A 27-year-old man presented with a 5-year history of left periscapular muscle spasm and constant shoulder pain in activities of daily living. Magnetic resonance imaging (MRI) and physical examination revealed scapular dyskinesis without pathologic lesions in the rotator cuff tendon and labrum. However, there was hypertrophy of the serratus anterior muscle on computed tomography (CT). Scapular dyskinesis can be caused by isolated hypertrophy of the serratus anterior. After 4 months of physiotherapy, including manual therapy, therapeutic exercises, and neuromuscular retraining, the patient recovered normal scapular movement and reported no pain.
Jin Hyuck Lee and Woong Kyo Jeong are with the Department of Sports Medical Center, Anam Hospital, Korea University College of Medicine, Seoul, South Korea. Ji Soon Park is with the Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, South Korea; and also with the Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, United Arab Emirates. Jin Hyuck Lee and Ji Soon Park contributed equally to this work. Johanna M. Hoch, PhD, ATC, University of Kentucky, is the report editor for this article.