Scapular dyskinesia

Question 1

Typical starting position of the scapula: upward rotation?

Answer 1

2-18 deg

Question 2

Typical starting position of the scapula: internal rotation?

Answer 2

33-35 deg

Question 3

Typical starting position of the scapula: anterior tilt - posterior tilt?

Answer 3

8-10 deg

Question 4

Typical starting position of the scapula: position inf angle?

Answer 4

T7

Question 5

Typical starting position of the scapula: lateral shift of inf angle?

Answer 5

8.1 cm from T7 SP

Question 6

What are the 4 contributors to scapular position?

Answer 6

1. thoracic influence
2. cervical influence
3. habitual influences
4. muscle imbalances

Question 7

Static posture of the scapula is the best indicator of pathology (T/F)

Answer 7

FALSE - what the scapula does during motion is most important

Question 8

In the scapula rehab algorithm, what are the two main categories that can be contributing to scapular dysfunction?

Answer 8

1. lack of soft tissue flexibility

2. lack of muscle performance

Question 9

In the scapular rehab program algorithm, lack of soft tissue flexibly can be broken down into what two categories? How would you treat this?

Answer 9

1. scapular muscles
2. GH muscle/capsule
   treatment - stretching and mob’s

Question 10

In the scapular rehab program algorithm, lack of muscular performance can be broken down into what two categories? How would you treat this?

Answer 10

1. muscular control; treat with neuromuscular coordination

2. muscular strength: treat with strength training

Question 11

What 3 scapular muscles may impact soft tissue flexibility?

Answer 11

1. pec minor
2. levator scapulae
3. rhomboids

Question 12

What 3 GH muscles (and part(s) of capsule) may impact soft tissue flexibility?

Answer 12

1. posterior capsule
2. infraspinatus
3. lat dorsi

Question 13

Stage __ = conscious activation of scapular force couples, scapular orientation exercise, biofeedback

Answer 13

1

Question 14

Stage __ = co-contraction in basic positions, activation with low load, exercises with high LFT/SA ratios

Answer 14

2

Question 15

Stage ___ = general scapula strengthening, integration of kinetic chain

Answer 15

3

Question 16

Stage ___ = advanced strengthening, sport specific, plyometric, kinetic chain integration

Answer 16

4

Question 17

What does the scapular orientation exercise include?

Answer 17

• 15-30 degrees forward of coronal plane

- upward rotation (lift acromion and glenoid)

Question 18

In the scapular orientation exercise, the inferior angle moves ________.

Answer 18

laterally

Question 19

In the scapular orientation exercise, place and hold pt in ideal position for __ reps of __ secs

Answer 19

10;10

Question 20

What are 3 examples of exercises in stage 2 of scapular rehab?

Answer 20

1. low row
2. lawnmover
3. robbery

Question 21

We often see ______ LFT and SA with excessive use of ___

Answer 21

decreased; UFT

Question 22

What are 2 exercises that target SA?

Answer 22

1. dynamic hug

2. bilateral SA punch to 120 deg abduction

Question 23

What are 3 exercise that target LFT?

Answer 23

1. prone full can
2. prone ER at 90 deg
3. prone horizontal ABD at 90 deg with ER

Question 24

What are 3 exercises with the greatest LFT:UFT ratios?

Answer 24

1. bilateral ER at 0 deg abd
2. side lying ER
3. prone horizontal ABD at 90 deg ABD and ER

Question 25

__________ shoulder flexion has highest amount of SA and LFT activity compared to free motion exercises

Answer 25

quadruped

Question 26

In a push up, extending ________ leg = increased SA activation

Answer 26

ipsilateral

Question 27

In a push up, extending _______ leg = increased LFT activation

Answer 27

contralateral

Question 28

In a low row pos'n, single leg stance on ________ leg = increased scapular muscle activity and improved ___:___

Answer 28

contralateral; UFT:LFT

Question 29

What are 4 examples of exercise to include in stage 4?

Answer 29

1. plyos 2. eccentrics 3. oscillations 4. rhythmic stabilization or perturbations

Question 30

If first three stages of the SSMP do not completely alleviate or reduce symptoms, then asses influence of manual therapy procedures throughout the _____, _______ and shoulder regions that may modulate shoulder symptoms

Answer 30

cervical; thoracic

Question 31

What are the 5 parts of the shoulder symptom modification procedure (SSMP)?

Answer 31

1. thoracic kyphosis 2. scapular position 3. winging scapular 4. humeral head procedure 5. symptom modification

Question 32

What 3 ways does the scapula move during arm elevation?

Answer 32

1. upward/downward rotation 2. anterior/posterior tilt 3. external/internal rotation

Question 33

Scapular motion about an axis ________ to the plane of the scapula is known as upward/downward rotation

Answer 33

perpendicular

Question 34

Upward rotation tilts the glenoid fossa superiorly during arm elevation and begins during the first ___ to ___ deg arm elevation

Answer 34

30-60

Question 35

From __ - __ deg the scapula should move very little

Answer 35

0-30

Question 36

From 30 deg - max elevation the ______ scapular border demonstrates smooth upward rotation, and the entire scapula ______

Answer 36

medial; entire

Question 37

Scapular motion around an axis roughly through the spine of the scapula is called ____

Answer 37

tilt (ant or post)

Question 38

During arm elevation the normal scapula moves into ______ tilting and lies flat against the thorax

Answer 38

posterior

Question 39

Scapular motion about a roughly vertical axis is known as ________

Answer 39

rotation

Question 40

The scapula normally externally rotates during arm elevation, particularly above ___ deg

Answer 40

90

Question 41

Generally expect < 1/2 inch protrusion of both the ____ border and ____ angle of the scapula off the thorax

Answer 41

medial; inferior

Question 42

______ _______ = an observable alteration in scapular motion and motion pattern relative to the thorax

Answer 42

scapular dyskinesis

Question 43

What are the two primary subtypes of scapular dyskinesia

Answer 43

1. winging | 2. dysthymia

Question 44

> or equal to ___ inch is considered abnormal winging

Answer 44

1

Question 45

_____ = lack of smooth scapulohumeral motion

Answer 45

dysrhythmia

Question 46

Most common dysrhythmia = early/excessive scapular elevation (____)

Answer 46

shrug

Question 47

Another common dysrhythmia = rapid downward rotation during lowering (____)

Answer 47

dump

Question 48

_____ angle should not pass it's original resting position

Answer 48

inferior

Question 49

Dysrhythmia may present asL UR before ___ during elevation, excessive UR (____); or DR below 90 deg is _______ on descent

Answer 49

30; shrug; uncontrolled / rapid

Question 50

It is uncommon to have abnormal motion bilaterally, so focus on symmetry when testing (T/F).

Answer 50

FALSE

Question 51

The issue is not the scapular position as rest but what happens during motion (T/F).

Answer 51

TRUE

Question 52

What are the 3 rating descriptors for scapular dyskinesis?

Answer 52

1. normal 2. subtle 3. obvious

Question 53

What are the components that the pt's do in the scapular assessment system?

Answer 53

1. 2 test motions (flexion and abduction) | 2. 5 reps each

Question 54

Women hold ___ lbs and men hold __ lbs during scapular assessment.

Answer 54

3;5

Question 55

To mark as O or S in the scapular assessment system, you must observe abormalities in > or equal to ___/ 5 reps.

Answer 55

2