The Association of Scapular Kinematics and Glenohumeral Joint Pathologies
Top Cited Papers
- 1 February 2009
- journal article
- review article
- Published by Journal of Orthopaedic & Sports Physical Therapy (JOSPT) in Journal of Orthopaedic & Sports Physical Therapy
- Vol. 39 (2), 90-104
- https://doi.org/10.2519/jospt.2009.2808
Abstract
Synopsis There is a growing body of literature associating abnormal scapular positions and motions, and, to a lesser degree, clavicular kinematics with a variety of shoulder pathologies. The purpose of this manuscript is to (1) review the normal kinematics of the scapula and clavicle during arm elevation, (2) review the evidence for abnormal scapular and clavicular kinematics in glenohumeral joint pathologies, (3) review potential biomechanical implications and mechanisms of these kinematic alterations, and (4) relate these biomechanical factors to considerations in the patient management process for these disorders. There is evidence of scapular kinematic alterations associated with shoulder impingement, rotator cuff tendinopathy, rotator cuff tears, glenohumeral instability, adhesive capsulitis, and stiff shoulders. There is also evidence for altered muscle activation in these patient populations, particularly, reduced serratus anterior and increased upper trapezius activation. Scapular kinematic alterations similar to those found in patient populations have been identified in subjects with a short rest length of the pectoralis minor, tight soft-tissue structures in the posterior shoulder region, excessive thoracic kyphosis, or with flexed thoracic postures. This suggests that attention to these factors is warranted in the clinical evaluation and treatment of these patients. The available evidence in clinical trials supports the use of therapeutic exercise in rehabilitating these patients, while further gains in effectiveness should continue to be pursued. Level of Evidence Level 5. J Orthop Sports Phys Ther 2009; 39(2):90–104. dor.10.2519/jospt.2009.2808Keywords
This publication has 129 references indexed in Scilit:
- The effect of scapular protraction on isometric shoulder rotation strength in normal subjectsJournal of Shoulder and Elbow Surgery, 2006
- Comparison of three stretches for the pectoralis minor muscleJournal of Shoulder and Elbow Surgery, 2006
- Effects of shoulder muscle fatigue caused by repetitive overhead activities on scapulothoracic and glenohumeral kinematicsJournal of Electromyography and Kinesiology, 2006
- In vivo anatomy of the Neer and Hawkins sign positions for shoulder impingementJournal of Shoulder and Elbow Surgery, 2006
- Functional activity characteristics of individuals with shoulder dysfunctionsJournal of Electromyography and Kinesiology, 2005
- Subacromial impingement syndrome: The role of posture and muscle imbalanceJournal of Shoulder and Elbow Surgery, 2005
- Effect of rotator cuff pathology on shoulder rhythmJournal of Shoulder and Elbow Surgery, 2005
- Arthroscopic surgery versus supervised exercises in patients with rotator cuff disease (stage II impingement syndrome): A prospective, randomized, controlled study in 125 patients with a 212-year follow-upJournal of Shoulder and Elbow Surgery, 1999
- Anatomy and actions of the trapezius muscleClinical Biomechanics, 1994
- The influence of coracoacromial arch anatomy on rotator cuff tearsJournal of Shoulder and Elbow Surgery, 1992