Rotator Cuff Injuries, the Scapula and Impingement Syndromes – Part 3

Abnormal shoulder blade motion (Scapular Dyskinesis)

Numerous studies have show that an alteration in normal shoulder blade motion can cause shoulder impingement. Abnormal shoulder blade motion frequently causes an alteration in muscle activity of three specific areas; the upper trapezius (UT), lower trapezius, and the serratus anterior muscle (SA). This alteration in muscle activity is often overlooked in patients who have been diagnosed with a rotator cuff injury.

These abnormal motion patterns affect the patient’s ability to perform certain actions such as the ability to bring their shoulder forward or backward (protraction and retraction).

A lack of backward motion (retraction) is often related to what is called hyperangulation; another risk factor for shoulder impingement (internal shoulder impingement).

If the practitioner tests for alteration in normal shoulder motion and finds a problem, appropriate Soft Tissue procedures (ART, Graston, Massage Therapy) and exercises can be implemented. I cannot stress the importance of establishing normal shoulder blade motion patterns. Without this normal motion pattern the probability of injury reoccurrence is extremely high.

Cools A, Witvrouw E, Declercq G, et al. Scapular muscle recruitment pattern: trapezius muscle latency in overhead athletes with and without impingement symptoms. Am J Sports Med 2003; 31: 542–549

Cools AM, Witvrouw EE, Danneels LA, et al. Test-retest reproducibility of concentric strength values for shoulder girdle protraction and retraction using the Biodex isokinetic dynamometer. Isokinetics Exerc Sci 2002; 10: 129–36.

Part Four of this Blog cover restrictions in internal rotation.

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