Prevalence of Scapular Dyskinesis in Overhead and Nonoverhead Athletes

Abstract

Background:Scapular dyskinesis, or abnormal dynamic scapular control, is a condition that is commonly associated with shoulder pathology but is also present in asymptomatic individuals. Literature varies on whether it represents a cause or symptom of shoulder pathology, but it is believed to be a risk factor for further injury. Clinical identification focuses on visual observation and examination maneuvers. Treatment of altered scapular motion has been shown to improve shoulder symptoms. It is thought to be more common in overhead athletes due to their reliance on unilateral upper extremity function but the incidence within nonoverhead athletes is unknown.Hypothesis:Overhead athletes will have a greater prevalence of scapular dyskinesis when compared with nonoverhead athletes.Study Design:Systematic review; Level of evidence, 3.Methods:After PROSPERO registration, a systematic review was performed using PRISMA guidelines through the PubMed database looking for studies published before October 2014. All studies containing the search terms scapular, scapulothoracic, dyskinesis, dyskinesia, shoulder athlete, or overhead athlete were included. Studies that did not include prevalence data for scapular dyskinesis were excluded. Study methodological quality was evaluated using the modified Coleman methodology score. Descriptive statistics and 2-proportion 2-tailed z-tests were used to compare the reported prevalence of scapular dyskinesis between overhead and nonoverhead athletes.Results:Twelve studies were analyzed including 1401 athletes (1257 overhead and 144 nonoverhead; mean age, 24.4 ± 7.1 years; 78% men). All the studies were evidence level 2 (33%) or level 3 (67%). The reported prevalence of scapular dyskinesis was significantly (P < .0001) higher in overhead athletes (61%) compared with nonoverhead athletes (33%).Conclusion:Scapular dyskinesis was found to have a greater reported prevalence (61%) in overhead athletes compared with nonoverhead athletes (33%).Clinical Relevance:Prevalence data for scapular dyskinesis are scarce within the literature. Information on the reported prevalence, laterality, and association with the dominant extremity will allow for better allocation of diagnostic and therapeutic interventions. Recognition and treatment will help athletes to optimize functional performance and decrease the risk of further shoulder injury.

Scapular dyskinesis increases the risk of future shoulder pain by 43% in asymptomatic athletes: a systematic review and meta-analysis

“…To answer this question, the prevalence of scapular dyskinesis in asymptomatic athletes and the risk of shoulder pain in athletes without scapular dyskinesis must be taken into account 33. Recent evidence suggests a 54% prevalence of scapular dyskinesis in asymptomatic overhead athletes 23. According to the results of the current review, the 46% of athletes without scapular dyskinesis would be exposed to a 25% risk, leading to 11 athletes in 100 developing shoulder pain.…”

“…The cross-sectional nature of the studies in previous reviews means one cannot determine whether scapular dyskinesis contributed to the development of shoulder pain or whether it arose subsequent to shoulder pain. Scapular dyskinesis is highly prevalent in the asymptomatic general population23 and substantially higher in overhead athletes 23. It remains unclear if dyskinesis is a sports-specific adoption that is potentially beneficial for maximal performance and protective against injury.…”

Risk Factors for Upper Limb Injury in Tennis Players: A Systematic Review

“…Visible alterations (winging or asymmetry) in the position and the motion of the scapula have been termed scapular dyskinesis [38], responsible for changes in activation of scapular stabilizing muscles [39]. Burn and colleagues [40] reported that overhead athletes have greater prevalence of developing scapular dyskinesis than non-overhead athletes, found to be present in 61% of overhead athletes. Cools and colleagues [22] highlighted the scapular dyskinesis as a possible variable for shoulder pathology in tennis players.…”

Exercise therapy may affect scapular position and motion in individuals with scapular dyskinesis: a systematic review of clinical trials

“…25,26 Indeed, scapular dyskinesis is characterized by a prominent scapular medial border and an inferior angle, early scapular elevation, or inadequate scapular upward and downward rotation during arm lifting or lowering. 15,16 Previous studies have claimed that 33%-100% of the patients with various shoulder disorders, like subacromial impingement syndrome (SIS), show scapular dyskinesis 4,33 ; however, it is frequently observed in asymptomatic individuals. 33 Preziosi Standoli et al, 34 in their recent study, reported scapular dyskinesis in 8.5% of asymptomatic elite young swimmers.…”