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SCAPULAR DYSKINESIA. RELATION TO PATHOLOGY IN THE SHOULDER
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Hello and welcome to Aula Fisio.
In today's video we are going to analyze in depth the relationship between scapular dyskinesia and the presence of shoulder pathology.
WHAT IS SCAPULAR DYSKINESIA?
It is an observable alteration of the normal position and movements of the scapula when
movement occurs in the upper limbs.
The scapula is one of the bones that make up the so-called shoulder joint complex and thanks to it, we can reach wider ranges of mobility with the arms.
Now, before we focus on dyskinesia as such, let us briefly review the importance of the scapula in the biomechanics of the shoulder.
The functions of the scapula in this task are 3:
1. STABILITY. One of the main tasks of the scapula is to provide a stable base where glenohumeral mobility can occur. Mechanically, a harmonious and coupled movement is needed between the scapula and the humerus to achieve a good range of motion.
This concept is known as the Scapulohumeral Rhythm and was first mentioned in 1934 by Codman. In it, there is a combined movement that occurs in certain proportions that are 2: 1. That is, every 3 degrees of movement, 2 would occur in the glenohumeral joint and 1 in the scapulothoracic joint.
2. MUSCLE INSERTION. The scapula serves as an insertion platform for numerous muscles, specifically, a total of 17 that are responsible for stabilizing it and coordinating its movements.
3. TRANSFER OF ENERGY. The scapula will serve as a link between the axial skeleton and the upper limbs, transferring the energy from proximal to distal. In this way, optimal positioning of the shoulder is achieved and its function is facilitated.
RELATION TO PATHOLOGY IN THE SHOULDER
Scapular dyskinesia is not considered a specific shoulder pathology, but it does have a very close relationship.
Various studies place the presence of scapular dyskinesia in 68% -100% of patients with shoulder injuries.
More concretely :
68% in rotator cuff pathology, 28% in labrum injuries, 100% unstable shoulders and 16% in swimmers with shoulder pain.
CAUSES
POSTURAL AND BONE ALTERATIONS.
ALTERATIONS OF MUSCLE FUNCTION.
CONTRACTURES AND LACK OF FLEXIBILITY.
NEUROLOGICAL CAUSES
PROPIOCEPTIV DEFICIT
CONSEQUENCES
MECHANICAL DISADVANTAGE
LOSS OF MOVEMENT CONTROL
LOSS OF THE KINETIC CHAIN
CLASSIFICATION
TYPE I
Inferomedial border of the prominent scapula
Shortened muscles: Pectoralis Minor, Short Head of Biceps, Elevator Scapula, Upper Trapezius
Weakened muscles: Serratus Anterior, Lower Trapezius
TYPE II
Medial edge of the scapula prominent.
Shortened muscles: the same as in type I
Weakened muscles: Serratus Anterior, Lower / Middle Trapezius, Rhomboids and Latissimus Dorsi
TYPE III
Superomedial border of a prominent scapula.
Weakened muscles: Serratus anterior, upper trapezius and levator scapula.
TYPE IV
Normal and symmetrical position and movement of the scapula.
TREATMENT
Treatment of scapular dyskinesia should be focused on achieving more effective neuromuscular control of scapular movement. For this, it will be necessary to work in exercises of motor control, proprioception and postural reeducation. It will also be necessary to work at fascial and muscular level, elongating the shortened muscles and enhancing the weakened ones.
If you are interested in scapular dyskinesia and want to know more about the effective exercises for its treatment, stay tuned or watch out as soon we will upload more videos with examples of exercises and their correct performance.
Thank you very much for getting here, and if you liked the video, give it a Like and don't forget to subscribe.
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