Rehabilitation of scapular dyskinesis: from the office worker to the elite overhead athlete.
There is a strong relationship between chronic neck and shoulder pain and dysfunction of the scapula. The scapula essentially acts as a ‘bridge’ between the cervical spine and shoulder complex – in that it provides both mobility and stability to the neck and shoulder region. Although the association between glenohumeral joint pathology and abnormal scapular kinematics has been well established within the literature, few studies have investigated such a relationship between scapular dysfunction and neck pain.
The aim of the current review was to provide an evidence-based clinical framework to facilitate the clinical reasoning process in the rehabilitation of scapular dyskinesis in patients with chronic symptoms within the upper quadrant. The algorithm is essentially divided into two columns, as a patient presenting with scapular dyskinesis may have deficits in muscle flexibility, muscle performance, or both. Each side of the algorithm requires a specific approach regarding rehabilitation. A lack of flexibility is addressed via appropriate stretching and mobilisation techniques, whereas normalisation of muscle recruitment is the primary aim for the patient presenting with muscle performance problems.
Although clinical evidence supports the use of therapeutic exercise in the rehabilitation of patients presenting with shoulder and neck pain, further studies are required to confirm the effectiveness of these exercise protocols > From Cools et al., Br J Sports Med (2013) (Epub ahead of print). All rights reserved to BMJ Group.
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