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Scapulothoracic Dyskinesis: A Concept Review

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Abstract

Purpose of Review

Scapulothoracic dyskinesis (SD) occurs when there is a noticeable disruption in typical position and motion of the scapula, which can result in debilitating pain. The purpose of this review is to describe the current knowledge regarding the diagnosis and management of scapulothoracic dyskinesis by providing an evidence-based overview of clinical exams and treatment modalities available for orthopedic surgeons and provide insight into which treatment modalities require further investigation.

Recent Findings

SD is highly prevalent in athletes, particularly those participating in overhead activities (e.g., baseball, tennis, and swimming) and can coexist with several shoulder pathologies. A holistic approach in the diagnosis of SD has been supported in the literature; however, it is important to recognize that diagnosis is currently limited to the absence of a quantitative SD clinical assessment. The main goal of the treatment of SD is to regain proper scapular positioning and dynamics. The standard of care for the management of SD is conservative interventions aimed at optimizing scapular kinematics. Surgical intervention is only considered in the presence of concomitant pathology requiring surgery.

Summary

Due to the complexity of coordinated movement of the shoulder girdle, recent literature has begun to move away from the use of traditional orthopedic tests, in favor of a more system-based approach for the diagnosis of SD. We present a concise review of clinical exams and treatment modalities available for orthopedic surgeons in the management of SD.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Henry Ford Hospital, 2799 W. Grand Blvd, Detroit, MI, 48202, USA

    Toufic R. Jildeh, Muhammad J. Abbas & Eric X. Jiang

  2. Wayne State University School of Medicine, 540 E Canfield St, Detroit, MI, 48201, USA

    Daisy A. Ference

  3. Mayo Clinic, Department of Orthopedic Surgery, 600 Hennepin Avenue, Suite 310, Minneapolis, MN, 55403, USA

    Kelechi R. Okoroha

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Kelechi R. Okoroha reports potential conflicts of interest from the following companies: Arthrex (grand and education), Smith & Nephew (education, travel, lodging), Pinnacle (education), Medwest Associates (education), Wright Medical Technology (travel and lodging), and Stryker Corporation (travel and lodging). Toufic R. Jildeh, Daisy A. Ference, Muhammad J. Abbas, and Eric X. Jiang declare that they have no conflict of interest.

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Jildeh, T.R., Ference, D.A., Abbas, M.J. et al. Scapulothoracic Dyskinesis: A Concept Review. Curr Rev Musculoskelet Med 14, 246–254 (2021). https://doi.org/10.1007/s12178-021-09705-8

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