| Abstrakt: |
The scapula is a pivotal element in normal scapulohumeral rhythm and glenohumeral stability. It helps to maintain normal glenohumeral angle and acts as a stable base for muscular origins. Scapular dyskinesis, or alterations in scapular position and motion in arm activity, is common in both traumatic and microtraumatic glenohumeral instability. The exact etiology of dyskinesis is not known, but the resulting biomechanical alterations increase glenohumeral angulation, increase tensile strain in the glenohumeral ligaments, and decrease rotator cuff activation. These two actions increase the dysfunction associated with instability and decrease the effectiveness of treatment. Evaluation of scapular motion should be an integral part of the evaluation of the unstable shoulder, and restoration of normal scapulohumeral kinematics should accompany treatment and rehabilitation of the underlying instability. |
