Scapular Dyskinesis and the Kinetic Chain: Recognizing Dysfunction and Treating Injury in the Tennis Athlete

Saini, Sundeep; Shah, Sarav S.; Curtis, Alan S.

doi:10.1007/s12178-020-09672-6

Cited by 24 publications

(35 citation statements)

References 63 publications

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“… 1 , 2 These patterns represent the net effect of different aetiologies and often require the countervailing mechanisms of the surrounding musculature to achieve the desired function, predisposing them to injury. 11 Type III is often associated with subacromial impingement and injuries to cuff tendons. 2 More than one type can coexist, making clinical evaluation challenging.…”

Section: Scapular Dyskinesismentioning

confidence: 99%

“…Regarding SD, the best current treatment is also the conservative one: physical therapy to correct positional and muscular force abnormalities, with specific exercises for scapular stabilization and muscular strengthening to optimize scapular kinematics ( Table 1 ). 11 , 17 …”

Section: Treatment Of Patients With Rotator Cuff Tear and Scapular Dyskinesismentioning

confidence: 99%

“…Initial treatment should focus on the proximal kinetic chain, with exercises for core musculature stabilization, and then distally, on the strengthening of scapular stabilizers. 11 , 23 Stretching and strengthening exercises improve proprioception and contribute to scapular stabilization. 8 , 11 , 33 Baumer et al demonstrated that physical therapy has a beneficial impact on clinical outcomes in patients with chronic RCT, by reducing pain, increasing the shoulder range of motion, and improving functional scores, but it had a subtle effect on glenohumeral and scapulothoracic motion patterns ( Table 1 ).…”

Section: Treatment Of Patients With Rotator Cuff Tear and Scapular Dyskinesismentioning

confidence: 99%

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The role of scapular dyskinesis on rotator cuff tears: a narrative review of the current knowledge

2021

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Scapular dyskinesis can be present in healthy individuals as in patients with shoulder pathology. Altered patterns of scapular kinematics can cause or exacerbate rotator cuff tear pathology. However, more research is needed. Regardless of the cause or the consequence of rotator cuff tear, scapular dyskinesis impairs shoulder function, worsens the symptoms, and compromises the success of clinical intervention. The available literature suggests physical therapy as the first treatment for degenerative cuff tears, and scapular dyskinesis should be addressed if present. Non-responsive cases or traumatic tears may require surgery. Postsurgical physical therapy protocols after rotator cuff repair must consider scapular dyskinesia to improve the outcomes. Cite this article: EFORT Open Rev 2021;6:932-940. DOI: 10.1302/2058-5241.6.210043

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Section: Scapular Dyskinesismentioning

confidence: 99%

Section: Treatment Of Patients With Rotator Cuff Tear and Scapular Dyskinesismentioning

confidence: 99%

Section: Treatment Of Patients With Rotator Cuff Tear and Scapular Dyskinesismentioning

confidence: 99%

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The role of scapular dyskinesis on rotator cuff tears: a narrative review of the current knowledge

2021

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“…34 Pathologic positioning or motion of the scapula has been termed scapular dyskinesia and has been identified as a significant risk factor for shoulder injuries in overhead athletes. 30,32,33,35,36 This may occur secondary to fatigue in the short-term or chronic overuse without proper recovery in the long-term. 37 Common associated pathologies include labral tears, internal impingement, glenohumeral internal rotation deficits, and rotator cuff tears.…”

Section: Biomechanics and Kinetic Chainmentioning

confidence: 99%

“…Scapular dyskinesis is an often-overlooked component of shoulder pain and underlies the development of many pathologies in the overhead athlete. 25,30,31,33 In fact a recent systematic review by Hickey et al 30 demonstrated that athletes with dyskinesia had a 43% increased risk of development of a shoulder injury than athletes without scapular dyskinesis. Scapular motion is highly complex, consisting of protraction/ retraction, elevation/depression, and upward/downward rotation.…”

Section: Scapular Dyskinesismentioning

confidence: 99%

Evaluation and treatment of shoulder injuries in tennis players: a review

Cirino

Colvin

2021

Current Orthopaedic Practice

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Tennis, one of the most popular sports in the United States, requires both strenuous aerobic and anaerobic effort, placing competitors at risk of significant fatigue and subsequently faulty mechanics. Repetitive stress on the upper extremity especially when serving contributes to the high incidence of chronic shoulder injuries as well as acute injuries. Shoulder injuries may include scapular dyskinesis, glenohumeral internal rotation deficit, internal impingement, and labral, biceps, or rotator cuff lesions. Physical therapy and rehabilitation are the mainstays of treatment. When surgical treatment is necessary, prolonged recovery and difficulty with a return to pre-injury levels of competition can occur. This review focuses on the most common shoulder injuries seen in tennis players, with an emphasis on evaluation and treatment.

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A low carrying angle is measured in elite tennis players just before ball impact during the forehand, suggesting a dynamic varus instant accommodation moving towards full extension

Arrigoni,

Cucchi,

Beltrame

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe goal of this study was to use image analysis recordings to measure the carrying angle of elite male tennis players during the forehand stroke, with the hypothesis that elite tennis players overstress their elbow in valgus over the physiological degree in the frontal plane just before ball contact on forehand groundstrokes.MethodsThe carrying angle of male tennis players ranked in the top 25 positions in the ATP ranking was measured on selected video frames with the elbow as close as possible to full extension just before the ball‐racket contact in forehands. These frames were extracted from 306 videos professionally recorded for training purposes by a high‐profile video analyst. All measures were conducted by three independent observers.ResultsSixteen frames were finally included. The mean carrying angle was 11.5° ± 4.7°. The intraclass correlation coefficient value was 0.703, showing good reliability of the measurement technique. The measured carrying angle was lower than what has been observed in historical cohorts using comparable measurement methodology, suggesting a possible instant varus accommodation mechanism before hitting the ball.ConclusionsThe observed decrease in the carrying angle is a consequence of an increase in elbow flexion position dictated by the transition from a closed to open, semi‐open stances. As the elbow flexes during the preparation phase, it is less constrained by the olecranon and its fossa, increasing the strain on the medial collateral ligament and capsule structures. Moving towards full extension before the ball‐racket contact, the elbow is dynamically stabilised by a contraction of the flexor muscles. These observations could provide a new explanation for medial elbow injuries among elite tennis players and drive specific rehabilitation protocols.Study DesignDescriptive epidemiology study.Level of EvidenceLevel IV.

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Scapular Dyskinesis and the Kinetic Chain: Recognizing Dysfunction and Treating Injury in the Tennis Athlete

Cited by 24 publications

References 63 publications

The role of scapular dyskinesis on rotator cuff tears: a narrative review of the current knowledge

The role of scapular dyskinesis on rotator cuff tears: a narrative review of the current knowledge

Evaluation and treatment of shoulder injuries in tennis players: a review

A low carrying angle is measured in elite tennis players just before ball impact during the forehand, suggesting a dynamic varus instant accommodation moving towards full extension

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