Scapular dyskinesis and shoulder pain: the devil is in the detail

Littlewood, Chris; Cools, Ann

doi:10.1136/bjsports-2017-098233

Cited by 19 publications

(11 citation statements)

References 8 publications

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“…[ 5 ]. However, there is considerable uncertainty regarding these diagnostic criteria [ 6 ], and the basis for them has been repeatedly challenged [ 7 , 8 ]. Clinically, it may not be possible to distinguish between these patho-anatomical diagnostic categories with certainty [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Towards an integrated clinical framework for patient with shoulder pain

et al. 2018

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BackgroundShoulder pain (SP) represents a common musculoskeletal condition that requires physical therapy care. Along the years, the usual evaluation strategies based on clinical tests and diagnostic imaging has been challenged. Clinical tests appear unable to clearly identify the structures that generated pain and interpretation of diagnostic imaging is still controversial. The current patho-anatomical diagnostic categories have demonstrated poor reliability and seem inadequate for the SP treatment.ObjectivesThe present paper aims to (1) describe the different proposals of clinical approach to SP currently available in the literature; to (2) integrate these proposals in a single framework in order to help the management of SP.ConclusionThe proposed clinical framework, based on a bio-psychosocial vision of health, integrates symptoms characteristics, pain mechanisms and expectations, preferences and psychosocial factors of patients that may guide physiotherapist to make a diagnostic triage and to choose the right treatment for the individual patient.

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Section: Introductionmentioning

confidence: 99%

Towards an integrated clinical framework for patient with shoulder pain

et al. 2018

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“…Hickey et al included static and dynamic tests for scapular dyskinesis, contrary to current expert consensus, 26 and the pooled number of injuries (n = 121) was below statistical recommendations for risk factor identification. 5 This was also highlighted in a recent editorial that questioned the CI range and the statistical certainty of the meta-analysis of Hickey et al 32 Since the Hickey et al publication, further studies have been published that could improve the statistical power of the meta-analysis. 2 These limitations indicate the need for an updated systematic review and meta-analysis investigating scapular dyskinesis and shoulder injury risk to provide a consensus-aligned, contemporary, and high-powered analysis.…”

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confidence: 99%

Scapular Dyskinesis Is Not an Isolated Risk Factor for Shoulder Injury in Athletes: A Systematic Review and Meta-analysis

et al. 2020

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Background: Scapular dyskinesis has been considered a risk factor for athletic shoulder injury; however, findings in the prospective literature have demonstrated mixed results. Purpose: To determine if scapular dyskinesis increases the risk of shoulder injury in athletes. Study Design: Meta-analysis. Methods: A systematic search was conducted on the MEDLINE, CINAHL Plus, SPORTDiscus, and Embase databases to identify prospective studies examining scapular dyskinesis and shoulder injury risk in athletes. Studies were included if they assessed participants using a dynamic scapular assessment at baseline and monitored for the development of shoulder injury. Data from the studies were subject to meta-analysis using the Mantel-Haenszel method to produce a pooled risk ratio. Results: Seven studies were eligible for inclusion, resulting in 212 shoulder injuries observed across 923 athletes. Scapular dyskinesis was present in 46% of participants, and these athletes had an injury rate of 25%. The presence of scapular dyskinesis displayed a trend to increase the risk of shoulder injury, but this was not statistically significant (risk ratio, 1.07; 95% CI, 0.85-1.34; P = .59). Conclusion: Scapular dyskinesis was not significantly associated with the development of shoulder injury in athletes. Registration: CRD42019133089 (PROSPERO).

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“…Some authors state that scapular dyskinesis will be present in every overhead athlete with shoulder pain [29], because training or muscle fatigue may induce aberrant scapular movement. However, there is no certainty that a subject will develop shoulder complaints if scapular dyskinesis is present [39].…”

Section: The Surfers' Shoulder Compared To Shoulder Complaints In Ovementioning

confidence: 99%

The Surfer’s Shoulder: A Systematic Review of Current Literature and Potential Pathophysiological Explanations of Chronic Shoulder Complaints in Wave Surfers

Langenberg

Lima

Heitkamp³

et al. 2021

Sports Med - Open

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Background Wave surfing will debut in the next Olympic Games and is increasingly popular as a sport. Chronic shoulder complaints are frequently reported amongst surfers, though literature researching its pathophysiology and prevention is scarce. This article provides an overview of the current literature, proposes a potential pathogenesis and a potential physiotherapeutic prevention program for surf-induced shoulder complaints. Methods A systematic review was performed considering the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for articles regarding kinematic analysis of the surf paddling movement. Data sources were Embase, MEDLINE (PubMed) and Research gate. We included case series and cohort studies that originally studied or described the paddle movement made by wave surfers, studies that reported on kinesiologic analysis with nerve conduction studies and studies on 3D motion analysis of the shoulder while paddling. Results Eight original articles were included that analysed the shoulder movement in paddling surfers. Muscles that are active during paddling are mainly internal rotators and muscles that are involved in shoulder flexion. Internal rotators are active in propelling the surfer through the water, though external rotator strength is only used while the arm is out of the water. Discussion In surfers with shoulder complaints, external rotation range of motion and external rotation strength are impaired. Scapulothoracic dyskinesis may occur and subacromial pain syndrome may coincide. Further research should address potential pectoralis minor shortening, which may lead to aberrant scapular tilt and lateral rotation of the scapula. The surfer’s shoulder is characterised by external rotation deficit, as opposed to internal rotation deficit in the thrower’s shoulder, and it differs substantially from shoulder complaints in swimmers. Therefore, a specific prevention or rehabilitation protocol for surfers is required. Decreased thoracic extension may thereby alter the risk of scapular dyskinesis and hence increase the risk of impingement around the shoulder joint. A potential physiotherapeutic prevention programme should address all these aspects, with the main goal being to increase external rotator strength and to stretch the internal rotators. Conclusion There is a high incidence of chronic surf-induced shoulder complaints in surfers. Symptoms may arise due to imbalanced training or scapular dyskinesis, which may subsequently trigger subacromial pain. Physiotherapeutic prevention should include stretching of the internal rotators, external rotator training and optimisation of thoracic extension and scapulothoracic movement.

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Scapular dyskinesis and shoulder pain: the devil is in the detail

Cited by 19 publications

References 8 publications

Towards an integrated clinical framework for patient with shoulder pain

Towards an integrated clinical framework for patient with shoulder pain

Scapular Dyskinesis Is Not an Isolated Risk Factor for Shoulder Injury in Athletes: A Systematic Review and Meta-analysis

The Surfer’s Shoulder: A Systematic Review of Current Literature and Potential Pathophysiological Explanations of Chronic Shoulder Complaints in Wave Surfers

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