Clinical implications of scapular dyskinesis in shoulder injury: the 2013 consensus statement from the ‘scapular summit’

British Journal of Sports Medicine - Tập 47 Số 14 - Trang 877-885 - 2013
W. Ben Kibler1, Paula M. Ludewig2, Phil W. McClure3, Lori A. Michener4, Klaus Bak5, Aaron Sciascia1
1Shoulder Center of Kentucky
2Department of Physical Therapy, University of Minnesota
3Department of Physical Therapy, Arcadia University
4Department of Physical Therapy, Virginia Commonwealth University.
5Parkens Private Hospital

Tóm tắt

The second international consensus conference on the scapula was held in Lexington Kentucky. The purpose of the conference was to update, present and discuss the accumulated knowledge regarding scapular involvement in various shoulder injuries and highlight the clinical implications for the evaluation and treatment of shoulder injuries. The areas covered included the scapula and shoulder injury, the scapula and sports participation, clinical evaluation and interventions and known outcomes. Major conclusions were (1) scapular dyskinesis is present in a high percentage of most shoulder injuries; (2) the exact role of the dyskinesis in creating or exacerbating shoulder dysfunction is not clearly defined; (3) shoulder impingement symptoms are particularly affected by scapular dyskinesis; (4) scapular dyskinesis is most aptly viewed as a potential impairment to shoulder function; (5) treatment strategies for shoulder injury can be more effectively implemented by evaluation of the dyskinesis; (6) a reliable observational clinical evaluation method for dyskinesis is available and (7) rehabilitation programmes to restore scapular position and motion can be effective within a more comprehensive shoulder rehabilitation programme.

Từ khóa


Tài liệu tham khảo

Kibler WB Sciascia AD Wilkes T . Disorders of the scapula: winging and snapping. In press, Iannotti JP, Williams GR, eds. Diagnosis of the shoulder: diagnosis and management. Vol. 3rd edn. Philadelphia: Lippincott Williams and Wilkins, 2013.

10.1097/00003086-199609000-00002

Bagg, 1988, A biomechanical analysis of scapular rotation during arm abduction in the scapular plane, Am J Phys Med Rehabil, 67, 238

Speer KP Garrett WE . Muscular control of motion and stability about the pectoral girdle. In: Matsen FA III Fu F Hawkins RJ , eds. The shoulder: a balance of mobility and stability. Rosemont: American Academy of Orthopaedic Surgeons, 1994:159–73.

10.2519/jospt.1999.29.10.574

10.2519/jospt.1996.24.2.57

10.2519/jospt.2004.1020

10.1016/j.bone.2005.08.010

10.1067/mse.2001.112954

10.1016/j.jse.2011.11.023

Kibler, 2009, Scapula summit 2009, J Orthop Sports Phys Ther, 39, A1, 10.2519/jospt.2009.0303

Wright AA Wassinger CA Frank M . Diagnostic accuracy of scapular physical examination tests for shoulder disorders: a systematic review. Br J Sports Med Published Online First: 18 October 2012 doi:10.1136/bjsports-2012-091573

10.2519/jospt.2005.1669

10.1177/0363546507303560

10.1016/j.jse.2011.01.008

Atalar, 2009, Restricted scapular mobility during arm abduction: implications for impingement syndrome, Acta Orthopaedica Belgica, 75, 19

10.1136/bjsm.2008.046284

10.1016/S0003-9993(03)00127-8

10.1053/apmr.2002.29666

10.1177/0363546506288728

10.2519/jospt.2008.2616

Weiser, 1999, Effects of simulated scapular protraction on anterior glenohumeral stability, Am J Sports Med, 27, 801, 10.1177/03635465990270061901

10.1177/0363546509346408

Kibler, 1998, The role of the scapula in athletic function, Am J Sports Med, 26, 325, 10.1177/03635465980260022801

10.1067/mse.2002.126766

10.4085/1062-6050-44.2.160

10.1016/j.arthro.2009.06.007

10.2519/jospt.2009.2808

10.5435/JAAOS-20-06-364

Kibler, 2003, Scapular dyskinesis and its relation to shoulder pain, J Am Acad Orthop Surg, 11, 142, 10.5435/00124635-200303000-00008

10.1136/bjsm.2009.058834

Ludewig, 2000, Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement, Phys Ther, 80, 276, 10.1093/ptj/80.3.276

10.1111/j.1600-0838.2010.01274.x

Timmons, 2012, Scapular kinematics and subacromial impingement syndrome: a meta-analysis, J Sport Rehabil, 21, 354, 10.1123/jsr.21.4.354

10.1016/j.jsams.2012.05.017

10.2106/JBJS.G.01483

10.1016/j.clinbiomech.2010.12.001

10.1016/j.apmr.2012.02.034

10.1080/14763141.2011.569563

10.1249/MSS.0b013e3181d64103

10.1016/j.clinbiomech.2007.04.006

10.2106/JBJS.J.01972

Kibler WB Sciascia AD . What went wrong and what to do about it: pitfalls in the treatment of shoulder impingement. In: Duwelius PJ Azar FM , eds. Instructional course lectures, vol. 57, Rosemont: American Academy of Orthopaedic Surgeons, 2008:103–12.

10.1016/j.jse.2005.04.007

10.1007/s00167-010-1232-z

McClure, 2006, Shoulder function and 3-dimensional scapular kinematics in people with and without shoulder impingement syndrome, Phys Ther, 86, 1075, 10.1093/ptj/86.8.1075

10.1016/j.jse.2009.02.012

Sarkar S Seeley S Beranek K . Rotator cuff proximity to potential impinging structures during clinical impingement tests. Paper presented at: IXth Conference of the International Shoulder Group. Wales, UK, 2012.

10.1016/j.math.2008.04.005

10.2106/JBJS.J.01748

Cools, 2003, Scapular muscle recruitment pattern: trapezius muscle latency with and without impingement symptoms, Am J Sports Med, 31, 542, 10.1177/03635465030310041101

Host, 1995, Scapular taping in the treatment of anterior shoulder impingement, Phys Ther, 75, 803, 10.1093/ptj/75.9.803

10.1016/j.jse.2004.09.018

10.1016/S1058-2746(05)80004-7

Dunn W Jones G . Factors associated with low outcomes scores in patients with full thickness rotator cuff tears. Paper presented at: American Academy of Orthopaedic Surgeons Annual Meeting, San Diego, CA, 2011.

10.1016/S0736-0266(01)00035-3

10.1016/S0268-0033(03)00047-0

10.1002/jmri.10327

10.1016/j.jse.2004.09.001

10.1007/s00221-006-0746-6

McMullen, 2000, A kinetic chain approach for shoulder rehabilitation, J Athl Train, 35, 329

10.1177/0363546508316281

10.1016/S0278-5919(05)70300-8

10.1177/0363546505281804

10.1053/jars.2003.50128

10.2519/jospt.2006.2146

10.1177/0363546509332505

Gumina, 2009, Scapular dyskinesis and SICK scapula syndrome in patients with chronic type III acromioclavicular dislocation, Arthroscopy, 25, 40, 10.1016/j.arthro.2008.08.019

Schlegel, 2001, A prospective evaluation of untreated acute grade 3 acromioclavicular seperations, Am J Sports Med, 29, 699, 10.1177/03635465010290060401

10.1177/0363546507300820

10.1007/s00167-005-0012-7

10.1016/j.jse.2003.09.005

10.1016/j.clinph.2005.04.019

Kibler WB . Scapular surgery I-IV. In: Reider B Terry MA Provencher MT , eds. Sports medicine surgery. Philadelphia: Elsevier Saunders, 2010:237–67.

Michener LA Lopes-Albers AD Timmons MK . Scapular Dyskinesis: Kinematic and Muscle Activity Alterations in Patients with Rotator Cuff Disease Scapula Summit 2012. Lexington, KY, 2012.

Sher, 1995, Abnormal findings on magnetic resonance images of asymptomatic shoulders, J Bone Joint Surg (Am), 77, 10, 10.2106/00004623-199501000-00002

10.1302/0301-620X.91B2.21069

Wassinger, 2013, Clinical measurement of scapular upward rotation in response to acute subacromial pain, J Orthop Sports Phys Ther, 43, 199, 10.2519/jospt.2013.4276

10.1016/j.clinbiomech.2006.02.001

10.1016/S1058-2746(97)90084-7

10.1177/0363546509346050

Baskurt, 2011, The effectiveness of scapular stabilization exercise in the patients with subacromial impingement syndrome, J Musculoskelet Rehabil, 24, 173, 10.3233/BMR-2011-0291

10.1016/j.csm.2008.07.007

10.1177/0363546504268138

10.1177/0363546507305098

10.4085/1062-6050-43.6.565

Seitz, 2012, No effect of scapular position on 3-dimensional scapular in the throwing shoulder of healthy professional pitchers, J Sport Rehabil, 21, 186, 10.1123/jsr.21.2.186

10.1097/JSA.0b013e31823a021f

Ellenbecker TS Roetert EP Kibler WB . Applied biomechanics of tennis. In: Magee DJ Manske RC Zachazewski JE Quillen WS , eds. Athletic and sport issues in musculoskeletal rehabilitation. St. Louis: Elsevier, 2011:265–86.

10.1016/0021-9290(93)90084-R

Kibler, 1995, Biomechanical analysis of the shoulder during tennis activities, Clin Sports Med, 14, 79, 10.1016/S0278-5919(20)30259-3

10.1136/bjsm.2009.070128

10.1016/j.jelekin.2005.06.015

10.2519/jospt.2006.2241

Cools, 2005, Isokinetic scapular muscle performance in overhead athletes with and without impingement symptoms, J Athl Train, 40, 104

10.1097/JSM.0b013e3182041de0

10.1136/bjsm.2003.004952

10.1016/S0749-8063(03)00389-X

10.1097/JSA.0b013e318243240c

10.1177/0363546508326712

10.1097/JSA.0b013e318244853e

Tripp, 2006, Functional multijoint position reproduction acuity in overhead athletes, J Athl Train, 41, 146

Warner, 1992, Scapulothoracic motion in normal shoulders and shoulders with glenohumeral instability and impingement syndrome, Clin Orthop Relat Res, 285, 199, 10.1097/00003086-199212000-00024

Tate AR McClure PW . Examination and management of scapular dysfunction. In: Skirven TM , ed. Rehabilitation of the hand and upper extremity, 6th ed. Philadelphia: Mosby/Elsevier, 2011:1209–24.

Koslow, 2003, Specificity of the lateral scapular slide test in asmptomatic competitive athletes, J Orthop Sports Phys Ther, 33, 331, 10.2519/jospt.2003.33.6.331

10.1016/j.apmr.2005.03.021

Odom, 2001, Measurement of scapular asymmetry and assessment of shoulder dysfunction using the lateral scapular slide test: a reliability and validity study, Phys Ther, 81, 799, 10.1093/ptj/81.2.799

10.1136/bjsm.2008.050872

10.4085/1062-6050-44.2.165

10.1016/j.math.2012.07.001

10.2519/jospt.2006.2234

10.1177/0363546503258911

10.1016/S0003-9993(99)90088-6

10.1136/bjsm.2009.066837

10.1016/j.jelekin.2009.12.003

Kendall FP McCreary EK Provance PG . Muscles: testing and function, vol. 4. Baltimore: Williams & Wilkins, 1993.

Cools, 2007, Isokinetic scapular muscle performance in young elite gymnasts, J Athl Train, 42, 458

Michener, 2005, Scapular muscle tests in subjects with shoulder pain and functional loss: reliability and construct validity, Phys Ther, 85, 1128, 10.1093/ptj/85.11.1128

Lewis, 2005, Subacromial impingement syndrome: the effect of changing posture on shoulder range of movement, J Orthopa Sports Phys Ther, 35, 72, 10.2519/jospt.2005.35.2.72

10.1186/1471-2474-11-39

10.1016/j.clinbiomech.2010.08.001

Solem-Bertoft, 1993, The influence of scapular retraction and protraction on the width of the subacromial space, Clin Orthop Relat Res, 296, 99, 10.1097/00003086-199311000-00018

Kalra, 2010, Effect of posture on acromiohumeral distance with arm elevation in rotator cuff disease using ultrasonography, J Orthop Sports Phys Ther, 40, 633, 10.2519/jospt.2010.3155

Sahrmann S . Diagnosis and treatment of movement impairment syndromes. St Louis: Mosby, 2001.

10.1186/1471-2474-8-64

Borstad, 2008, Measurement of pectoralis minor muscle length: validation and clinical application, J Orthop Sports Phys Ther, 38, 169, 10.2519/jospt.2008.2723

10.1177/0363546510370291

10.1053/apmr.2002.34815

10.1097/00005768-200212000-00028

10.1067/mse.2002.119853

Gerber, 2003, Effect of selective capsulorrhaphy on the passive range of motion of the glenohumeral joint, J Bone Joint Surg (Am), 85, 48, 10.2106/00004623-200301000-00008

10.2519/jospt.2007.2337

Kuhn, 1995, Scapular winging, J Am Acad Orthop Surg, 3, 319, 10.5435/00124635-199511000-00002

Sciascia, 2012, Kinetic chain rehabilitation: a theoretical framework, Rehabil Res Pract, 2012, 1

10.1136/bjsm.2009.058875

10.1136/bjsm.2011.084038.29

De May, 2013, Conscious correction of scapular orientation in overhead athletes performing selected shoulder rehabilitation exercises: the effect on trapezius muscle activation measured by surface electromyography, J Orthop Sports Phys Ther, 43, 3, 10.2519/jospt.2013.4283

10.1197/j.jht.2004.02.004

10.1177/0363546512453297

10.1016/j.math.2008.01.010

McClure, 2004, Shoulder function and 3-dimensional kinematics in people with shoulder impingement syndrome before and after a 6-week exercise program, Phys Ther, 84, 832, 10.1093/ptj/84.9.832

10.1016/j.jse.2012.06.010

10.1007/s10067-012-2093-2

10.2340/16501977-0453

Network MOO . Effectiveness of Physical Therapy in Treating Atraumatic Full Thickness Rotator Cuff Tears. A Multi-Center Prospective Cohort Study. The American Shoulder and Elbow Surgeons open meeting. San Diego, CA, 2011.

10.1177/0363546510370937

Moore SD Uhl TL Sciascia AD . Clinical Predictive Factors for Successful Outcome of Rehabilitation in Patients with SLAP Tears. The Disabled Throwing Shoulder: Spectrum of Pathology. Lexington, KY, 2011.

Fedoriw WW Ramkumar P Lintner DM . Nonsurgical and Surgical Treatment of Superior Labral Tears in Professional Baseball Players. American Orthopaedic Society for Sports Medicine. Baltimore, MD, 2012.

10.1002/pri.468