Does SICK Scapula Equal Pain?

Scapular dyskinesis (aka SICK scapula syndrome) is an alteration or deviation in the normal resting or active position of the scapula during shoulder movement. This observation of “abnormal” or “erratic” movement is often associated with pain. But does scapular dyskinesis actually cause a painful shoulder? Does SICK scapula equal pain 

A recent study in the Journal of Orthopedic and Sports Medicine set to find that out. They looked at 135 participants, in which approximately half had painful shoulders and the other half had non-painful shoulders. They had two experienced clinicians determine if a shoulder demonstrated scapular dyskinesis or not. And can you guess what they found?

They found that there were NO significant differences in the prevalence of SICK scapula between the group with shoulder pain and the group without shoulder pain.

Does sick scapula equal pain

The implication of these findings is that the presence of scapular dyskinesis does not necessarily mean that it will be the cause of your shoulder pain. It also means that the presence of SICK scapula may NOT be a relevant impairment for those with shoulder pain and may actually represent a NORMAL movement variation.

This is different than looking at scapular positioning while performing exercises to try and recruit the scapular stabilizers (i.e. serratus anterior). In that sense, scapular position is used as a sign of muscle function/recruitment during exercise, not necessarily as a test to diagnose pain or pathology.

MAIN POINT: Humans are not robots, and we are NOT programmed to all move the same! While we might like to categorize an “optimal” form of movement, it is unrealistic to expect EVERYONE to move the same way when our anatomy is so uniquely individualized! SICK scapula does NOT equal pain!

READ: Evidence Based Shoulder Exercises

Citations
Plummer, Hillary A., et al. “Observational Scapular Dyskinesis: Known-Groups Validity in Patients With and Without Shoulder Pain.” Journal of Orthopaedic & Sports Physical Therapy, vol. 47, no. 8, 2017, pp. 530–537., doi:10.2519/jospt.2017.7268. (Link here)

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