The Role of Scapular Dyskinesis in Shoulder Pain: Understanding and Correcting Improper Movement

Shoulder pain is one of the most common complaints seen in physiotherapy clinics. While many people think of rotator cuff tears, arthritis, or other well-known injuries when they experience shoulder pain, one often overlooked cause is scapular dyskinesis. This condition refers to abnormal movement of the scapula (shoulder blade) during arm motion, and it plays a significant role in many cases of shoulder pain.

In this blog post, we’ll explore the link between scapular dyskinesis and shoulder pain, why it happens, and how it can be corrected through physiotherapy.

What Is Scapular Dyskinesis?

Scapular dyskinesis is a term used to describe abnormal movement patterns of the scapula during arm movements. Essentially, the scapula isn’t moving as it should, which can affect the function of the shoulder joint and lead to pain and discomfort. The scapula serves as the foundation for many shoulder movements, so any dysfunction in its motion can impact the entire shoulder complex.

In a healthy shoulder, the scapula should smoothly glide along the rib cage during arm movement, allowing for proper range of motion and coordination. When scapular dyskinesis occurs, the scapula may be raised too high, tilted, or rotated abnormally, which can create tension in the surrounding muscles, leading to pain, inflammation, and restricted movement.

The Link Between Scapular Dyskinesis and Shoulder Pain

When the scapula moves improperly, it affects the shoulder’s biomechanics, putting excessive strain on the muscles, tendons, and ligaments that surround the shoulder joint. This can lead to several common shoulder problems, including:

• Rotator Cuff Injuries: The rotator cuff muscles rely on the scapula for proper functioning. If the scapula moves incorrectly, it can interfere with the rotator cuff’s ability to stabilize the shoulder, leading to impingement or tears.

• Shoulder Impingement Syndrome: Scapular dyskinesis can cause narrowing of the space between the humeral head (upper arm bone) and the acromion (part of the shoulder blade), leading to pinching of the rotator cuff tendons. This results in impingement syndrome, which causes pain, weakness, and limited range of motion.

• Shoulder Instability: If the scapula is not stabilizing the shoulder joint properly, the ball-and-socket joint becomes unstable, increasing the risk of dislocations or subluxations (partial dislocations).

• Tendonitis: Dysfunctional scapular movement can lead to overuse of certain muscles, resulting in tendinitis in the rotator cuff or biceps tendon.

What Causes Scapular Dyskinesis?

Scapular dyskinesis is often the result of muscle imbalances or poor posture. Some common causes include:

1. Weakness in the Scapular Stabilizers: Muscles like the serratus anterior, lower trapezius, and rhomboids are responsible for stabilizing the scapula. If these muscles are weak or not firing properly, the scapula may move inappropriately during arm motion.

2. Tight or Overactive Muscles: Overactive upper trapezius or pectoral muscles can pull the scapula out of alignment, affecting its movement and stability.

3. Poor Posture: Rounded shoulders or a forward head posture can create a misalignment in the scapula, leading to abnormal movement patterns.

4. Previous Injuries: Shoulder injuries, such as dislocations, rotator cuff tears, or fractures, can cause changes in the mechanics of scapular movement, either due to weakness or protective compensation.

5. Repetitive Strain: Activities that involve repetitive overhead motions, such as swimming, tennis, or weightlifting, can lead to overuse of the shoulder muscles and contribute to dyskinesis.

How to Correct Scapular Dyskinesis

Correcting scapular dyskinesis requires a comprehensive approach that focuses on strengthening weak muscles, stretching tight muscles, and improving overall posture. Physiotherapy plays a key role in the treatment of scapular dyskinesis, with the following strategies:

1. Strengthening Scapular Stabilizers: The first step is to strengthen the muscles responsible for stabilizing the scapula, including the serratus anterior, lower trapezius, and rhomboids. Targeted exercises, such as scapular push-ups, rows, and wall slides, can help restore proper movement patterns.

2. Stretching Tight Muscles: Stretching the upper trapezius, pectorals, and other overactive muscles can help reduce tension and allow for better scapular positioning. A physiotherapist will guide you through stretches that target these specific muscle groups.

3. Postural Correction: Improving overall posture is crucial for preventing and correcting scapular dyskinesis. Exercises that promote proper alignment, such as chin tucks and shoulder blade squeezes, can improve posture and reduce stress on the shoulder.

4. Movement Retraining: A physiotherapist will help you re-educate your body to move correctly, with an emphasis on proper scapular mechanics during activities like lifting, reaching, and pushing.

5. Manual Therapy: In some cases, manual therapy techniques, such as joint mobilizations or soft tissue massage, can be used to improve scapular mobility and reduce muscle tightness.

6. Functional Exercises: Once the scapula’s movement is restored, functional exercises that mimic the motions used in sports or daily activities are essential for ensuring that the shoulder can perform optimally.

Final Thoughts

Scapular dyskinesis is a significant contributing factor to shoulder pain and injury, yet it often goes unrecognized. Understanding the importance of scapular movement and addressing the underlying issues through physiotherapy can help prevent long-term problems, improve shoulder function, and enhance overall performance.

If you’re struggling with shoulder pain or suspect you might have scapular dyskinesis, don’t hesitate to reach out to us at Muscle People Physiotherapy. Our team is here to assess your condition, create a personalized treatment plan, and help you achieve pain-free movement.