Scapular dyskinesis is an alteration in the normal position or motion of the scapula during coupled scapulohumeral movements. It occurs in a large number of injuries involving the shoulder joint and often is caused by injuries that result in the inhibition or disorganization of activation patterns in scapular stabilizing muscles. It may increase the functional deficit associated with shoulder injury by altering the normal scapular role during coupled scapulohumeral motions. Scapular dyskinesis appears to be a nonspecific response to shoulder dysfunction because no specific pattern of dyskinesis is associated with a specific shoulder diagnosis. It should be suspected in patients with shoulder injury and can be identified and classified by specific physical examination. Treatment of scapular dyskinesis is directed at managing underlying causes and restoring normal scapular muscle activation patterns by kinetic chain-based rehabilitation protocols.
"In addition, all muscles lengths estimated through simulation were based on glenohumeral kinematics recorded on healthy subjects, while relative contribution of glenohumeral joint is known to vary in compensation for shoulder injury during active arm elevation (Ben Kibler and McMullen, 2003). Hence, thoracohumeral results proposed in appendix may be underestimated, as thoracohumeral–glenohumeral elevation ratio in patients may be increased. "
"For example, Warner et al.  reported this association in 14 of their 22 patients with shoulder instability and in all of their seven patients with subacromial impingement. In two other studies, scapular dyskinesis was observed in 15 out of 15 patients with glenohumeral instability  . The 72 patients with scapular muscle detachment described by Kibler et al.  did not have glenohumeral instability. "
[Show abstract][Hide abstract] ABSTRACT: We report the case of a 28-year-old transgender (male-to-female) patient that had a partial tear of the rhomboid major tendon, scapulothoracic bursitis, and glenohumeral instability on the same side. These conditions resulted from traumatic events during circus acrobatic maneuvers. Additional aspects of this case that make it unique include (1) the main traumatic event occurred during a flagpole exercise, where the patient's trunk was suspended horizontally while a vertical pole was grasped with both hands, (2) headaches were associated with the periscapular injury and they improved after scapulothoracic bursectomy and rhomboid tendon repair, (3) surgical correction was done during the same operation with an open anterior capsular-labral reconstruction, open scapulothoracic bursectomy without bone resection, and rhomboid tendon repair, (4) a postoperative complication of tearing of the serratus anterior and rhomboid muscle attachments with recurrent scapulothoracic pain occurred from patient noncompliance, and (5) the postoperative complication was surgically corrected and ultimately resulted in an excellent outcome at the one-year final follow-up.
"Despite the advantages offered by the three-dimensional dyskinesis method, however, it does not easily enable measurement mainly because it is too expensive and the equipment is excessively bulky. Given that clinicians could not use this approach, they typically employ Kibler's observational typing method, which was considered the gold standard in clinical examinations (Kibler & McMullen, 2003; Uhl, Kibler, Gecewich, & Tripp, 2009). Nevertheless, even though Kibler's observational typing method is practical, the current study opted to measure scapular anterior tilting (scapular anterior tilting index) and the scapular upward rotation angle. "
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