BRADY L . TRIPP , MEd , ATC , and TIM L . UHL , PhD , ATC , PT • University of Kentucky Clinical Assessment of Scapular Motion

© 2003 Human Kinetics • ATT 8(5), pp. 20-24 Many athletic therapists appreciate the role that scapular function plays in maintaining the integrity of the shoulder and therefore include its assessment in their comprehensive shoulder evaluation. A clinician’s observation might result in a determination of pathology called scapular dyskinesis, indicating the presence of abnormal scapular motion or position.1 This term is used to describe a lack of neuromuscular control or ineffective positioning of the scapula but does not describe the abnormal motion observed. Reporting findings in this manner cripples communication among clinicians and hampers the further understanding of the patient’s dysfunction. One can imagine the difficulty this creates between athletic therapists while they discuss rehabilitation protocols. Consider a clinician seeking guidance to develop a rehabilitation program for a patient with a functionally unstable ankle. The communication would suffer if the clinician’s sole description of his or her assessment were “ankle dysfunction.” The exchange would be more productive if the description included the severity and direction of instability, as well as the motion that reproduces the patient’s dysfunction. In this case a better description might have been “the athlete displays ankle instability resulting in an ankle-inversion mechanism during a figure8 functional test.” Our ability to effectively describe dysfunction is essential to improve communication and develop our clinical evaluation and rehabilitation skills. Because of the overlying muscle mass obscuring surface landmarks, the movement of the scapula under the skin, and the lack of lever arm to help quantify scapular movements, clinical testing of the scapula provides a greater challenge than with other joints. Several techniques have been devised to attempt to clinically evaluate scapular dyskinesis, including measurement of scapular displacement from the trunk, inclinometer, visual evaluation, and three-dimensional motion analysis. As our understanding of the role the scapula plays in normal and abnormal shoulder function evolves, so should our clinical skills.