How much weight should we place an individuals scapular mobility into treating their subacromial pain? I am frequently encountering PTs that identify patients scapular winging, tilting, abduction etc. and they place a lot of weight on how this affects shoulder mechanics and pain. I know the guidelines for subacromial pain frequently include periscapular strengthening, but how/should we incorporate scapular mobility. Scapular mobility sounds so vague to me and I find it difficult to evaluate let alone progress through therex.
Hi Sean!
This is a good question. I would agree that scapular mobility sounds vague to me too. Have you checked read our free content on the shoulder? We have a four part series, and I think this first article would likely answer most of your questions.
In short, I would not be concerned with an individual’s scapular mobility when treating subacrominal shoulder pain.
In order to describe a movement as “abnormal” or pathological we must define what “normal” is. Turns out, a large degree of variation exists in scapulohumeral rhythm between individuals.
Even if we are to determine that there is an ideal, or “normal” scapular mobility or kinematics, we must also agree upon how we area measuring this “mobility” in a reliable, accurate, and valid manner. According to the data that we have, we aren’t great at measuring “mobility,” and even if we were, the diagnostic accuracy of said measurement or screening tool is not very useful.
Hope this helps!
Hannah