Scapular Dyskinesis

synonyms: SICK scapula sydrome (scapular malposition, inferior medial border promince, coradoic pain and malposition, and dysKinesis of scapular movement)

Scapular Dyskinesis ICD-9

• 719.41 (Pain in joint; shoulder region)

Scapular Dyskinesis Etiology / Epidemiology / Natural History

• Scapular dyskinesis = alteration in the normal position or motion of the scapula during coupled scapulohumeral movements. Related to inhibition or disorganization of activation patterns in scapular stabilizing muscles.
• Posteroinferior capsular thightness and scapular dyskinesis may lead to articular surface RTC tears and SLAP lesions.
• Tenderness over the coracoid may be related to pectoralis minor tendon contracture secondary to scapular malposition.

Scapular Dyskinesis Anatomy

• see Shoulder anatomy.

Scapular Dyskinesis Clinical Evaluation

• Posteroinferior shoulder pain.
• Medial border prominence demonstrates increased scapular internal rotation.
• Tenderness over the coracoid
• (Kibler WB, JSES 2002;11:550). 3

Scapular Dyskinesis Xray / Diagnositc Tests

Scapular Dyskinesis Classification / Treatment

• Initial treatment: physical therapy directed at stretching the posterior capsule and pectoralis minor.
• Consider Alignmed bracing.
• Type I dyskinesis: inferior medial border prominence
• Type II dyskinesis: prominence of the entire medial border

Scapular Dyskinesis Associated Injuries / Differential Diagnosis

• RTC tear
• SLAP lesion
• Throwning athlete injuries are often associated with scapular dyskinesis.

Scapular Dyskinesis Complications

Scapular Dyskinesis Follow-up Care

Scapular Dyskinesis Review References

• Kibler WB, JAAOS 2003; 11: 142
• Burkhart SS, Arthroscopy 2003;19:641