Scapular Dyskinesis and the Kinetic Chain: Recognizing Dysfunction and Treating Injury in the Tennis Athlete
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SPORTS INJURIES AND REHABILITATION: GETTING ATHLETES BACK TO PLAY (R GALLO, SECTION EDITOR)
Scapular Dyskinesis and the Kinetic Chain: Recognizing Dysfunction and Treating Injury in the Tennis Athlete Sundeep S. Saini 1 & Sarav S. Shah 1 & Alan S. Curtis 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review This article aims to provide a comprehensive understanding of the evaluation, diagnosis, and management of scapular dyskinesis and its impact on the kinetic chain in tennis athletes. Recent Findings Optimal glenohumeral biomechanics are intimately associated with proper scapular motion and function. The tennis serve requires the scapula to act as a force transducer in the kinetic chain to convert potential energy generated in the lower extremities to kinetic energy in the upper extremity. Any aberration within this complex kinetic chain will result in force uncoupling and increases the potential for injury through compensatory mechanisms. Specifically, scapular dyskinesis has been associated with an increased risk of shoulder pain of up to 43% in overhead athletes. These pathologies include rotator cuff disease, subacromial and posterior impingement, labral injuries, and SLAP tears. Although the direct causality of these injuries remains controversial, multiple kinematic studies have demonstrated altered scapular positioning increasing the predilection for soft tissue pathology. Summary The diagnosis of scapular dyskinesis is predicated upon a thorough history, physical examination, and observational analysis of key nodes in the kinetic chain during tennis activity. Conservative management remains the mainstay of treatment and consists of a graduated physical therapy regimen. Although shoulder pain in the overhead athletes is often multifactorial, early recognition and treatment of scapular dyskinesis generally carry a favorable prognosis and result in improved patient outcomes. Keywords Scapular dyskinesis . Tennis kinetic chain . Shoulder pain in the tennis athlete . Tennis nodes
Introduction The glenohumeral joint allows for the greatest range of motion in the human body and is pivotal in force transmission for overhead athletes. Tennis, specifically the serving motion, requires a repetitive overhead abduction-external rotation moment which places an unnatural and highly dynamic load on This article is part of the Topical Collection on Sports Injuries and Rehabilitation: Getting Athletes Back to Play * Sarav S. Shah [email protected] Sundeep S. Saini [email protected] Alan S. Curtis [email protected] 1
Division of Sports Medicine, New England Baptist Hospital, 125 Parker Hill Avenue, Boston, MA 02120, USA
the shoulder, often exceeding the physiologic limits of the joint [1]. Therefore, optimal energy transfer from the trunk to the distal aspect of the upper extremity requires a delicate and reproducible balance between shoulder mobility and stability. Any aberration within this complex kinetic chain leaves the shoulder highly susceptible to injury.
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