The scapula is the relay station that passes energy from the legs and trunk to the arm; if that relay station is shaky, the smaller muscles in the arm have to overwork, and that’s when things start tearing.
Teaching on assessment, testing, investigation, diagnosis and physiotherapy treatment of scapular instability


Scapular dyskinesis refers to an alteration in the normal motion of the shoulder blade. Rather than being a standalone injury, it is a physical impairment indicating that the underlying system is failing. Because the shoulder blade acts as the socket for the glenohumeral joint, any dysfunction in its movement can lead to broader issues like shoulder pain or impingement, acting as a hidden driver behind many common clinical complaints.
Research indicates that scapular dyskinesis is incredibly prevalent among those experiencing shoulder issues. In symptomatic patients, the incidence of some form of altered scapular motion ranges from 64% to 100%, depending on the specific joint condition. This high frequency suggests that if a patient has a shoulder problem, such as a rotator cuff concern, there is a very high likelihood that their scapular gears are not functioning correctly.
While scapular dyskinesis is highly visible in overhead athletes, it is not exclusive to them. Approximately 30% to 70% of overhead athletes, including volleyball players and swimmers, show signs of this impairment due to the demands of their sports. However, it also frequently appears in the general population as a physical impairment that accompanies various shoulder injuries, highlighting the importance of checking the shoulder blade in all clinical cases.
Focusing solely on the glenohumeral joint, or the ball and socket, often ignores the foundation of shoulder movement. The scapula must move perfectly for the rest of the shoulder to function. Treating dyskinesis as a primary diagnosis without finding the 'why' can lead to missing the actual cause of the dysfunction. Understanding the relationship between the shoulder blade and the rotator cuff is essential for addressing the root of the impairment.
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