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Clinical assessment of the scapula: a review of the literature
  1. Filip Struyf1,2,
  2. Jo Nijs1,2,
  3. Sarah Mottram3,
  4. Nathalie A Roussel1,2,
  5. Ann M J Cools4,
  6. Romain Meeusen2
  1. 1Department of Healthcare, Division of Musculoskeletal Physiotherapy, Artesis University College Antwerp, Merksem, Antwerp, Belgium
  2. 2Department of Human Physiology, Vrije Universiteit Brussel, Brussels, Belgium
  3. 3KC International, London, UK
  4. 4Department of Rehabilitation Sciences and Physiotherapy, University Ghent, Gent, Belgium
  1. Correspondence to Dr Filip Struyf, Division of Musculoskeletal Physiotherapy, Department of Healthcare, Artesis University College Antwerp, Van Aertselaerstraat 31, Merksem, Antwerp 2170, Belgium; filip.struyf{at}vub.ac.be

Scientific evidence supporting a role for faulty scapular positioning in patients with various shoulder disorders is cumulating. Clinicians who manage patients with shoulder pain and athletes at risk of developing shoulder pain need to have the skills to assess static and dynamic scapular positioning and dynamic control. Several methods for the assessment of scapular positioning are described in scientific literature. However, the majority uses expensive and specialised equipment (laboratory methods), making their use in clinical practice nearly impossible. On the basis of biometric and kinematic studies, guidelines for interpreting the observation of static and dynamic scapular positioning pattern in patients with shoulder pain are provided. At this point, clinicians can use reliable clinical tests for the assessment of both static and dynamic scapular positioning in patients with shoulder pain. However, this review also provides clinicians several possible pitfalls when performing clinical scapular evaluation. On the basis of its clinical relevance, its proven reliability, its relation to body length and its applicability in a clinical setting, this review recommends to assess the scapula both static (visual observation and acromial distance or Baylor/double square method for shoulder protraction) and semidynamic (visual observation and inclinometry for scapular upward rotation). In addition, when the patient demonstrates with shoulder impingement symptoms, the scapular repositioning test and scapular assistant test are recommended for relating the patients’ symptoms to the position or movement of the scapula.

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  • Competing interests We certify that no party having a direct interest in the results of the research supporting this article has or will confer a benefit on us or on any organisation with which we are associated.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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