Scapular positioning and movement in unimpaired shoulders, shoulder impingement syndrome, and glenohumeral instability

Authors

  • F. Struyf,

    1. Department of Health Sciences, Division of Musculoskeletal Physiotherapy, Artesis University College Antwerp, Antwerp, Belgium
    2. Department of Human Physiology, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
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  • J. Nijs,

    1. Department of Health Sciences, Division of Musculoskeletal Physiotherapy, Artesis University College Antwerp, Antwerp, Belgium
    2. Department of Human Physiology, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
    3. University Hospital Brussels, Brussels, Belgium
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  • J.-P. Baeyens,

    1. Department of Biometry and Biomechanics, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
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  • S. Mottram,

    1. KC International, Portsmouth, UK
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  • R. Meeusen

    1. Department of Human Physiology, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
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Corresponding author: Jo Nijs, PhD, Department of Health Sciences, Division of Musculoskeletal Physiotherapy, Artesis University College Antwerp, Campus HIKE, Van Aertselaerstraat 31, 2170 Merksem, Antwerp, Belgium. Tel: +32 364 18265, E-mail: jo.nijs@artesis.be

Abstract

The purpose of this manuscript is to review the knowledge of scapular positioning at rest and scapular movement in different anatomic planes in asymptomatic subjects and patients with shoulder impingement syndrome (SIS) and glenohumeral shoulder instability. We reviewed the literature for all biomechanical and kinematic studies using keywords for impingement syndrome, shoulder instability, and scapular movement published in peer reviewed journal. Based on the predefined inclusion and exclusion criteria, 30 articles were selected for inclusion in the review. The literature is inconsistent regarding the scapular resting position. At rest, the scapula is positioned approximately horizontal, 35° of internal rotation and 10° anterior tilt. During shoulder elevation, most researchers agree that the scapula tilts posteriorly and rotates both upward and externally. It appears that during shoulder elevation, patients with SIS demonstrate a decreased upward scapular rotation, a decreased posterior tilt, and a decrease in external rotation. In patients with glenohumeral shoulder instability, a decreased scapular upward rotation and increased internal rotation is seen. This literature overview provides clinicians with insight into scapular kinematics in unimpaired shoulders and shoulders with impingement syndrome and instability.

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