This document discusses scapular dyskinesis, including its definition, causes, associated disorders, and rehabilitation. Scapular dyskinesis is an alteration in the normal resting or dynamic position of the scapula during shoulder movements. It can be caused by postural abnormalities, soft tissue inflexibilities, muscular imbalances, or neurovascular issues. Associated problems include shoulder impingement, rotator cuff tendinitis, stiffness, and labral tears. The document outlines a rehabilitation algorithm for treating scapular dyskinesis.

1. S.Thiruvarangan
Physiotherapist
BSc (Hons) Col, MSc (UK)

2. Alteration in the normal resting or dynamic position of the
scapula during coupled scapulohumeral movements.
Kibler WB et al., 2002
What is the normal..??
What is coupled scapulohumeral movements..??
What is Scapular Dyskinesis?

3. Learning outcomes
Recall the anatomy of shoulder girdle
Understanding the biomechanics of shoulder complex
Explain the definition, causes and associated disorders of
scapular dyskinesis
Connecting the theory to clinical applications to establish
the scapular dyskinesis rehabilitation algorithm

4. Articulations
???
Anatomy
Muscles Soft tissues
 Ligaments
 Capsule
 Labrum
 Nerves
 Vascular

5. Arthrokinematics
 Roll
 Glide/Slide
 Spin
Convex-Concave Rule???
Body Planes/Axis
Biomechanics

6. Type
Degree of freedom
Osteokinematics Eg: GH joint
 Abduction/Adduction – Frontal
 Flexion/Extension – Sagittal
 Medial Rotation/L.R – Transverse
Arthrokinematics
 Glide/Slide, Roll & Spin
Joints

7. Scapulo-humeral Rhythm
Carvalho SC et al., 2019

8. Integrated function of shoulder
By Joints By Muscles
GHJ STJ
SCJ ACJ
Scapulo-humeral rhythm
2:1

9. Scapular Dyskinesia
 Definition
 Classification
Type I
Type II
Type III
Thiruvarangan S et al., 2020

10.  Causes
 Postural abnormalities
Kyposis/ Upper Cross syndrome?????
 Lack of soft tissues flexibility
GIRD???
 Muscular imbalances
Force couples, dynamic & static stabilizers???
 Neurovascular deficit
Wing’s scapular/ long thoracic nerve lesion

11. Takenaga T et al., 2015

12. Associated Problems
Alterations in scapular position and motion occur in 68 – 100%
of patients with shoulder injuries.
Kibler WB et al., 2013
 2o SAIS
 Rotator cuff tendinitis
 Arthrofibrosis/ Adhesive capsulitis
 GIRD
 SLAP

13. Scapular Dyskinesia Rehabilitation Algorithm
Cools AM et al., 2007

14. References
 Waugh, A. and Grant, A (2018). Ross & Wilson Anatomy and
Physiology in Health and Illness. Elsevier Health Sciences.
 Neumann, D. A (2013). Kinesiology of the Musculoskeletal
System. Foundations for Rehabilitation.
 Thiruvarangan ,S.(2019).A Current Concept of Scapular
Dyskinesia and Scapular Algorithm. Annals of Orthopaedics,
Trauma and Rehabilitation. 2(2).
 Thiruvarangan ,S. (2020). A trial of conservative care for
restoring scapular dyskinesis: A clinical series: Journal of
Novel Physiotherapy and Rehabilitation. 4(1).