Scapular dyskinesis describes an alteration in the normal movement or resting position of the shoulder blade, also known as the scapula. This condition can limit the shoulder’s range of motion and may indicate an underlying injury. This article explores whether scapular dyskinesis can be successfully treated, outlining its development, identification, and various treatment strategies.
Understanding Scapular Dyskinesis
Scapular dyskinesis involves irregular movement of the shoulder blade. The scapula provides a stable base for the rotator cuff, and any injury to surrounding soft tissue, muscle, or bone can affect its function. This alteration can manifest as a “winging” appearance, where the shoulder blade protrudes abnormally, either at rest or during activity.
It often stems from muscle imbalances or poor posture. Weakness or fatigue in muscles surrounding the scapula, such as the serratus anterior or trapezius, can lead to altered movement patterns. Overuse injuries, repetitive motions, and previous shoulder injuries also contribute to its onset. Symptoms include pain or tenderness around the shoulder blade, especially during overhead arm movements or lifting. Other signs are a snapping or popping sensation with shoulder movement, decreased arm and shoulder strength, and noticeable asymmetry in posture.
Identifying Scapular Dyskinesis
Recognizing scapular dyskinesis involves a physical examination by healthcare professionals. They visually observe the shoulder blade’s movement, often asking the individual to raise their arms overhead, sometimes with light weights. This visual assessment helps reveal muscle weakness or abnormal motion patterns.
Specific tests, such as the Scapular Assistance Test (SAT) and the Scapular Retraction Test (SRT), may also be performed. These tests involve manually assisting or stabilizing the scapula during arm movements to see if pain decreases or strength improves. A comprehensive evaluation by a physical therapist or medical doctor is important for accurate identification and to ensure other shoulder issues are not overlooked. Imaging techniques like X-rays and MRIs are not needed for diagnosis, as the condition is best observed dynamically, though they may identify other underlying injuries.
Strategies for Correction
Addressing scapular dyskinesis primarily involves non-surgical methods to restore proper shoulder blade movement and stability. Physical therapy is a common approach, often lasting four to eight weeks depending on severity. Targeted exercises strengthen specific muscles, such as the serratus anterior and lower trapezius, which are important for scapular control. Exercises like push-up plus, wall slides, and scapular retractions improve stability and neuromuscular control.
Manual therapy techniques, including soft tissue mobilization, may improve scapular mobility and alleviate pain. These methods address muscle tightness and imbalances that hinder normal scapular motion. Improving daily posture is another aspect, with training focused on maintaining neutral spine alignment and proper shoulder blade positioning. Posture correction exercises, such as chin tucks and scapular retractions, reinforce beneficial body mechanics.
Activity modification is also advised to temporarily alter movements that aggravate symptoms. This may involve avoiding overhead activities, pushing, pulling, or lifting that cause discomfort. The goal is to allow the shoulder to rest and heal while gradually reintroducing activities with improved movement patterns. While physical therapy is the primary treatment, surgery is rarely needed unless dyskinesis results from a significant injury or trauma.
Sustaining Improvement
Maintaining improvements in scapular dyskinesis requires a commitment to long-term management. Continued adherence to prescribed exercise programs is important to prevent symptom recurrence. These exercises reinforce muscle strength and coordination, ensuring the scapula moves optimally during daily activities.
Individuals should integrate proper movement patterns and body mechanics into their daily routines and during physical activities. This involves being mindful of posture, especially during repetitive tasks or overhead movements, to avoid undue strain on the shoulder complex. Regular check-ups or follow-up sessions with a physical therapist can ensure lasting improvement and address any re-emerging issues, allowing for adjustments to the exercise program and guidance on progressing activities safely.