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What is Scapular Rotation Dysfunction?

Scapular rotation dysfunction is a condition in which the movement of the scapula, or shoulder blade, on the rib cage is abnormal. The scapula normally rotates and tilts in coordination with the humerus, or upper arm bone, during shoulder movements. This allows for optimal function and stability of the shoulder joint.

What Causes Scapular Rotation Dysfunction?

Scapular Rotation Dysfunction can be caused by various factors, such as: 

  • Shoulder injuries that affect the muscles, tendons, ligaments, or nerves of the shoulder complex, such as rotator cuff tears, impingement syndrome, labral tears, or instability.
  • Neck injuries that affect the cervical spine or nerve roots, such as mechanical neck pain, cervical radiculopathy, or whiplash.
  • Postural abnormalities that affect the alignment and mobility of the thoracic spine or rib cage, such as excessive thoracic kyphosis, cervical lordosis, or scoliosis.
  • Muscle imbalances or weakness that affect the force couples that control the scapular motion, such as tightness of the pectoralis minor or levator scapulae muscles, or weakness of the serratus anterior or lower trapezius muscles.

What are the Signs and Symptoms of Scapular Rotation Dysfunction?

Scapular Rotation Dysfunction can lead to various shoulder problems, such as pain, inflammation, decreased range of motion, strength, and stability, increased stress and strain, and degeneration. Some common signs of scapular rotation dysfunction are: 

  • Scapular Winging: The medial border or inferior angle of the scapula becomes more prominent and lifts off the rib cage. This may be due to weakness or paralysis of the serratus anterior muscle or injury to the long thoracic nerve.
  • Scapular Dumping: The scapula rotates downward excessively during arm lowering. This may be due to weakness or fatigue of the lower trapezius muscle or tightness of the pectoralis minor muscle.
  • Scapular Shrugging: The scapula elevates excessively during arm elevation. This may be due to weakness or inhibition of the rotator cuff muscles or overactivity of the upper trapezius muscle.

How is Scapular Rotation Dysfunction Diagnosed?

Scapular Rotation Dysfunction is diagnosed by observing the scapular motion during shoulder movements and comparing it to the normal patterns. The scapular motion can be measured using a goniometer or an inclinometer. Other tests, such as X-rays or MRI, may be ordered to rule out other causes of shoulder pain or dysfunction.

How is Scapular Rotation Dysfunction Treated?

Treatment of scapular rotation dysfunction involves addressing the underlying causes and restoring normal scapular motion and function. Some common interventions are:

  • Stretching exercises for tight muscles that restrict scapular motion, such as pectoralis minor, levator scapulae, and the latissimus dorsi.
  • Strengthening exercises for weak muscles that control scapular motion, such as serratus anterior, lower trapezius, middle trapezius, rhomboids, or rotator cuff.
  • Manual therapy for mobilizing stiff joints that affect scapular motion, such as thoracic spine, rib cage, acromioclavicular joint, or sternoclavicular joint.
  • Postural education and correction for improving alignment and mobility of the spine and rib cage.
  • Functional exercises for integrating scapular motion with shoulder movements and activities.
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