Does scapula dyskinesia matter? Over the past decade, evidence has complied showing scapular assessment may not provide much value. Not only are they difficult to assess, with inter- and intra-rater reliability being fair or poor and the changes in motion after interventions being subtle, but they also lack diagnostic and prognostic utility. The position and movement of the scapula are highly variable, influenced by anatomy, history of physical activity, and current demands. If we find differences in scapula mechanics between populations with and without pain, are the movement changes a cause or result of the pain? This study assessed the association between changes in pain or function with changes in scapular rotations in patients with subacromial shoulder pain over an 8-week period.
The study included 25 adults with one of the following findings: (1) painful arc movement during shoulder flexion or abduction, (2) pain with the Jobe’s test, or (3) pain on resisted lateral rotation or abduction. A scapular rotator was used to assess the scapula's upward/downward rotation and anterior/posterior tilt. Pain and scapula position was measured at 60°, 90°, and 120° scapular arm elevation. The assessments were performed 8 weeks apart and patients were permitted to seek any treatment (or no treatment) during that time. The goal was simply to assess the relationship between pain and scapula position. At the 8-week mark, pain and function significantly improved but there were no changes in scapula position. This study has many limitations and cannot lead to any conclusions on its own. It is simply another data point within a host of studies on this topic. It should cause us to continue to question whether there is a relationship between pain, function, injury, and scapular mechanics.