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Scapular dyskinesis and shoulder pain: the devil is in the detail
  1. Chris Littlewood1,
  2. Ann M J Cools2
  1. 1Research Institute for Primary Care and Health Sciences and Keele Clinical Trials Unit, Arthritis Research UK Primary Care Centre, Keele University, Keele, UK
  2. 2Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Gent, Belgium
  1. Correspondence to Dr Chris Littlewood, Research Institute for Primary Care and Health Sciences and Keele Clinical Trials Unit, Arthritis Research UK Primary Care Centre, Keele University, Keele ST5 5BG, UK; c.littlewood{at}keele.ac.uk

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The systematic review by Hickey et al1 evaluated whether the presence of scapular dyskinesis in asymptomatic athletes increased risk of developing future shoulder pain. This review was conducted on the backdrop of conflicting evidence and concluded that athletes with scapular dyskinesis have 43% greater risk of developing shoulder pain than those without scapular dyskinesis. This headline is an interesting finding that appears to add some clarity to the many unknowns in relation to assessment and management of shoulder pain. However, as is always the case with research, the devil is in the detail, which warrants further consideration.

The review reports that 65% (104/160) of those with scapular dyskinesis did not go on to develop shoulder pain, whereas 25% (65/259) of those without scapular dyskinesis did. As the authors reflect, an increased risk informs us only that there is an increased chance of developing shoulder pain, but is not a guarantee that it will, that is, the presence of scapular dyskinesis does not guarantee that an athlete will develop shoulder pain nor does its …

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