Skip to main content
SpringerLink
Log in
Book cover

Sports Injuries pp 323–341Cite as

Scapulothoracic Disorders

  • Reference work entry
  • First Online:

  • 291 Accesses

Abstract

The scapulothoracic joint plays a key role in the correct function of the shoulder. A thorough understanding of the anatomy and biomechanics is essential to perform an adequate physical exam that has a vital role in the diagnosis of scapular dyskinesis.

Some shoulder problems affect mainly the scapulothoracic joint, causing primary scapular dyskinesis. Such is the case when different conditions affect the nerves that innervate the scapular girdle or mechanical alterations in the STJ cause snapping or crepitus. Violent trauma can also severely injure the joint in scapulothoracic dissociation.

In other occasions, the scapular dyskinesis appears in the context of other shoulder problems such as glenohumeral instability, clavicle fractures, acromioclavicular disorders, and impingement syndrome. In these cases, the true role of the scapular involvement as a cause, facilitator of consequence of the problem is often not clear; but the dyskinesis needs to be addressed specifically during treatment. In most cases, a proper rehabilitation protocol is the main therapeutic weapon available in dealing with scapular dyskinesis.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   699.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   999.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  • Aggarwal A, Wahee P et al (2011) Variable osseous anatomy of costal surface of scapula and its implications in relation to snapping scapula syndrome. Surg Radiol Anat 33(2):135–140

    Article  Google Scholar 

  • Babyar SR (1996) Excessive scapular motion in individuals recovering from painful and stiff shoulders: causes and treatment strategies. Phys Ther 76(3):226–238; discussion 239–247

    Article  CAS  Google Scholar 

  • Bagg SD, Forrest WJ (1988) A biomechanical analysis of scapular rotation during arm abduction in the scapular plane. Am J Phys Med Rehabil 67(6):238–245

    CAS  Google Scholar 

  • Borich MR, Bright JM et al (2006) Scapular angular positioning at end range internal rotation in cases of glenohumeral internal rotation deficit. J Orthop Sports Phys Ther 36(12):926–934

    Article  Google Scholar 

  • Borstad JD, Ludewig PM (2005) The effect of long versus short pectoralis minor resting length on scapular kinematics in healthy individuals. J Orthop Sports Phys Ther 35(4):227–238

    Article  Google Scholar 

  • Brucker PU, Gruen GS et al (2005) Scapulothoracic dissociation: evaluation and management. Injury 36(10):1147–1155

    Article  Google Scholar 

  • Burkhart SS, Morgan CD et al (2003) The disabled throwing shoulder: spectrum of pathology part I: pathoanatomy and biomechanics. Arthroscopy 19(4):404–420

    Article  Google Scholar 

  • Canadian Orthopaedic Trauma Society (2007) Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial. J Bone Joint Surg Am 89(1):1–10

    Google Scholar 

  • Cools AM, Witvrouw EE et al (2003) Scapular muscle recruitment patterns: trapezius muscle latency with and without impingement symptoms. Am J Sports Med 31(4):542–549

    Article  Google Scholar 

  • Cools AM, Dewitte V et al (2007) Rehabilitation of scapular muscle balance: which exercises to prescribe? Am J Sports Med 35(10):1744–1751

    Article  Google Scholar 

  • Cools AM, Struyf F et al (2014) Rehabilitation of scapular dyskinesis: from the office worker to the elite overhead athlete. Br J Sports Med 48(8):692-7

    Google Scholar 

  • De Mey K, Cagnie B et al (2009) Trapezius muscle timing during selected shoulder rehabilitation exercises. J Orthop Sports Phys Ther 39(10):743–752

    Article  Google Scholar 

  • Ebraheim NA, Lu J et al (1998) Vulnerability of long thoracic nerve: an anatomic study. J Shoulder Elbow Surg 7(5):458–461

    Article  CAS  Google Scholar 

  • Edwards SL, Lee JA et al (2010) Nonoperative treatment of superior labrum anterior posterior tears: improvements in pain, function, and quality of life. Am J Sports Med 38(7):1456–1461

    Article  Google Scholar 

  • Ekstrom RA, Donatelli RA et al (2003) Surface electromyographic analysis of exercises for the trapezius and serratus anterior muscles. J Orthop Sports Phys Ther 33(5):247–258

    Article  Google Scholar 

  • Escamilla RF, Yamashiro K et al (2009) Shoulder muscle activity and function in common shoulder rehabilitation exercises. Sports Med 39(8):663–685

    Article  Google Scholar 

  • Flanagin BA, Leslie MP (2013) Scapulothoracic dissociation. Orthop Clin North Am 44(1):1–7

    Article  Google Scholar 

  • Gaskill T, Millett PJ (2013) Snapping scapula syndrome: diagnosis and management. J Am Acad Orthop Surg 21(4):214–224

    Article  Google Scholar 

  • Giphart JE, van der Meijden OA et al (2012) The effects of arm elevation on the 3-dimensional acromiohumeral distance: a biplane fluoroscopy study with normative data. J Shoulder Elbow Surg 21(11):1593–1600

    Article  Google Scholar 

  • Goldstein LJ, Watson JM (2000) Traumatic scapulothoracic dissociation: case report and literature review. J Trauma 48(3):533–535

    Article  CAS  Google Scholar 

  • Gumina S, Carbone S et al (2009) Scapular dyskinesis and SICK scapula syndrome in patients with chronic type III acromioclavicular dislocation. Arthroscopy 25(1):40–45

    Article  Google Scholar 

  • Halder AM, Itoi E et al (2000) Anatomy and biomechanics of the shoulder. Orthop Clin North Am 31(2):159–176

    Article  CAS  Google Scholar 

  • Higuchi T, Ogose A et al (2004) Clinical and imaging features of distended scapulothoracic bursitis: spontaneously regressed pseudotumoral lesion. J Comput Assist Tomogr 28(2):223–228

    Article  Google Scholar 

  • Hurov J (2009) Anatomy and mechanics of the shoulder: review of current concepts. J Hand Ther 22(4):328–342; quiz 343

    Article  Google Scholar 

  • Jeon IH, Neumann L et al (2005) Scapulothoracic fusion for painful winging of the scapula in nondystrophic patients. J Shoulder Elbow Surg 14(4):400–406

    Article  Google Scholar 

  • Katsamouris AN, Kafetzakis A et al (2002) The initial management of scapulothoracic dissociation: a challenging task for the vascular surgeon. Eur J Vasc Endovasc Surg 24(6):547–549

    Article  CAS  Google Scholar 

  • Kibler WB, McMullen J (2003) Scapular dyskinesis and its relation to shoulder pain. J Am Acad Orthop Surg 11(2):142–151

    Article  Google Scholar 

  • Kibler WB, Sciascia AD (2013) Introduction to the second international conference on scapular dyskinesis in shoulder injury–the ‘scapular summit’ report of 2013. Br J Sports Med 47(14):874

    Article  Google Scholar 

  • Kibler WB, Sciascia AD et al (2008) Electromyographic analysis of specific exercises for scapular control in early phases of shoulder rehabilitation. Am J Sports Med 36(9):1789–1798

    Article  Google Scholar 

  • Kibler WB, Sciascia A et al (2012) Scapular dyskinesis and its relation to shoulder injury. J Am Acad Orthop Surg 20(6):364–372

    Article  Google Scholar 

  • Kibler WB, Ludewig PM et al (2013) Clinical implications of scapular dyskinesis in shoulder injury: the 2013 consensus statement from the ‘scapular summit’. Br J Sports Med 47(14):877–885

    Article  Google Scholar 

  • Kuhn JE, Plancher KD et al (1998) Symptomatic scapulothoracic crepitus and bursitis. J Am Acad Orthop Surg 6(5):267–273

    Article  CAS  Google Scholar 

  • Ledger M, Leeks N et al (2005) Short malunions of the clavicle: an anatomic and functional study. J Shoulder Elbow Surg 14(4):349–354

    Article  Google Scholar 

  • Lehtinen JT, Macy JC et al (2004) The painful scapulothoracic articulation: surgical management. Clin Orthop Relat Res 423:99–105

    Article  Google Scholar 

  • Ludewig PM, Reynolds JF (2009) The association of scapular kinematics and glenohumeral joint pathologies. J Orthop Sports Phys Ther 39(2):90–104

    Article  Google Scholar 

  • Ludewig PM, Phadke V et al (2009) Motion of the shoulder complex during multiplanar humeral elevation. J Bone Joint Surg Am 91(2):378–389

    Article  Google Scholar 

  • Lukasiewicz AC, McClure P et al (1999) Comparison of 3-dimensional scapular position and orientation between subjects with and without shoulder impingement. J Orthop Sports Phys Ther 29(10):574–583; discussion 584–576

    Article  CAS  Google Scholar 

  • Lunden JB, Braman JP et al (2010) Shoulder kinematics during the wall push-up plus exercise. J Shoulder Elbow Surg 19(2):216–223

    Article  Google Scholar 

  • Manske RC, Reiman MP et al (2004) Nonoperative and operative management of snapping scapula. Am J Sports Med 32(6):1554–1565

    Article  Google Scholar 

  • Martin RM, Fish DE (2008) Scapular winging: anatomical review, diagnosis, and treatments. Curr Rev Musculoskelet Med 1(1):1–11

    Article  Google Scholar 

  • Matsumura N, Ikegami H et al (2010) Effect of shortening deformity of the clavicle on scapular kinematics: a cadaveric study. Am J Sports Med 38(5):1000–1006

    Article  Google Scholar 

  • McCabe RA, Orishimo KF et al (2007) Surface electromyographic analysis of the lower trapezius muscle during exercises performed below ninety degrees of shoulder elevation in healthy subjects. N Am J Sports Phys Ther 2(1):34–43

    Google Scholar 

  • McClure PW, Michener LA et al (2006) Shoulder function and 3-dimensional scapular kinematics in people with and without shoulder impingement syndrome. Phys Ther 86(8):1075–1090

    Article  Google Scholar 

  • Meininger AK, Figuerres BF et al (2011) Scapular winging: an update. J Am Acad Orthop Surg 19(8):453–462

    Article  Google Scholar 

  • Mell AG, LaScalza S et al (2005) Effect of rotator cuff pathology on shoulder rhythm. J Shoulder Elbow Surg 14(1 Suppl S):58S–64S

    Article  Google Scholar 

  • Millett PJ, Gaskill TR et al (2012) Technique and outcomes of arthroscopic scapulothoracic bursectomy and partial scapulectomy. Arthroscopy 28(12):1776–1783

    Article  Google Scholar 

  • Morris AD, Kemp GJ et al (2004) Shoulder electromyography in multidirectional instability. J Shoulder Elbow Surg 13(1):24–29

    Article  Google Scholar 

  • Moseley JB Jr, Jobe FW et al (1992) EMG analysis of the scapular muscles during a shoulder rehabilitation program. Am J Sports Med 20(2):128–134

    Article  Google Scholar 

  • Myers JB, Laudner KG et al (2006) Glenohumeral range of motion deficits and posterior shoulder tightness in throwers with pathologic internal impingement. Am J Sports Med 34(3):385–391

    Article  Google Scholar 

  • Ogston JB, Ludewig PM (2007) Differences in 3-dimensional shoulder kinematics between persons with multidirectional instability and asymptomatic controls. Am J Sports Med 35(8):1361–1370

    Article  Google Scholar 

  • Pearse EO, Bruguera J et al (2006) Arthroscopic management of the painful snapping scapula. Arthroscopy 22(7):755–761

    Article  Google Scholar 

  • Reinold MM, Escamilla RF et al (2009) Current concepts in the scientific and clinical rationale behind exercises for glenohumeral and scapulothoracic musculature. J Orthop Sports Phys Ther 39(2):105–117

    Article  Google Scholar 

  • Romero J, Gerber C (2003) Levator scapulae and rhomboid transfer for paralysis of trapezius. The Eden-Lange procedure. J Bone Joint Surg Br 85(8):1141–1145

    Article  CAS  Google Scholar 

  • Safran MR (2004) Nerve injury about the shoulder in athletes, part 2: long thoracic nerve, spinal accessory nerve, burners/stingers, thoracic outlet syndrome. Am J Sports Med 32(4):1063–1076

    Article  Google Scholar 

  • Sampson LN, Britton JC et al (1993) The neurovascular outcome of scapulothoracic dissociation. J Vasc Surg 17(6):1083–1088; discussion 1088–1089

    Article  CAS  Google Scholar 

  • Sisto DJ, Jobe FW (1986) The operative treatment of scapulothoracic bursitis in professional pitchers. Am J Sports Med 14(3):192–194

    Article  CAS  Google Scholar 

  • Smith J, Kotajarvi BR et al (2002) Effect of scapular protraction and retraction on isometric shoulder elevation strength. Arch Phys Med Rehabil 83(3):367–370

    Article  Google Scholar 

  • Streit JJ, Lenarz CJ et al (2012) Pectoralis major tendon transfer for the treatment of scapular winging due to long thoracic nerve palsy. J Shoulder Elbow Surg 21(5):685–690

    Article  Google Scholar 

  • Tauber M, Moursy M et al (2008) Direct pectoralis major muscle transfer for dynamic stabilization of scapular winging. J Shoulder Elbow Surg 17(1 Suppl):29S–34S

    Article  Google Scholar 

  • Uhl TL, Kibler WB et al (2009) Evaluation of clinical assessment methods for scapular dyskinesis. Arthroscopy 25(11):1240–1248

    Article  Google Scholar 

  • van Riet RP, Van Glabbeek F (2007) Arthroscopic resection of a symptomatic snapping subscapular osteochondroma. Acta Orthop Belg 73(2):252–254

    Google Scholar 

  • Warner JJ, Navarro RA (1998) Serratus anterior dysfunction. Recognition and treatment. Clin Orthop Relat Res 349:139–148

    Article  Google Scholar 

  • Wattanaprakornkul D, Halaki M et al (2011) Direction-specific recruitment of rotator cuff muscles during bench press and row. J Electromyogr Kinesiol 21(6):1041–1049

    Article  Google Scholar 

  • Wiater JM, Flatow EL (1999) Long thoracic nerve injury. Clin Orthop Relat Res 368:17–27

    Article  Google Scholar 

  • Zelle BA, Pape HC et al (2004) Functional outcome following scapulothoracic dissociation. J Bone Joint Surg Am 86-A(1):2–8

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Unidad de Hombro y Codo, Hospital Universitario Ramón y Cajal, Cta Colmenar Km 9.100, Madrid, Spain

    Miguel Ángel Ruiz Ibán, Jorge Díaz Heredia & Valencia Mora Mora

  2. Hospital Maz, Zaragoza, Spain

    Jose Luis Ávila

  3. Hospital Asepeyo, Calle joaquin de cardenas 2, Coslada, Madrid, Spain

    Francisco Serrano Sáenz de Tejada & Miguel García Navlet

Authors
  1. Miguel Ángel Ruiz Ibán
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jorge Díaz Heredia
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jose Luis Ávila
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Francisco Serrano Sáenz de Tejada
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Valencia Mora Mora
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Miguel García Navlet
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Miguel Ángel Ruiz Ibán .

Editor information

Editors and Affiliations

  1. Department of Orthopaedics and Traumatology and Department of Sports Medicine, Hacettepe University, Istanbul, Turkey

    Mahmut Nedim Doral

  2. Department of Orthopaedic Surgery, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden

    Jon Karlsson

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag Berlin Heidelberg

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Ruiz Ibán, M.Á., Díaz Heredia, J., Ávila, J.L., de Tejada, F.S.S., Mora, V.M., García Navlet, M. (2015). Scapulothoracic Disorders. In: Doral, M.N., Karlsson, J. (eds) Sports Injuries. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-36569-0_276

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-36569-0_276

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-36568-3

  • Online ISBN: 978-3-642-36569-0

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation