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

Hickey, Darren; Solvig, Veronica; Cavalheri, Vinícius; Harrold, Megan; McKenna, Leanda

doi:10.1136/bjsports-2017-097559

Cited by 145 publications

(106 citation statements)

References 64 publications

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“…Considerable variability was noted across other movements although a trend for more thoracic rotation in the upper spine and lateral flexion in the lower during unilateral UL movement was noted 37,38 ; differentiation of the upper and lower thoracic spine regions is an important consideration to support targeted rehabilitation and precision in exercise prescription. Where much attention has been paid to scapular dyskinesis in athletes, 12,13 current findings may usefully stimulate further investigation of the kinematic interaction between the scapula and the thoracic spine during functional UL movement, a notable gap in the current evidence base, yet essential for force transfer, movement and motor control between the UL and thorax.…”

Section: General Commentsmentioning

confidence: 83%

“…Beyond a somewhat simplistic association with static posture in the general population, and inconclusive evaluation of scapular dyskinesis in athletes presenting with shoulder pain, the kinematic relationship between the thoracic spine and the shoulder in a sporting population is currently unknown. For example, thoracic kyphosis is commonly cited at a contributor to shoulder impingement, via a proposed reduction in the subacromial space, and scapular dyskinesis exists with and without shoulder pain in athletes . Whilst the thoracic spine does not feature strongly in the sporting literature for reasons including its relatively low pain prevalence and challenges with measurement, evidence supports the thoracic spine as playing a significant role in sporting performance, contributing to the estimated 55% of the total force and kinetic energy generated during a throw, around 80% of the total available range of “trunk” axial rotation, and kinematically important to the UL .…”

Section: Introductionmentioning

confidence: 99%

“…For example, thoracic kyphosis is commonly cited at a contributor to shoulder impingement, via a proposed reduction in the subacromial space, 14,15 and scapular dyskinesis exists with and without shoulder pain in athletes. 13 Whilst the thoracic spine does not feature strongly in the sporting literature for reasons including its relatively low pain prevalence and challenges with measurement, 16 evidence supports the thoracic spine as playing a significant role in sporting performance, contributing to the estimated 55% of the total force and kinetic energy generated during a throw, 17 around 80% of the total available range of "trunk" axial rotation, 18 and kinematically important to the UL. 19,20 With a three times higher elbow/ shoulder injury prevalence in softball players with low trunk rotation flexibility, 2 and a beneficial effect of an UL injury prevention program including thoracic mobility exercises on shoulder/elbow injury prevalence, 1,21 a greater focus on the thoracic spine, as a discrete region within the trunk and its contribution to UL function, is required.…”

Section: Introductionmentioning

confidence: 99%

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Thoracic spine mobility, an essential link in upper limb kinetic chains in athletes: A systematic review

et al. 2019

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Knowledge of the contribution of the thoracic spine movement, a requisite for UL functional movement, offers the potential for novel directions for research and management in rehabilitation. This systematic reviewed synthesized evidence of thoracic spine mobility during UL movement in athletes. Using three reviewers at each stage, key databases (MEDLINE, CINAHL, Web of Science) were searched up to 30/6/18. Eligibility criteria: adults age 18‐40 (reflecting athletic population) and studies assessing thoracic spine and UL movement. Quality assessment was evaluated using AXIS tool and GRADE for overall quality of evidence. Seven studies were included (n = 168, mean age 26.4 years, 33% males) with n = 20 in an athlete population. Main findings were: Unilateral and bilateral UL flexion resulted in 6.7‐8.0 and 12.0‐12.8° thoracic extension, respectively. Unilateral and bilateral UL abduction resulted in 3.0‐4.0 and 9.0‐15.0 and degrees, respectively. Other thoracic spine movement (lower and upper, rotation and lateral flexion) was variable across movement planes. Overall there was unequivocal evidence of thoracic spine movement, mainly extension during UL movement and notably at the end of elevation across all planes. Findings support further targeted high‐quality research and examination of thoracic mobility, an essential link in the kinetic chain, in practice.

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Section: General Commentsmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Thoracic spine mobility, an essential link in upper limb kinetic chains in athletes: A systematic review

et al. 2019

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“…Die meisten Skapula-bezogenen Probleme bei Wurfsportlern können auf den Verlust der Kontrolle über die Ruheposition der Skapula und die dynamische Bewegung der Skapula zurückgeführt werden [31]. Hickey et al konnten in ihrer Übersichtsarbeit zeigen, dass Sportler mit Skapuladyskinesie ein 43 % höheres Risiko haben, Schulterschmerzen zu entwickeln, als solche ohne Skapuladyskinesie [32].…”

Section: Skapuladyskinesieunclassified

Die „Handballer-Schulter“ im Fokus von Diagnostik und Therapie

Hepp

Henkelmann

2020

Sportverletz Sportschaden

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ZusammenfassungHandball zählt zu den beliebtesten Mannschaftssportarten in Deutschland. Bei Diagnostik und Therapie von Schulterverletzungen und Schulterbeschwerden muss zwischen der sportartspezifischen jahrelangen Adaptation und einer vermeintlichen Dekompensation zwingend unterschieden werden. Im Gegensatz zu reinen Wurfsportarten, wie z. B. Baseball oder Speerwerfen, werden im Handball wegen des gleichzeitigen Gegnerkontaktes die beabsichtigten Bewegungsabläufe durch erlaubte und unerlaubte Behinderungen oft plötzlich und ruckartig beeinflusst. Hierdurch können zusätzliche Verletzungen entstehen. Der Übergang einer physiologisch adaptierten Handballer-Schulter zu einer therapiebedürftigen pathologischen Werfer-Schulter ist meist fließend. Die Werfer-Schulter ist durch eine Leistungseinschränkung charakterisiert, die durch Schmerzen in der Schulter bei wiederholter sportartspezifischer Belastung hervorgerufen wird. Neben einer gründlichen klinischen Untersuchung ist, aufgrund der Tatsache, dass Veränderungen der Handballer-Schulter sich in der Muskultur, den Sehnen und im Knochen im Sinne von Überlastungsreaktionen (bone bruise) darstellen, das MRT die bevorzugte Untersuchungsmethode. Neben einer Sportkarenz und einer suffizienten Schmerztherapie sollte eine gezielte Physiotherapie erfolgen. Die Interpretation der MRT-Ergebnisse sollte immer mit den Symptomen und den klinischen Untersuchungsergebnissen abgeglichen werden. Indikationen zur Operation sind eine ausbleibende Besserung nach gezielter Schmerz- und Physiotherapie, strukturelle Schäden entsprechend der Symptome ohne Heilungschance bzw. mit höherer Gewissheit der Verbesserung der Beschwerden und Funktion durch eine Operation. Nach einer operativen Therapie spielt die anschließende Rehabilitation eine große Rolle. Eine Sportfähigkeit ist je nach Verletzung in bis zu 90 % wieder möglich.

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“…The systematic review by Hickey et al 1 evaluated whether the presence of scapular dyskinesis in asymptomatic athletes increased risk of developing future shoulder pain. This review was conducted on the backdrop of conflicting evidence and concluded that athletes with scapular dyskinesis have 43% greater risk of developing shoulder pain than those without scapular dyskinesis.…”

mentioning

confidence: 99%