Clinical Diagnosis of Scapular Dyskinesis in a Youth Softball Pitcher: A Case Report
# Introduction Effective rehabilitation strategies for upper extremity injuries in softball pitchers are scarce in current literature, especially among youth athletes. Additionally, there continues to be ambiguity regarding the interpretation and clinical practicality when treating an overhead athl...
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| Format: | Article |
| Language: | English |
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North American Sports Medicine Institute
2024-02-01
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| Series: | International Journal of Sports Physical Therapy |
| Online Access: | https://doi.org/10.26603/001c.91642 |
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| _version_ | 1825197035560632320 |
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| author | Connor Skoumal Matt Dewald |
| author_facet | Connor Skoumal Matt Dewald |
| author_sort | Connor Skoumal |
| collection | DOAJ |
| description | # Introduction
Effective rehabilitation strategies for upper extremity injuries in softball pitchers are scarce in current literature, especially among youth athletes. Additionally, there continues to be ambiguity regarding the interpretation and clinical practicality when treating an overhead athlete with scapular dyskinesis. The purpose of this case report is to highlight the examination and treatment of a youth softball pitcher referred to physical therapy with the diagnosis of scapular dyskinesis.
# Case Description
This case report presents data and outcomes for a 14-year-old female who experienced chronic right shoulder discomfort related to performing the windmill softball pitch (WSP). The subject was clinically diagnosed with scapular dyskinesis by her referring physician and demonstrated abnormal scapular movement when elevating and lowering her upper extremity. Internal and external rotator isokinetic strength testing and the Athletic Shoulder Test (ASH) were used as primary objective measures. Both were performed six days after the initial evaluation and again six weeks later. Initial testing demonstrated decreased peak torque and total work. Initial treatment involved periscapular and shoulder strengthening with progression to overhead loading. Later rehabilitation strategies focused on neuromuscular control, functional training, and sport-specific activities.
# Outcomes
The subject initially demonstrated improved peak torque and total work of the shoulder with isokinetic strength testing but continued to have symptoms with pitching, even though the Scapular Dyskinesis Test had become negative. After changing the focus to neuromuscular and functional training the subject had fewer symptoms and became comfortable with self-management.
# Discussion
This case matches previous research that endorses scapular dyskinesis being a normal finding in overhead athletes with and without shoulder pain. Neuromuscular control and functional training after a period of scapular strengthening were beneficial in improving symptoms in this athlete.
# Level of Evidence
5 |
| format | Article |
| id | doaj-art-b840351c1bda4054a8d50f18e6e00803 |
| institution | Kabale University |
| issn | 2159-2896 |
| language | English |
| publishDate | 2024-02-01 |
| publisher | North American Sports Medicine Institute |
| record_format | Article |
| series | International Journal of Sports Physical Therapy |
| spelling | doaj-art-b840351c1bda4054a8d50f18e6e008032025-02-11T20:28:02ZengNorth American Sports Medicine InstituteInternational Journal of Sports Physical Therapy2159-28962024-02-01192Clinical Diagnosis of Scapular Dyskinesis in a Youth Softball Pitcher: A Case ReportConnor SkoumalMatt Dewald# Introduction Effective rehabilitation strategies for upper extremity injuries in softball pitchers are scarce in current literature, especially among youth athletes. Additionally, there continues to be ambiguity regarding the interpretation and clinical practicality when treating an overhead athlete with scapular dyskinesis. The purpose of this case report is to highlight the examination and treatment of a youth softball pitcher referred to physical therapy with the diagnosis of scapular dyskinesis. # Case Description This case report presents data and outcomes for a 14-year-old female who experienced chronic right shoulder discomfort related to performing the windmill softball pitch (WSP). The subject was clinically diagnosed with scapular dyskinesis by her referring physician and demonstrated abnormal scapular movement when elevating and lowering her upper extremity. Internal and external rotator isokinetic strength testing and the Athletic Shoulder Test (ASH) were used as primary objective measures. Both were performed six days after the initial evaluation and again six weeks later. Initial testing demonstrated decreased peak torque and total work. Initial treatment involved periscapular and shoulder strengthening with progression to overhead loading. Later rehabilitation strategies focused on neuromuscular control, functional training, and sport-specific activities. # Outcomes The subject initially demonstrated improved peak torque and total work of the shoulder with isokinetic strength testing but continued to have symptoms with pitching, even though the Scapular Dyskinesis Test had become negative. After changing the focus to neuromuscular and functional training the subject had fewer symptoms and became comfortable with self-management. # Discussion This case matches previous research that endorses scapular dyskinesis being a normal finding in overhead athletes with and without shoulder pain. Neuromuscular control and functional training after a period of scapular strengthening were beneficial in improving symptoms in this athlete. # Level of Evidence 5https://doi.org/10.26603/001c.91642 |
| spellingShingle | Connor Skoumal Matt Dewald Clinical Diagnosis of Scapular Dyskinesis in a Youth Softball Pitcher: A Case Report International Journal of Sports Physical Therapy |
| title | Clinical Diagnosis of Scapular Dyskinesis in a Youth Softball Pitcher: A Case Report |
| title_full | Clinical Diagnosis of Scapular Dyskinesis in a Youth Softball Pitcher: A Case Report |
| title_fullStr | Clinical Diagnosis of Scapular Dyskinesis in a Youth Softball Pitcher: A Case Report |
| title_full_unstemmed | Clinical Diagnosis of Scapular Dyskinesis in a Youth Softball Pitcher: A Case Report |
| title_short | Clinical Diagnosis of Scapular Dyskinesis in a Youth Softball Pitcher: A Case Report |
| title_sort | clinical diagnosis of scapular dyskinesis in a youth softball pitcher a case report |
| url | https://doi.org/10.26603/001c.91642 |
| work_keys_str_mv | AT connorskoumal clinicaldiagnosisofscapulardyskinesisinayouthsoftballpitcheracasereport AT mattdewald clinicaldiagnosisofscapulardyskinesisinayouthsoftballpitcheracasereport |