1. Scapular Dyskinesis

2. Normal Anatomy
The scapular makes up most of the joints in the shoulder girdle
Articulates with thorax
Provides an attachment for stabilising muscles of the glenohumeral joint

3. Scapular Movements- Elevation and Depression

4. Scapular Movements- Upward and Downward Rotation

5. Scapular Movements- Anterior and Posterior Tilting

6. Scapular Movements- Protraction and Retraction

7. Pathology
Alteration in movement of the scapular during shoulder motion
A ‘Cause’ and/or ‘Effect’ of most shoulder pathologies

8. Causes
Posture
Nerve Palsy
Soft Tissue Mobility
Muscle Weakness

9. Classification Type 1- Inferior Angle Winging Increased anterior tilt
Lower trapz weakness
Increased thoracic kyphosis, tight pec minor, short head of biceps

10. Classification Type 2- Medial Border Winging
Increased internal rotation
Serratus Anterior weakness

11. Classification Type 3- Superior Medial Border Winging
Shrugging with arm elevation

12. Associated Pathologies
External Impingement
Internal Impingement
Rotator Cuff Tears
SLAP Lesions
Shoulder Instability

13. Objective Observation Flexion or abduction with a small weight
Watch for
Winging
Lack of co-ordination or control
Fast downward rotation with eccentric lowering

14. Objective Scapular Assistance Test
Manually assist scapular upward rotation
Change in symptoms?

15. Objective Scapular Repositioning Test
Manually assist scapular external rotation and posteriorly tilt
Change in symptoms?

16. Conservative - Management
Based on the associated pathology
Treatment of the scapular dyskinesis
Posture Correction
Restore Normal Mobility
Restore Stability

17. Conservative - Management

18. Serratus Anterior

19. Serratus Anterior

20. Lower Trapezius

21. Lower Trapezius

22. Lower Trapezius

23. Lower Trapezius

24. Conservative Management
Motor Control and Strength
Endurance
Neuromuscular Control
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