Cheatography
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Scapular dyskinesis Rx, Hx, PE
This is a draft cheat sheet. It is a work in progress and is not finished yet.
Scapula dyskinesis
- Dominant shoulder more affected |
- Abnormal scapula motion causes a shift in the humeral head |
- Increases stress on shoulder capsule, anterior GH ligaments and rotator cuff |
- Loss of rotator cuff strength |
Causes
- Muscular imbalance |
- Neurological injury |
- Joint pathology |
- Weakness, tightness, fatigue, altered activation in pec minor, short head of biceps
- Excessive pull on corocoid process
weakness of lower traps/serratus anterior - inadequate acromial elevation |
- Excessive mobile phone use |
- Dysfunction in distal kinetic chain - hip abductor or core weakness |
- Hyperkyphosis |
- Secondary:
AC seperation/instability/arthrosis
Labral injury
GHID
GH instability
Bicep tendinitis
Clavicle/scapula f# |
- Cx radiculopathy |
- Peripheral neuropathy ( Spinal accessory nerve, long thoracic, suprascapular nerve |
Hx
- Can be asymptomatic |
- Pain in anterior/posterosuperior aspect of the shoulder |
- Discomfort radiates inferiorly towards lateral deltoid/superiorly into traps |
- Pain over coracoid (pec minor tightness) |
SICK scapular syndrome
- Made up of Scapula malpositiong, Inferior ankle prominence, Coracoid tenderness/malpositiong, dysKinesis |
- Observe for winging or asymmetry |
- Drop arm test - look for scapula smoothness |
PE
- +ve drop arm test |
- Decreased ROM (int rot) |
- TTP of coravoid, subacromial, pecs, biceps, upper traps, rotator cuff |
- Look for UCS signs and hip abductor weakness |
- Arch of impingement |
Management
- Stretch out/myofascial release of tight muscles (pec minor, biceps, upper traps) |
- Exercises (serratus anterior, lower traps, middle traps (external rotation, prone extension, pure horizontal abduction), scapula retraction |
- Avoid shrugging shoulders |
- Strengthening of glut med/core |
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