scapula retraction exercise crossover symmetry

Having said that, there is nothing inherently wrong following a “routine”. I think realistically, once you get efficient at it, it should not take much longer than a minute or so. We also should not have to devote a significant amount of time to it. I do not think we need to stick to a set procedure with this sort of assessment.We may need to combine a number of different options/changes to scapula position and other areas (neck or thoracic spine for example) to see if we get a “cumulative” change.You could even assess the impact on resting pain (assuming they have pain at rest). Ideally we should utilise a painful functional task, but a painful/limited movement or test will suffice.Anything less than this is arguably not very important ( Ostelo et al 2008). In line with some of the references above this at least needs to be within the realms of a to 20 to 30% improvement. Look for significant improvement in symptoms.Assess the impact of altering scapula positioning on a patient’s symptoms, call it “symptom modification” if you like.

I could go on, but I doubt it would get any clearer! Like most things in clinical practice, there is plenty of uncertainty, and I think this is a good thing. And maybe they just need 1 single exercise, rather than a complex exercise regime ( Littlewood et al, 2016). Maybe we just ignore the scapula and get them “lifting” and “pushing” within sensible pain parameters based on what they have trouble doing.

Studies like Hotta et al (2017) provide support for scapula focused exercise regimes, but this particular study compared the exercise group with another group….that was not treated.There is insufficient evidence to support or disprove specific exercise strategies for treatment of individuals with subacromial impingement syndrome (Shire et al, 2017).Scapula focused treatment/exercise approaches do not necessarily appear superior to generalised approaches ( Bury et al, 2016).“Symptom modification” is a commonly used term to describe this.īut interestingly (again, not an exhaustive list): If symptoms can be reduced, there is potentially merit in targeting this “dysfunction” as part of treatment.

When the patient exhibits symptoms we should be utilising “repositioning tests” to ascertain if the symptoms can be changed.

Scapula dyskinesis is not necessarily more prevalent in those with shoulder pain ( Plummer et al, 2017).

Just because a patient has differences in scapula symmetry side to side, we should not assume this is a “dysfunction” as pain-free individuals can demonstrate scapula asymmetry ( Morais and Pascoal, 2013).

Some of the research I have become aware of over the past few years (obviously not an exhaustive list……): In hindsight, without having a valid reason for doing it! I should know, I used to give all of my neck, shoulder and thoracic pain patients scapula retraction exercises. Like “core stability” this trend of scapula retraction seems to have also become entrenched in clinical practice. I have had a run of shoulder patients over the last few months, a number of which have been having treatment with other providers, the vast majority of them “setting” their scapula in a retracted position (in layman’s terms “pulling the shoulder-blade back and down”) while doing their other exercises such as biceps curls, shoulder presses et cetera. Please ignore that this is my first post for 2017! It is becoming a trend of mine to do a post in the last few hours of the year.

Scapula retraction exercise crossover symmetry