Scapular dyskinesias refers to abnormal movements of the scapular. The scapular are connected to each other through various soft tissue attachments such as ligaments and tendons. As you move your arm around the body your scapular assists with this movement to maintain ball and socket alignment at the shoulder. Issues that present in the scapular will cause visible alternations. Firstly, the normal resting position of the scapular will change, and/or the required motion of the scapular will change as the arm moves.
Symptoms of Dyskinesias
- Pain and/or tenderness around the scapular especially towards the mid line of the back
- Weakness on the effected arm (becomes fatigued faster than usual)
- Limited range of motion especially with overhead movements
- Crunching or snapping sound with shoulder movements
- Noticeable difference, sticking out of the scapular in resting positions
- A forward tilted or dropped posture on the affected side
Types of scapular Dyskinesias
Type 1 – Inferior-medial scapular border prominence
- This abnormal position normally occurs in throwing and is a result of tightness on the anterior portion of the body, (front) pectorals may lack flexibility and underlying weakness in lower fibres of the traps and serratus anterior muscles.
Type 2 – Medial border prominence
- This pattern shows the entire middle portion of the scapular at rest this is visible to the naked eye. It is normally caused by fatigue of the muscles that stabilise the scapular (trapezius and rhomboids).
Type 3 – Superior – medial border prominence
- This type of dyskinesias is normally a result of an underlying rotator cuff pathology. At rest the top portion of the scapular will be more prominent than the rest.
Main causes relating to scapular dyskinesias include:
- Any kind of damage or injury to stabilising muscles of the shoulder or scapular
- Injuries to the nerve root or nerve pathways that supply theses muscles (loss of motor function)
- Weaknesses or imbalance in surrounding muscle groups that aid with the control of the movements at the shoulder and scapular.
Home treatments/ management
Some home exercises are useful and may help and cure your scapular condition. Depending on which type of condition you are presenting with, alter which type of treatment suitable for you.
Heat therapy – to help with decreasing muscle tightness. The use of a hot bath or heat packs to increase blood flow.
Good posture – when performing work based or activities of daily living for long periods of time, try to maintain a good posture and not have your shoulders fall too far forwards or too high up. You should bend your elbows and shoulders down and backward with the aim of squeezing the shoulder blades together.
Exercise program – if you participate in regular gym training you should ensure your gym programme aims to correct balance between push and pull exercises. It is easy to fall into working the front of our body (the mirror muscles that we see) and forget about the importance of our posterior chain (back of the body) being strong is very important. Haveing a good balance between the two is vital for good posture and in decreasing your risk of injury.