Scapular dyskinesis

Scapular dyskinesis is a movement disorder affecting the scapula (the shoulder bone that forms part of the shoulder joint). In this condition, the scapula does not move properly and in sync with the rest of the shoulder during movements.

Scapular dyskinesis can cause pain, weakness, fatigue, and decreased mobility in the shoulder, and can be a contributing factor to shoulder-related musculoskeletal injuries. There is evidence that 43% of patients with scapular dyskinesis will develop shoulder pain within two years of diagnosis.

Causes of Scapular Dyskinesis
The cause of scapular dyskinesis is multifactorial and can include a combination of muscular, skeletal, and neurological factors. Some of the most common causes include:

• Chronic neck pain: Chronic neck pain can alter the activation patterns of the scapular muscles, causing scapular dyskinesis.
• Cervical or thoracic spine deformities: Dorsal kyphosis or scoliosis can cause scapular dyskinesis.
• Nerve paralysis: Nerves that innervate the muscles that move the scapula and can cause scapular dyskinesis.
• Shoulder injuries: A shoulder injury, such as a tendon rupture or dislocation, can affect the mobility and strength of the scapula.
• Muscle imbalances: Muscle imbalances in the shoulder and back can disrupt normal scapular movement and cause dyskinesis.
• Motor control problems: Motor control problems, such as Parkinson's disease or multiple sclerosis, can affect the coordination and movement of the scapula.
• Improper posture: Poor posture, such as sitting in front of a computer for prolonged periods, can cause long-term scapular dyskinesis.
• Muscle weaknesses: Muscle weaknesses in the scapula, shoulder, and back can affect mobility and strength of the scapula and cause dyskinesis.

Diagnosis of Scapular Dyskinesis
The diagnosis of scapular dyskinesis is clinical. Some of the procedures that may be used for diagnosis include:

• Clinical history and physical examination: The doctor may ask about symptoms, medical history, and lifestyle to determine the possible cause of scapular dyskinesis. A physical examination will then be performed, which will include an assessment of shoulder and scapular mobility, strength, and posture.
• Additional tests: such as X-rays, ultrasound, magnetic resonance imaging (MRI), or computed tomography (CT) can help identify bone or muscle injuries that may be contributing to scapular dyskinesis.
• Functional Assessments: Functional assessments, such as strength and mobility tests, can help evaluate the scapula's ability to move properly and synchronize with the rest of the shoulder.

It is important to note that diagnosing scapular dyskinesis can be difficult and requires a thorough evaluation by an orthopedic surgeon specializing in the treatment of shoulder injuries. An accurate diagnosis is essential for proper and effective treatment.

Treatment for Scapular Dyskinesis
Treatment for scapular dyskinesis depends on the underlying cause and the severity of symptoms. Treatment is conservative in the vast majority of cases. Some treatment options include:

• Physical Therapy: Physical therapy can help strengthen weak muscles and improve scapular mobility.
• Lifestyle Modifications: Lifestyle modifications, such as improving posture and avoiding activities that worsen symptoms, may be helpful in the treatment of scapular dyskinesis.
• Pharmacological treatment: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce the pain and inflammation associated with scapular dyskinesis.
• Manual therapy: Manual techniques, such as massage and manipulation, can help improve scapular mobility and reduce the symptoms of dyskinesis.
• Surgery: In severe cases or those that are refractory to other treatments, surgery may be necessary to correct underlying bone or muscle injuries.

It is important to speak with an orthopedic surgeon to determine the most appropriate treatment for scapular dyskinesis. Furthermore, combinations of different treatments may be required to achieve a full recovery.