Scapular dyskinesia Flashcards
Typical starting position of the scapula: upward rotation?
2-18 deg
Typical starting position of the scapula: internal rotation?
33-35 deg
Typical starting position of the scapula: anterior tilt - posterior tilt?
8-10 deg
Typical starting position of the scapula: position inf angle?
T7
Typical starting position of the scapula: lateral shift of inf angle?
8.1 cm from T7 SP
What are the 4 contributors to scapular position?
- thoracic influence
- cervical influence
- habitual influences
- muscle imbalances
Static posture of the scapula is the best indicator of pathology (T/F)
FALSE - what the scapula does during motion is most important
In the scapula rehab algorithm, what are the two main categories that can be contributing to scapular dysfunction?
- lack of soft tissue flexibility
2. lack of muscle performance
In the scapular rehab program algorithm, lack of soft tissue flexibly can be broken down into what two categories? How would you treat this?
- scapular muscles
- GH muscle/capsule
treatment - stretching and mob’s
In the scapular rehab program algorithm, lack of muscular performance can be broken down into what two categories? How would you treat this?
- muscular control; treat with neuromuscular coordination
2. muscular strength: treat with strength training
What 3 scapular muscles may impact soft tissue flexibility?
- pec minor
- levator scapulae
- rhomboids
What 3 GH muscles (and part(s) of capsule) may impact soft tissue flexibility?
- posterior capsule
- infraspinatus
- lat dorsi
Stage __ = conscious activation of scapular force couples, scapular orientation exercise, biofeedback
1
Stage __ = co-contraction in basic positions, activation with low load, exercises with high LFT/SA ratios
2
Stage ___ = general scapula strengthening, integration of kinetic chain
3
Stage ___ = advanced strengthening, sport specific, plyometric, kinetic chain integration
4
What does the scapular orientation exercise include?
- 15-30 degrees forward of coronal plane
- upward rotation (lift acromion and glenoid)
In the scapular orientation exercise, the inferior angle moves ________.
laterally
In the scapular orientation exercise, place and hold pt in ideal position for __ reps of __ secs
10;10
What are 3 examples of exercises in stage 2 of scapular rehab?
- low row
- lawnmover
- robbery
We often see ______ LFT and SA with excessive use of ___
decreased; UFT
What are 2 exercises that target SA?
- dynamic hug
2. bilateral SA punch to 120 deg abduction
What are 3 exercise that target LFT?
- prone full can
- prone ER at 90 deg
- prone horizontal ABD at 90 deg with ER
What are 3 exercises with the greatest LFT:UFT ratios?
- bilateral ER at 0 deg abd
- side lying ER
- prone horizontal ABD at 90 deg ABD and ER
__________ shoulder flexion has highest amount of SA and LFT activity compared to free motion exercises
quadruped
In a push up, extending ________ leg = increased SA activation
ipsilateral
In a push up, extending _______ leg = increased LFT activation
contralateral
In a low row pos’n, single leg stance on ________ leg = increased scapular muscle activity and improved ___:___
contralateral; UFT:LFT
What are 4 examples of exercise to include in stage 4?
- plyos
- eccentrics
- oscillations
- rhythmic stabilization or perturbations
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
cervical; thoracic
What are the 5 parts of the shoulder symptom modification procedure (SSMP)?
- thoracic kyphosis
- scapular position
- winging scapular
- humeral head procedure
- symptom modification
What 3 ways does the scapula move during arm elevation?
- upward/downward rotation
- anterior/posterior tilt
- external/internal rotation
Scapular motion about an axis ________ to the plane of the scapula is known as upward/downward rotation
perpendicular
Upward rotation tilts the glenoid fossa superiorly during arm elevation and begins during the first ___ to ___ deg arm elevation
30-60
From __ - __ deg the scapula should move very little
0-30
From 30 deg - max elevation the ______ scapular border demonstrates smooth upward rotation, and the entire scapula ______
medial; entire
Scapular motion around an axis roughly through the spine of the scapula is called ____
tilt (ant or post)
During arm elevation the normal scapula moves into ______ tilting and lies flat against the thorax
posterior
Scapular motion about a roughly vertical axis is known as ________
rotation
The scapula normally externally rotates during arm elevation, particularly above ___ deg
90
Generally expect < 1/2 inch protrusion of both the ____ border and ____ angle of the scapula off the thorax
medial; inferior
______ _______ = an observable alteration in scapular motion and motion pattern relative to the thorax
scapular dyskinesis
What are the two primary subtypes of scapular dyskinesia
- winging
2. dysthymia
> or equal to ___ inch is considered abnormal winging
1
_____ = lack of smooth scapulohumeral motion
dysrhythmia
Most common dysrhythmia = early/excessive scapular elevation (____)
shrug
Another common dysrhythmia = rapid downward rotation during lowering (____)
dump
_____ angle should not pass it’s original resting position
inferior
Dysrhythmia may present asL UR before ___ during elevation, excessive UR (____); or DR below 90 deg is _______ on descent
30; shrug; uncontrolled / rapid
It is uncommon to have abnormal motion bilaterally, so focus on symmetry when testing (T/F).
FALSE
The issue is not the scapular position as rest but what happens during motion (T/F).
TRUE
What are the 3 rating descriptors for scapular dyskinesis?
- normal
- subtle
- obvious
What are the components that the pt’s do in the scapular assessment system?
- 2 test motions (flexion and abduction)
2. 5 reps each
Women hold ___ lbs and men hold __ lbs during scapular assessment.
3;5
To mark as O or S in the scapular assessment system, you must observe abormalities in > or equal to ___/ 5 reps.
2
