What is Scapular Dyskinesia and Should You Be Concerned?

Apr 7

If you’ve been told you have scapular dyskinesia, you might be wondering what it means and if it’s something you should worry about. Scapular dyskinesia simply refers to an alteration in how your shoulder blade moves—but does it cause pain? Should you be trying to fix it? Let's break it down.

Understanding Scapular Dyskinesia

The scapula (shoulder blade) plays a crucial role in shoulder movement, acting as a stable base for the arm. Beyond being the anchor for the arm to the body, the scapula enables greater movement of the arm bone (humerus). For example, when you raise your arm overhead the scapula rotates at the same time as the arm bone pivots within the ball and socket joint of your shoulder. This combination of movement enables us to have a greater range of movement in the arm. Scapular dyskinesia means there is some alteration in the way your shoulder blade moves.

Most people are probably not even aware of how their shoulder blades moves during arm motion (and why would they?), but the movement of the scapula has been a point of great contention in the rehab world.

In the past, therapists would assess a patient’s arm and shoulder movements to identify any altered patterns of the scapula. It was believed that if these altered patterns of movement could be changed, it could reduce or prevent shoulder injuries from occurring. From a mechanical perspective this kind of makes sense; there is theoretically an ideal strategy of moving the scapula during various shoulder movements and if it is altered it could cause some issues.

Fortunately, as we are going to go over, the evidence of the past ten years has debunked this idea. The truth is that this variation is common, even in people without pain.

Key Facts About Scapular Dyskinesia

Most people have differences in scapula movement. Research shows 75% of people have variations in scapular motion, regardless of whether they have pain (Uhl et al., 2009).
Scapular motion is difficult to measure clinically. Visual assessments of movement differences can be inconsistent.
Scapular dyskinesia does not necessarily cause pain. Studies show that people with and without shoulder pain have similar rates of scapular dyskinesia (Plummer et al., 2017).
Exercise can maybe change scapular movement—but doing so doesn’t necessarily change pain. (Turgut et al., 2017).

Scapular Dyskinesia or Altered Shoulder Blade Movement

Should You Be Concerned?

Scapular dyskinesia alone is not a diagnosis and doesn’t automatically mean something is wrong. If you have shoulder pain, the most important thing is how you feel, not how your shoulder blade moves.

Instead of focusing on correcting scapular motion alone, the goal of treatment should be:

✔ Reducing pain

✔ Improving strength and function

✔ Returning to your daily activities

What You Can Do

If you have shoulder pain, a physiotherapist or chiropractor can help by:

Assessing your symptoms, not just your movement
Identifying the potential sources for your pain
Creating a treatment plan focused on pain relief and function
Providing individualized exercises that help you move and feel better

Final Thoughts

If adjusting your scapular movement helps with your symptoms, that’s great! But if your shoulder blade moves differently and you don’t have pain, there’s no need to fix it. The most important thing is improving how your shoulder feels and functions—not chasing a “perfect” movement pattern.

If you have concerns about shoulder pain or function, we’re here to help. Book an appointment with one of our professionals at Pursuit Physiotherapy to find the best plan for you!

References:

Uhl TL, Kibler WB, Gecewich B, Tripp BL. Evaluation of clinical assessment methods for scapular dyskinesis. Arthroscopy. 2009;25(11):1240-1248. doi:10.1016/j.arthro.2009.06.007
Plummer HA, Sum JC, Pozzi F, Varghese R, Michener LA. Observational Scapular Dyskinesis: Known-Groups Validity in Patients With and Without Shoulder Pain. J Orthop Sports Phys Ther. 2017;47(8):530-537. doi:10.2519/jospt.2017.7268
Turgut E, Duzgun I, Baltaci G. Effects of Scapular Stabilization Exercise Training on Scapular Kinematics, Disability, and Pain in Subacromial Impingement: A Randomized Controlled Trial. Arch Phys Med Rehabil. 2018;99(10):

Dana Tostenson, MPT

With a passion for people and health, physiotherapy has been a natural fit for Dana.

He enjoys working with clients through a holistic approach; incorporating manual therapy, tailored exercise prescription, and evidence informed education to help his patients overcome their pain, improve performance, and enhance their overall health.

Victoria, BC physiotherapist Dana is excited to help people return to the activities they love, approaching any issue, big or small, with enthusiasm and compassion. As a former varsity athlete and now a recreational competitor, his passion for sports and performance optimization makes him a great fit for injured athletes or weekend warriors hoping to return to and excel in the game.

Dana is a graduate of the University of British Columbia (Masters of Physical Therapy), the University of Alberta (Bachelor of Science in Nutrition), and has completed his Transitional Doctorate in Physical Therapy. He has advanced training in Functional Dry Needling, joint manipulation, chronic pain management, nutrition, as well as vestibular and TMJ disorders.

Outside the clinic you can find Dana on the jiu-jitsu mats, taking in the island’s natural beauty, or tending to his admittedly too many house plants (which have now spilled into the clinic).