I’ve been reading and listening to probably what is more than a healthy amount of scapular research and rehabilitation lately. It’s great for me because I’m currently working with a few athletes with scapular dyskinesia and shoulder pain. I wrote a bit about scapular dyskinesia some time back and it’s easily one of my most popular articles to date.
Now, it’s important to understand that winging and dyskinesia can happen for variety of reasons. Pain is a huge player in the mix as well as specific weakness or muscle imbalance. As a therapist it’s our job to determine why this winging is occurring and troubleshoot how to correct it. This article is going to talk more about specific weaknesses.
There are also several different types of winging and dyskinesia. Sometimes the inferior border of the scapula pops up with movement (Type 1). Sometimes the shoulder is protracted (scap anterior tilt/internal rotation) at rest (Type 1). Sometimes we get a shrug with excessive downward rotation when we raise our arms overhead (Type 3). What I’d like to talk about today is medial border prominence (Type 2) as shown in the picture above. I see this quite a bit in athletes especially when they’re attempting pushups.
This article’s inspiration comes from Ann Cools. She is a researcher, physiotherapist and professor. She is an absolute boss when it comes to the shoulder and specifically the scapula. The clinical reasoning process used in this article comes from her.
First off, when you see this occur in your patients you have to ask the question of why is this occurring? Dyskinesia could theoretically cause shoulder pain but can also occur because someone is in pain (Maybe an individual is moving differently to decrease stress on a sensitive area in the shoulder). Ultimately we want to promote symmetry …read more