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Getting the Shoulder Blade Back on Track

Shoulder injuries affect more than just the shoulder joint. The scapula (shoulder blade) is often involved, too. In fact, changes in the position and function of the scapula occur in 68 to 100 percent of all shoulder injuries.

This report gives information about the scapula to help guide treatment. Normal scapular function is reviewed in detail. There are many factors that can change scapular motion. When the shoulder blade moves or is positioned abnormally, the problem is called scapular dyskinesis.

The authors point out how posture, injury, and muscle weakness can cause scapular dyskinesis. Muscle tightness and muscle incoordination can make the problem worse. The effects of dyskinesis are also reviewed. For example, a baseball pitcher can't throw properly without full and normal scapular motion.

Ways to test and measure the scapula are presented along with motions that can be done to correct the problem. The legs, hips, and trunk must also be checked for possible problems that can contribute to scapular dyskinesis. Changes in total body posture can have a direct effect on scapular motion.

Finally, treatment by a physical therapist to reduce symptoms and restore normal movement patterns is discussed. The authors conclude that scapular retraining must be part of any shoulder rehabilitation.

References: W. Ben Kibler, MD, and John McMullen, ATC. Scapular Dyskinesis and Its Relation to Shoulder Pain. In Journal of the American Academy of Orthopaedic Surgeons. March/April 2003. Vol. 11. No. 2. Pp. 142-151.

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