Short Communication

A trial of conservative care for restoring scapular dyskinesis: A clinical series

S Thiruvarangan*, P Srigrishna and B Thileebphan

Published: 08 June, 2020 | Volume 4 - Issue 1 | Pages: 011-015

The shoulder is the greatest movable joint in the human body. Its anatomical design allows a wide range of motion in all directions, leading to an insubstantial balance between stability and mobility. Conservative treatments are suggested by a number of authors for restoring the scapular dyskinesis. However, this condition can be overlapped by other clinical findings. Therefore, comprehensively analysing individual biomechanical rationale is central to design the ideal rehabilitation regimen to overcome scapular dyskinesis by restoring the scapular thoracic rhythm and preventing the associated problems. This study presents a brief clinical series of three patients with shoulder pain due to the alteration of their scapulahumeral rhythm and highlights a comprehensive examination and follow up an evidence-based rehabilitation algorithm to regain pain free functional ability in daily routine life.

Read Full Article HTML DOI: 10.29328/journal.jnpr.1001031 Cite this Article Read Full Article PDF


Scapular dyskinesis; Conservative approach; Scapular algorithm


  1. Feleusa MA, Bierma-Zeinstraa HS, Miedemab MD, Bernsena AN, Verhaard BW, et al. Department of General Practice Manual Therapy. 2008; 13: 426–433.
  2. Greving K. Incidence, prevalence, and consultation rates of shoulder complaints in general practice. Scand J Rheumatol.. 2012; 41: 150-155. PubMed: https://pubmed.ncbi.nlm.nih.gov/21936616  
  3. Sciascia, AD. Clinical implications of scapular dyskinesis in shoulder injury: the consensus statement from the “Scapular Summit”. Br J Sports Med. 2013; 47: 877–885. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23580420   
  4. Seitz AL, Mc Clure PW, Lynch SS, Ketchum JM, et al. Effects of scapular dyskinesis and scapular assistance test on subacromial space during static arm elevation. J Shoulder Elbow Surg. 2012; 21: 631-640. PubMed: https://pubmed.ncbi.nlm.nih.gov/21444218  
  5. Smith R, Nyquist-Battie C, Clark M, Rains J. Anatomical Characteristics of the Upper Serratus Anterior: Cadaver Dissection. J Orthop Sports Phys Ther. 2003; 33: 449-453. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/12968858  
  6. Edward R, Laskowski ER, Newcomer-Aney K, Smith J. Refining Rehabilitation with Proprioception Training: Expediting Return to Play. Phys Med Rehabil Clin N Am. 1997; 25. PubMed: https://pubmed.ncbi.nlm.nih.gov/2008686  
  7. Tyler TF, Nicholas SJ, Roy T, Gleim GW. Quantification of posterior capsule tightness and motion loss in patients with shoulder impingement. Am J Sports Med. 2000; 28: 668-673. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/11032222  
  8. Kibler W. Sciascia, A. Current concepts: scapular dyskinesis. Br J Sports Med. 2010; 44: 300–305.                                                           PubMed: https://www.ncbi.nlm.nih.gov/pubmed/19996329  
  9. Burkhart SS, Morgan CD, Kibler WB. The disabled throwing shoulder: spectrum of pathology. Part III: The SICK scapula, scapular dyskinesis, the kinetic chain, and rehabilitation. Arthroscopy. 2003; 19: 641-661. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/12861203  
  10. Kent BE. Functional anatomy of the shoulder complex, a review. Phys Ther. 1971; 51: 867-887. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/4997967  
  11. Warwick R. Williams P. Gray’s Anatomy, 35th British Ed. Philadelphia: WB Saunders Co. 1973; 399-407.
  12. Sarrafian SK. Gross and functional anatomy of the shoulder. Clin Orthop. 1983; 19: 173: 11-19. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/6825322  
  13. Kapanji IA. Upper Limb. New York. Churchill Livingstone, The Physiology of the Joints. 1970; 24-76.
  14. Evans PJ, Maniac A. Rotator cuff tendinopathy many causes, many solutions. J Musculo Med. 1997; 14: 47-61.
  15. Soslowsky LJ, Carpenter JE, Bucchieri JS, Flatow EL. Biomechanics of the rotator cuff. Orthop Clin of North Am. 1997; 28: 17-30. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/9024428  
  16. Miniaci A, Salonen D. Rotator cuff evaluation: Imaging and diagnosis. Orthop Clin of North Am. 1997; 28: 43-58. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/9024430   
  17. Postacchini R, Carbone S. Scapular dyskinesis: Diagnosis and treatment. OA Musculoskeletal Medicine. 2013; 18: 20.
  18. Kibler WB, McMullen J. Scapular dyskinesis and its relation to shoulder pain. J Am Acad Orthop Surg. 2013; 11: 142-151. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/12670140   
  19. Kibler WB. The role of the scapula in athletic shoulder function. Am J Sports Med. 1998; 26: 325-337. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/9548131   
  20. Rubin BD, Kibler WB. Fundamental principles of shoulder rehabilitation: conservative to postoperative management. Arthroscopy. 2002; 18: 29-39. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/12426529   
  21. Russ P, Michael LV. The role of the scapula. Int J Sports Phys Ther. 2013; 8: 617–629. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3811730/  
  22. Cools AM, Dewitte V, Lanszweert F, Notebaert D, Roets A, Soetens B. Rehabilitation of scapular muscle balance: which exercises to prescribe? Am J Sports Med. 2007; 35: 1744-1751. PubMed: https://pubmed.ncbi.nlm.nih.gov/17606671  
  23. Cricchio M, Frazer C. Scapulothoracic and scapulohumeral exercises: a narrative review of electromyographic studies. J Hand Ther. 2011; 24: 322-333. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21820276  
  24. Mottram SL, Woledge RC, Morrissey D. Motion analysis study of a scapular orientation exercise and subjects’ ability to learn the exercise. Man Ther. 2009; 14: 13-18. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/17910930
  25. McClure PW, Michener LA, Sennett BJ, Karduna AR. Direct 3-dimensional measurement of scapular kinematics during dynamic movements in vivo. J Shoulder Elbow Surg. 2008; 10: 269–277. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/11408911


Figure 1

Figure 1

Figure 1

Figure 2

Figure 1

Figure 3

Figure 1

Figure 4

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More