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Scapular Dyskinesis
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Normal Anatomy The scapular makes up most of the joints in the shoulder girdle Articulates with thorax Provides an attachment for stabilising muscles of the glenohumeral joint
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Scapular Movements- Elevation and Depression
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Scapular Movements- Upward and Downward Rotation
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Scapular Movements- Anterior and Posterior Tilting
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Scapular Movements- Protraction and Retraction
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Pathology Alteration in movement of the scapular during shoulder motion A ‘Cause’ and/or ‘Effect’ of most shoulder pathologies
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Causes Posture Nerve Palsy Soft Tissue Mobility Muscle Weakness
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Classification Type 1- Inferior Angle Winging Increased anterior tilt
Lower trapz weakness Increased thoracic kyphosis, tight pec minor, short head of biceps
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Classification Type 2- Medial Border Winging
Increased internal rotation Serratus Anterior weakness
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Classification Type 3- Superior Medial Border Winging
Shrugging with arm elevation
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Associated Pathologies
External Impingement Internal Impingement Rotator Cuff Tears SLAP Lesions Shoulder Instability
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Objective Observation Flexion or abduction with a small weight
Watch for Winging Lack of co-ordination or control Fast downward rotation with eccentric lowering
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Objective Scapular Assistance Test
Manually assist scapular upward rotation Change in symptoms?
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Objective Scapular Repositioning Test
Manually assist scapular external rotation and posteriorly tilt Change in symptoms?
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Conservative - Management
Based on the associated pathology Treatment of the scapular dyskinesis Posture Correction Restore Normal Mobility Restore Stability
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Conservative - Management
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Serratus Anterior
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Serratus Anterior
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Lower Trapezius
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Lower Trapezius
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Lower Trapezius
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Lower Trapezius
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Conservative Management
Motor Control and Strength Endurance Neuromuscular Control Return to Sport
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