Scapular vs Glenohumeral Dysfunction

Scapula vs Glenohumeral Dysfunction – Which is the chicken and which is the egg?

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Course Outline

The principle scapular dysfunctions implicated in Rotator Cuff Related Pain Syndrome (RCRPS) are a reduction in upward rotation &/or posterior tilt. These change the arthrokinematics of the glenoid during shoulder movement.

Glenohumeral joint positional dysfunction can mainly present as anterior &/or superior translation of the humeral head. This loss of centring of the humerus in the glenoid and reduction of the subacromial space, especially with shoulder abduction and external rotation, is also implicated in RCRPS.

So, when we are presented with a patient with RCRPS, with shoulder pain during activities involving elevation, how do we decide where to start? When is scapular dysfunction causative & when is it compensatory in shoulder pain? Is scapular dyskinesis diagnostic of different shoulder pathologies? Is there any benefit to a scapular focused treatment approach for shoulder pain? How important is optimal arthrokinematics at the glenohumeral joint?

This presentation examines the recent research to discuss the potential relative contributions of the both the scapula and the glenohumeral joint to the patient’s shoulder pain as well as propose a plausible evidence-based clinical approach to this much debated challenge.

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