Scapular Dyskinesis

Dynamic Patterns - Scapular Girdle

Scapular dyskinesis refers to altered scapular motion or positioning during arm movement. It is often associated with shoulder pain, impingement, and reduced overhead performance.

Biomechanical Mechanism

Imbalance between scapular stabilizers (serratus anterior, lower trapezius) and overactive upper trapezius or pectoralis minor. Poor thoracic mobility can further reduce upward rotation and posterior tilt.

Clinical Rationale

Scapular control is essential for shoulder mechanics. Dysfunction increases impingement risk and reduces force transfer.

Practical Solution

Improve thoracic mobility and scapular stabilization before heavy overhead work. Reinforce upward rotation and posterior tilt patterns.

Common Compensations

• Winging during elevation
• Early upper trap dominance
• Limited overhead reach

Progression

1. Level 1: Low-load activation
2. Level 2: Isometrics and controlled ROM
3. Level 3: Loaded retraction/protraction
4. Level 4: Overhead integration

Regression

• Reduce load
• Use supported positions
• Focus on slow tempo

Red Flags

• Severe shoulder pain
• Loss of strength after trauma
• Neurological symptoms

Differential Diagnosis

• Rotator cuff tendinopathy
• Impingement syndrome
• Cervical involvement

Related Patterns

• rounded shoulders

Related Exercises

• wall elbow walk band
• y raise swiss ball
• serratus push up
• scapular squeeze
• ytw series
• face pull
• wall slide
• external rotation band
• thoracic extension foam roller
• bear position
• posterior shoulder ball
• plank roll

Related Assessments

• scapular dyskinesis assessment
• scapular assistance assessment
• lateral scapular slide assessment

Evidence