7 Trusted Exercises For Scapular Dyskinesis: How To Fix

Scapular dyskinesis is a fancy word for abnormal scapula movement. You can typically see scapular dyskinesis during shoulder movement if you look hard enough. Sometimes you can’t physically see the observable scapular dyskinesis, but you will feel it. These are the most effective 7 exercises for scapular dyskinesis.

What Is Scapular Dyskinesis?

In the simplest terms scapular dyskinesis is the abnormal movement of the shoulder blades while the shoulder is moving in shoulder elevation.

If you have ever seen someone with scapular dyskinesis, or if you are looking at your back in the mirror you will typically be able to see the shoulder blade on one side sticking out. This is often called scapular winging.

Scapular dyskinesis can be caused by muscular imbalances, nerve damage, poor posture and overuse, specifically with overhead activities. Overhead athletes such as baseball athletes are particularly at risk of scapular dyskinesis.

Symptoms of Scapular Dyskinesis

Although the symptoms of scapular dyskinesis can vary from person to person, these are the telltale signs of scapular dyskinesis:

• Asymmetrical posture of uneven shoulders
• Pain in the shoulder blade or shoulder pain, which is worse when raising arm above your head
• “Scapular winging” of shoulder blade
• Decreased strength of the painful shoulder blade or arm

Rehabilitation Program

A rehabilitation program is crucial in fixing scapular dyskinesis. These physical therapy scapular exercises should focus on regaining a normal scapular motion, improving scapular stability and overall strength of the muscles supporting the scapula, shoulder and spine.

The best scapular exercises to fix scapular dyskinesis are 1. Scapular Retractions 2. Wall Slide 3. Quadruped Y’s 4. Wall Circles 5. Serratus Punch 6. Wall Push Up 7. Bilateral Shoulder ER.

1. Scapular Retractions

• Start by standing with good posture and your shoulders relaxed.
• Now slowly draw your shoulder blades back by squeezing them together.
• Hold this scapular squeeze for 3 seconds and then return to starting position.
• For added difficulty you can perform this scapular retraction with a resistance band.
• You will have the resistance band anchored to a sturdy object and hold onto the ends of the resistance band with your hands.
• The goal of this exercise is to control your scapulas or shoulder blades as you draw them. backwards and squeeze them.
• Scapular retractions are a great posture exercise as well.

2. Wall Slide

• The starting position for this exercise is to stand near a wall with a resistance band around your wrists.
• Place the ulnar aspect or pinky side of your hand on the wall.
  • Your palms will be facing each other.
• Mantain pressure on the wall and slowly slide your arms along the wall and overhead and then slowly back down to the original position.
• Keep tension in the resistance band throughout the motion.
• This is the best shoulder exercise for dynamic stabilization of the scapula.
• If this is too difficult start by performing exercise without a band.

3. Quadruped Y

• This is a great exercise that you can perform with just your bodyweight.
• Start by supporting yourself on your hands and knees in a quadruped position with your hands directly below your shoulders.
• Now stabilize yourself with one shoulder while reaching out at a diagonal or in a “Y” shape with the other arm.
• Lift the arm up to shoulder level and then slowly return to the starting position.
• Be sure to perform this shoulder movement on both sides even if the scapular dyskinesis is only on one side.
• This will help to avoid any muscle imbalances as well as improve shoulder stability in both shoulders.
• For added resistance you can perform this exercise with a resistance band or light dumbbell.

4. Wall Circles

• You can perform this shoulder and scapula stability exercise with either a towel or weighted ball depending on your skill level and strength.
• Now push into either the towel or weighted ball with your shoulder.
• It is important that you do not just lean your body into the wall.
• You want to protract your shoulder forwards and towards the wall in order to use your shoulder stabilizing muscles.
• Now slowly move your shoulder in a circle.
• Perform circles clockwise 10 times and then counterclockwise 10 times while maintaining contact with the wall.

5. Serratus Punch

• The purpose of scapular stabilization exercise is to improve the stability of the scapula. This will prevent the scapula from moving too much within the shoulder joint during shoulder movement.
• Start by lying on your back.
• Hold your affected arm up towards the ceiling.
• Now protract your shoulder by lifting the back of your shoulder off the ground and attempt to punch towards the ceiling and then slowly return your shoulder to the starting position with the back of your shoulder resting on the floor.

6. Wall Push Up

• Start by standing approximately 1 foot away from a wall with your hands against a wall.
• Your shoulders should be at shoulder width apart
• Slowly lower your body toward the wall by bending your elbows in a controlled motion
• Once your chest is near the wall (or as close as you’re comfortable), push your hands into the wall and straighten your arms to return to the starting position.

7. Bilateral Shoulder ER

• Hold a resistance band in both of your hands with your palms facing up.
• You should be standing with your spine in a neutral position
• Your elbows should be at 90 degrees.
• Now slowly rotate your shoulders outwards by pulling the band in opposite directions while maintaining the elbows at 90 degrees.

Scapular Kinematics

The scapulohumeral rhythm is the motion between the humerus and the scapula. This scapulohumeral rhythm occurs during shoulder elevation. The first 30 degrees is what is called the “setting phase” and he majority of movement comes from the glenohumeral vs the scapulothoracic joint.

After 30 degrees of shoulder elevation the humerus and scapula or glenohumeral and scapulothoracic joints move together.

The ideal ratio of humeral elevation to scapular upward rotation movement is 2:1. In other words for every 2 degrees that the humerus moves, the scapula should move 1 degree.

When these scapular movement patterns deviate from the norm such as in scapular dyskinesis, it can cause muscle imbalances and shoulder injuries.

For example in scapular dyskinesis when the scapula is no longer in the normal scapular position, additional stress may be placed on the shoulder. This can cause shoulder injuries such as shoulder impingement syndrome, rotator cuff injuries, periarthritis of the shoulder, and sick scapula syndrome

The proper muscle movement control is the rotation of the scapula in an upward rotation, posterior tilt, and external rotation during shoulder elevation.

Posture in Scapular Dyskinesis

The most common physical feature of scapular dyskinesis upon visual observation is the scapular winging, however there are other posture signs that indicate that someone has scapular dyskinesias.

Scapular dyskinesias can cause muscle imbalances and cause the muscles of the chest, particularly the pectoralis minor to become very tight.

The neck muscles, including the upper trapezius muscle, can also become tight and painful. You may even have neck pain stemming from scapular dyskinesias. The shoulders will be rounded and the shoulders will be asymmetric meaning one shoulder will be higher than the other.

How To Fix

Conservative management is typically the best way to treat scapular dyskinesis. This can be done through physical therapy.

The best therapeutic exercise will include shoulder stability exercises and shoulder strengthening exercises, specifically exercises focused on improving the lower trapezius muscles, serratus anterior muscles and rhomboid muscle. It may also include stretching of the tight muscles such as the levator scapulae and pec muscles.

Medical Disclaimer

As always it is important to professional medical advice from a licensed doctor. Your doctor will be able to give you clearance prior to starting a new exercise routine, especially if you have underlying conditions or suspect a shoulder injury.

These are physical therapy exercises and are best performed with a physical therapist as they have clinical experience and will be able to correct your form and prevent you from injuring yourself.

Summary

These exercises for scapular dyskinesia will improve scapular stability, shoulder and scapula pain, posture and overall function of the shoulder. Consistency will play an important role in your recovery process.

If you have scoliosis and believe your pain is stemming from scoliosis you can find 15 Simple Scoliosis Shoulder Pain Exercises here.