gms | German Medical Science

Clinical issue/s: The scapula serves multiple functions to allow movement on the shoulder and on the back. It is also the base support for glenohumeral mobility. Its stability depends on the subject's body integrity: bones, muscles, ligaments and joints.

When there's a scapula malfunction, a soft tissue injury or a situation in which a bone is compromised, it is not possible to properly lift one's shoulder. Frequently, there is not a precise explanation for a shoulder suffering limited mobility, but the scapula does not participate. Even though there are situations in which there is only mild trauma, the response differs in every patient: sometimes the movement of the arms is more limited than in others and does not correspond with the level of the injury the patient has. In all of the cases a limited involvement of the scapula can be noticed.

Clinical reasoning: The patient raises his arm without using the scapula, which is what helps swing all shoulder mobility. When shoulder mobility is limited, the scapula is not harmonically involved in the movements that lift the arms or the shoulder along with its swinging functions, whether there is a limit or not. Although in some cases the limit is related to the bones, in all of the situations the patient feels pain. The limit is set by the patient. The scapula does not move on the same level of the movements of the shoulder or the arms and the reason can vary from an emotional issue (what is known as «limited or frozen shoulder») to a specific injury, or because of an insufficient rehabilitation.

Innovative, analytical or new approach: My intention is to incorporate sensory perception and present a self-produced method of scapular dyskinesis rehabilitation based on different protocols and implemented in a self-developed method.

Contribution to advancing HT practice: A combination of techniques based on personal experiences and conclusions, aiming to improve the rehabilitation process and enhancing it to obtain better results. The use of physiotherapy is essential and a treatment based on floor and mat exercises.