Scapular dyskinesis and its relation to shoulder injury.

The scapula plays a key role in nearly every aspect of normal shoulder function. Scapular dyskinesis-altered scapular positioning and motion-is found in association with most shoulder injuries. Basic science and clinical research findings have led to the identification of normal three-dimensional scapular kinematics in scapulohumeral rhythm and to abnormal kinematics in shoulder injury, the development of clinical methods of evaluating the scapula (eg, scapular assistance test, scapular retraction test), and the formulation of rehabilitation guidelines. Primary scapular presentations such as scapular winging and snapping should be managed with a protocol that is focused on the scapula. Persons with associated conditions such as shoulder impingement, rotator cuff disease, labral injury, clavicle fracture, acromioclavicular joint injury, and multidirectional instability should be evaluated for scapular dyskinesis and treated accordingly.