Scapular Stabilization for Shoulder Pain: Putting the Cart Before the Horse?

Observational evaluation of arm elevation is a routine part of the examination of patients with shoulder pain and dysfunction. However, the interdependency of the glenohumeral and scapulothoracic joints during arm elevation presents a challenge for clinicians when attempting to characterize movement...

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Main Authors: Alyssa Elder, Christopher M. Powers
Format: Article
Language:English
Published: North American Sports Medicine Institute 2025-02-01
Series:International Journal of Sports Physical Therapy
Online Access:https://doi.org/10.26603/001c.128049
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author Alyssa Elder
Christopher M. Powers
author_facet Alyssa Elder
Christopher M. Powers
author_sort Alyssa Elder
collection DOAJ
description Observational evaluation of arm elevation is a routine part of the examination of patients with shoulder pain and dysfunction. However, the interdependency of the glenohumeral and scapulothoracic joints during arm elevation presents a challenge for clinicians when attempting to characterize movement impairments and underlying causes. Given that identification of movement impairments related to the scapulothoracic joint (i.e. scapular winging or excessive scapular elevation) are more easily observed compared to movement faults at the glenohumeral joint (i.e. superior or anterior translation of the humeral head) an inherent bias may exist in which clinicians prioritize movement impairments and associated physical impairments at the scapulothoracic joint in developing a treatment plan. Interpreting the cause(s) of abnormal scapulothoracic motion without considering the potential influence of the glenohumeral joint (and vice-versa) may lead to faulty clinical reasoning when developing a plan of care. The purpose of this clinical commentary is to highlight the potential impact of faulty glenohumeral joint mechanics as being contributory to scapulothoracic joint kinematics. We first review the normal kinematics and muscular actions associated with typical arm elevation and then discuss how impairments at the glenohumeral joint may be contributory to faulty scapulothoracic motion. Specifically, we address movement faults characterized by excessive motion of the scapula. # Level of Evidence 5
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spelling doaj-art-8cbe7793a83e48ad828eac1d6070a34f2025-02-01T02:57:04ZengNorth American Sports Medicine InstituteInternational Journal of Sports Physical Therapy2159-28962025-02-01202Scapular Stabilization for Shoulder Pain: Putting the Cart Before the Horse?Alyssa ElderChristopher M. PowersObservational evaluation of arm elevation is a routine part of the examination of patients with shoulder pain and dysfunction. However, the interdependency of the glenohumeral and scapulothoracic joints during arm elevation presents a challenge for clinicians when attempting to characterize movement impairments and underlying causes. Given that identification of movement impairments related to the scapulothoracic joint (i.e. scapular winging or excessive scapular elevation) are more easily observed compared to movement faults at the glenohumeral joint (i.e. superior or anterior translation of the humeral head) an inherent bias may exist in which clinicians prioritize movement impairments and associated physical impairments at the scapulothoracic joint in developing a treatment plan. Interpreting the cause(s) of abnormal scapulothoracic motion without considering the potential influence of the glenohumeral joint (and vice-versa) may lead to faulty clinical reasoning when developing a plan of care. The purpose of this clinical commentary is to highlight the potential impact of faulty glenohumeral joint mechanics as being contributory to scapulothoracic joint kinematics. We first review the normal kinematics and muscular actions associated with typical arm elevation and then discuss how impairments at the glenohumeral joint may be contributory to faulty scapulothoracic motion. Specifically, we address movement faults characterized by excessive motion of the scapula. # Level of Evidence 5https://doi.org/10.26603/001c.128049
spellingShingle Alyssa Elder
Christopher M. Powers
Scapular Stabilization for Shoulder Pain: Putting the Cart Before the Horse?
International Journal of Sports Physical Therapy
title Scapular Stabilization for Shoulder Pain: Putting the Cart Before the Horse?
title_full Scapular Stabilization for Shoulder Pain: Putting the Cart Before the Horse?
title_fullStr Scapular Stabilization for Shoulder Pain: Putting the Cart Before the Horse?
title_full_unstemmed Scapular Stabilization for Shoulder Pain: Putting the Cart Before the Horse?
title_short Scapular Stabilization for Shoulder Pain: Putting the Cart Before the Horse?
title_sort scapular stabilization for shoulder pain putting the cart before the horse
url https://doi.org/10.26603/001c.128049
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