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Learning Center

Learning Center

Session Name: Learning Centers

Pod 1 - Winging It - Clinical Evaluation of Scapular Dyskinesis

Saturday, November 18, 2023
8:00 AM – 9:00 AM CT
Location: Learning Center in the Pavilion
In-Person

    Session Director(s)

  • Andrea L. Aagesen, DO

    Assistant Professor
    University of Michigan PM&R Program
    Ann Arbor, Michigan

    No financial relationships to disclose.

    • Faculty(s)

  • Evan A. Plunkett, MD

    Assistant Professor
    University of Michigan
    Ann Arbor, Michigan

    No financial relationships to disclose.

  • Adam Lewno, DO

    Assistant Professor
    University of Michigan
    Ann Arbor, Michigan

    Disclosure(s): No financial relationships to disclose

  • Reina Nakamura, DO

    Assistant Clinical Professor
    University of Michigan
    Ann Arbor, Michigan

    Disclosure(s): No financial relationships to disclose

  • Hassen Berri, DO

    Assistant Professor
    University of Michigan
    Ann Arbor, Michigan

    No financial relationships to disclose.

  • Kimbie Casten, MD, Other (she/her/hers)

    Attending Physician
    Intermountain Health
    Spanish Fork, Utah

    No financial relationships to disclose.

  • Johan Latorre, MD, Other

    Assistant Professor
    University of Alabama at Birmingham
    Birmingham, Alabama

    No financial relationships to disclose.

  • Jonathan Etter, MD, PhD

    Spinal Cord Injury Fellow
    University of Michigan
    Ann Arbor, Michigan

    No financial relationships to disclose.

  • AH

    Anne Hartigan, MD

    No financial relationships to disclose.

  • AL

    Ann Laidlaw, MD

    No financial relationships to disclose.

Lab Marketing

Description: :
Scapular dyskinesis is a condition where the scapula is not positioned or moving properly due to nerve or muscle injury or muscle atrophy. This condition is crucial for shoulder biomechanics and injury prevention. Overhead athletes with scapular dyskinesis have a 43% higher risk of shoulder pain. This skills lab simplifies scapular anatomy and kinematics to improve clinical evaluation and rehabilitation.

Why is this lab needed? : Scapular dyskinesis is commonly present in patients with shoulder pain; however, identifying the root cause can be challenging. Having a systematic approach to the physical examination of the shoulder with a particular focus on scapular kinematics will help clinicians identify individuals with dysfunction, target counseling and interventions appropriately.

Lab Outline/Format::
Introduction (10-15 minutes): Review anatomy and normal and abnormal scapular motion. Discuss various definitions (scapular winging, scapular dyskinesis, SICK, STAM etc)​. Overview of how to evaluate the for focal weakness, identify compensation patterns and nerve injuries, and introduce rehab exercises with a specific focus on strengthening and stretching exercises based on the clinical presentation.

Station 1: (10 minutes) Evaluation of scapular protraction and activation of the serratus anterior muscle.

Station 2: (10 minutes) Evaluation of shoulder abduction and the upper and lower trapezius muscles.

Station 3: (10 minutes) Shoulder ER and static to dynamic scapular tilt due to muscle tightness /weakness.

Station 4: (10 minutes) Secondary influences on scapular motion including rib cage ROM, thoracic ROM and glenohumeral ROM.

Learning Objectives:

  • Understand scapular kinematics and the role that the periscapular muscles play in normal and abnormal scapular motion.
  • Appreciate how abnormal scapular motion affects shoulder pathology, such as rotator cuff tears, labral tears and impingement.
  • Confidently perform a comprehensive clinical evaluation of scapular kinematics.
  • Prescribe specific rehabilitation exercises to target the various etiologies of scapular dyskinesis.