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Larry W. Mattocks and Susan L. Whitney

Snapping scapula syndrome is a symptom, not a diagnosis. Soft tissue pathology and bony abnormalities can lead to scapular noise. Anatomy and biomechanics of the scapulothoracic mechanism are reviewed prior to discussion of the possible pathology that may lead to scapular noise and pain. Key points concerning the differential diagnosis are covered briefly. Guidelines are presented for rehabilitation of the patient with soft tissue lesions causing scapular pain and noise.

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Manuel Trinidad-Fernández, Manuel González-Sánchez, and Antonio I. Cuesta-Vargas

The description of scapular motion in the thorax continues to be a scientific and clinical challenge because the kinematics of the scapula is altered in many shoulder disorders. 1 , 2 Scapular protraction is defined as scapular anterior tilting together with scapular internal rotation. 3 The many

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Jin-Young Park, Junhyun Kim, Beom Ho Seo, Ho Dong Yu, Ju Hyun Sim, Jae Hyung Lee, Kyung Soo Oh, and Seok Won Chung

hypothesized that in baseball players with a pathologic condition of the shoulder or elbow, there would be a dysfunctional movement pattern of the scapula in the dominant arm compared with the nondominant arm. Materials and Methods Materials This study was conducted as a cross-sectional study of scapular

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Oliver Silverson, Nicole Cascia, Carolyn M. Hettrich, Matt Hoch, and Tim Uhl

Clinical Scenario Quantifying movement of the scapula is an important component in the evaluation and treatment of the shoulder complex due to its role in scapulohumeral rhythm during overhead motion. 1 – 3 Scapular upward rotation has been identified to be an essential component of glenohumeral

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Miti Gupta, Amitabh Dashottar, and John D. Borstad

The biomechanical changes due to increased arm mass in individuals with high body mass index (BMI) may lead to altered scapular motions at the shoulder joint. Scapula kinematic alterations are often associated with shoulder pain and pathology, and if present in overweight or obese individuals could impact shoulder health. The purpose of this study was to examine if scapula biomechanics differ between groups separated by BMI. Three-dimensional scapula kinematic data during arm elevation were collected on 41 subjects, and then compared between higher BMI (BMI ≥ 27; n = 10) and lower BMI (BMI ≤ 23; n = 10) individuals, both with and without holding a 1.36 kg (3 lb) weight. Data were analyzed with a mixed-model ANOVA with Group and Elevation Angle the between- and within-subject factors, respectively. The higher BMI group had significantly greater scapula upward rotation than the lower BMI group at 120° for both the unweighted and weighted tasks. Individuals with higher BMI in this study had altered scapulothoracic movement, which may be a strategy to better manage increased arm mass. With increased scapula upward rotation also reported in groups with rotator cuff tears, this study supports the potential link between high BMI, kinematics, and rotator cuff pathology.

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Taha Ibrahim Yildiz, Elif Turgut, and Irem Duzgun

Alterations in dynamic scapular stabilization have been detected in patients with NNP. 8 , 9 Szeto et al 8 reported more protracted acromion and scapula on patients with neck pain. According to Helgadottir et al, 10 there is less scapular posterior tilt on patients with NNP compared with asymptomatic

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Yaheli Bet-Or, Wolbert van den Hoorn, Venerina Johnston, and Shaun O’Leary

Kinematics of the upper extremity are defined by relative movement of the clavicle, scapula, and humerus to the thorax. Accurate measurement of complex scapula motion during functional shoulder girdle activities is important in understanding normal human movement. 1 The acromion marker

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Jun-Seok Kim, Moon-Hwan Kim, Duk-Hyun Ahn, and Jae-Seop Oh

The musculoskeletal disorder of scapular dysfunction is associated with sustained abnormal scapular posture, 1 muscle imbalance in the glenohumeral and scapulothoracic regions, 2 , 3 and repetitive movement with a deviated scapulohumeral rhythm. 4 A winged scapula (WS), which is known as

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Marcelo P. de Castro, Daniel Cury Ribeiro, Felipe de C. Forte, Joelly M. de Toledo, Daniela Aldabe, and Jefferson F. Loss

The current study aimed to compare the shoulder kinematics (3D scapular orientation, scapular angular displacement and scapulohumeral rhythm) of asymptomatic participants under unloaded and loaded conditions during unilateral shoulder elevation in the scapular plane. We used a repeated-measures design with a convenience sample. Eleven male participants with an age range of 21–28 years with no recent history of shoulder injury participated in the study. The participants performed isometric shoulder elevation from a neutral position to approximately 150 degrees of elevation in the scapular plane in intervals of approximately 30 degrees during unloaded and loaded conditions. Shoulder kinematic data were obtained with videogrammetry. During shoulder elevation, the scapula rotated upwardly and externally, and tilted posteriorly. The addition of an external load did not affect 3D scapular orientation, scapular angular displacement, or scapulohumeral rhythm throughout shoulder elevation (P > .05). In clinical practice, clinicians should expect to observe upward and external rotation and posterior tilt of the scapula during their assessments of shoulder elevation. Such behavior was not influenced by an external load normalized to 5% of body weight when performed in an asymptomatic population.

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Alon Rabin, Brakha R. Tabi, Timothy L. Uhl, and Zvi Kozol

Scapular dysfunction including diminished upward rotation (UR), posterior tilt, and medial rotation may lead to secondary subacromial impingement among athletes or overhead workers. 1 – 3 A possible cause for insufficient scapular UR is impaired function of the primary movers of the scapula