associated pathology
• Treatment of the scapular dyskinesis– Posture Correction– Restore Normal Mobility– Restore Stability
Conservative - Management
Serratus Anterior
Serratus Anterior
Lower Trapezius
Lower Trapezius
Lower Trapezius
Lower Trapezius
Conservative Management
1. Motor Control and Strength2. Endurance3. Neuromuscular Control4. Return to Sport