Mohamad Hassan, PT, DPT, is a physical therapist at Premier Physical Therapy in Chicago. This study demonstrated that both isokinetic and isometric testing in the scapular plane are valid methods for measurement of the strength of external rotation and abduction of the shoulder. Geriatr Orthop Surg Rehabil. If the strength increase with gluteal contraction core/lower extremity strengthening can be added to the treatment plan. 2 0 obj bv#t# t,Oz4D`? Middle deltoid. Isometric abduction in scapular plane to activate Deltoid Isometrics - YouTube Phase 2: Submaximal Shoulder Isometric Exercises - YouTube Electromyographic study of the scapular rotators during arm abduction in the scapular plane. <> Kim Y, Lee K, Moon J, Koo D, Park J, Kim K, Hong D, Shin I. J Phys Ther Sci. PDF Reverse Total Shoulder Protocol International journal of sports physical therapy,12(3), 417. Flex your elbows and pull them behind your back as far as possible . eCollection 2018. ?suo/*vhxUvUz[nUmX,E4xnl.hka/.Vvd;7v=P2E:wjo0tl{KV5/\>A'Ibvmb6T^#erk+A`{xxx>bsYm/|ZP>. PDF Reverse Total Shoulder - Lahey Health 60`;@$i/hPVzhr$QR>ou6Ox"o7ru|N"ob2v9b3~>\^]1~ O1k2$KgOim)\^]5"3q;n;|FFz>w 'm3cXoq0ZQ{z9(jQW|_xK['5='x3,m6jHB6i!uH8r#8wu].O,;ZwFftY#DSB,Rzq7bF5/f% 2^}>KV7~ sJ[~pHoF0C ="`XaAB8Xf%];Zd_afC^h;k'l!Hh;ZpFI:7wl(Y819Vk,%YJ]%9f~(? Bend the elbow on the side of the shoulder you want to exercise and make a fist. dq PDF Shoulder Isometric Strengthening Program - OrthoIndy Repeat the exercise multiple times. 2014 Apr;26(4):525-8. doi: 10.1589/jpts.26.525. PDF Reverse Total Shoulder Arthroplasty Post-Operative Care - Ortho Bethesda Movement. Ebq=nD.Jsq. Shoulder plyometrics, involving exerting maximum force in short intervals. Another study [12] found that during the scapular plane elevation of the arm, there was a consistent pattern of scapular upward rotation, posterior tilting, and external rotation along with clavicular elevation and retraction. 579 0 obj <> endobj - Begin sub m aximal deltoid isometrics in the scapula plane (Avoid shoulder extension) - Continue frequent Cryotherapy 4-5 times day for about twenty minutes NO strengthening or resistance until 6 weeks 3-6 Weeks Progress exercise listed above Progress PROM: - Flex ion in the scaption plane to 120 - ER in scapula plane to tolerance, PDF Reverse Total Shoulder Arthroplasty Clinical Practice Guidelines Modalities (i.e. [15]. x\rF}W#UeOvdU[db.&Z=3=g@\%IJ gz==dk^xke2Y?2Km_9,&)3fl0_#EUM)Z-9%/7\.Kyk*?/vx\i,:qN"BNnGgEUyVuVOf\4fTfP+Diq ]A ]? Repeat testing demonstrated a high reliability of isokinetic measurements and of isometric measurements at angles within the range of the production of peak torque. 2 0 obj 3 0 obj . [31], The sternoclavicular (SC) and acromioclavicular (AC) joints should be assessed for instability. [13] An early study [14] found an overall ratio of 2:1 between glenohumeral elevation and scapular upward rotation. 3 0 obj Shoulder Flashcards | Chegg.com Scapular muscles weakness in subjects with traumatic anterior Reverse Total Shoulder Replacement Post-Op Protocol . Although we strive to deliver accurate and up-to-date information, no guarantee to that effect is made. Nikolaidou O, Migkou S, Karampalis C. Rehabilitation after Rotator Cuff Repair. The https:// ensures that you are connecting to the Please enable it to take advantage of the complete set of features! endobj You can also perform the exercise one side at a time, pinching your left shoulder blade inward for five to 10 seconds, followed by your right. 1 0 obj Limit FE (supine forward elevation in the scapular plane) to 90 degrees Limit ER (external rotation) to neutral 30 degrees Do Not perform Pendulums. The Correct Posture for One-Arm Dumbbell Rows. }6BE`}w- + :af)/)DEDTU9=&KV/DDM:!1?):$= XLE(WC9F,WQP &T5LSNGh4*HY0~/7,[R27e Y3*/LDjs4A[K?U D JBC!^ E6]D.JSUo 3dSg3_lJ-b-` *{yA0Avds;cSrrCTnChD7`0t2J R4b$-.h'5+.\9")[6k]d5!z Ypl{CP /Sg/v0GMa-X&>UdB[d=rbB[@8U@t ^Mib/Tzt^eG'x%+u8Cpg|M$*Y[6To Ew* stream ) _$pxi~f80yv!T{`16@Ezp/$}//qfu65f_*"g9_QMS*4Qu-=@j6S[8n";"V@$$OFjadhkp{8+$;'^6{>;NP(EBD}9~0;&]T!`;*#dg,\07isp}7JzTI{5(GiCFZ_EKAnA;,A EZ@*\ zP9Av`>B#:.Z>xPq*Vc+o|>~}*{6XBH%9O!"8b8OyIY^07^+P\QFQt&Sdh!M}vn=:m<5I-HGdA:91vUmU\F(u(;sKw&y#>12R:8kJinNLnlhh3(.IX76yhkW|P>c3G~CZ\$rt* KY[u[lk("x9Hc#+Xjp.JUbw[)4uVG.w)V\^ }1YG/T4{h)0hq]S^JLGnc0VE'[[s~:~I7JVL7B7i9i J56$sl_NAV\ %PDF-1.3 Escamilla RF, Yamashiro K, Paulos L, Andrews JR. Sports Med. Flex your elbows and pull them behind your back as far as possible, squeezing your shoulder blades together. Current Views of Scapular Dyskinesis and its Possible Clinical Relevance. endobj Isokinetic evaluation of rotational strength in normal shoulders and shoulders with impingement syndrome. The information contained on this site is for informational purposes only, and should not be used as a substitute for the advice of a professional health care provider. Unable to load your collection due to an error, Unable to load your delegates due to an error. a cuff-deficient shoulder, the scapular plane abduction activates different components of the deltoid as suggested by the literature. Various shrug exercises can change scapular kinematics and scapular rotator muscle activities in subjects with scapular downward rotation syndrome. Reverse Total Shoulder Replacement Rehab - Adam Watson Orthopaedic &gg0{-tR. Tie the middle of a resistance band to a doorknob and hold the ends. In most cases Physiopedia articles are a secondary source and so should not be used as references. 1173185. 2017;11:154-162. doi:10.2174/1874325001711010154. PDF Department of Rehabilitation Services Reverse Total Shoulder [39][40][41], Stabilization exercises based on stretching and strengthening to optimize scapular kinematics, and improve muscle strength and joint position sense [42] [43] [44]: Closed and open kinetic chain exercises, including push-ups, lawnmower exercises, and resisted scapular retraction. Strengthening the scapular muscles is essential for improving and maintaining scapulohumeral rhythm -- the coordinated movements between the humerus bone of your upper arm and the scapula bone, which includes the shoulder socket in which the head of the humerus fits. HHS Vulnerability Disclosure, Help 8 0 obj 65g"n|aA*V A physical therapist may recommend performing isometric-strengthening exercises if your scapulohumeral rhythm breaks down due to an injury. MeSH %PDF-1.5 Kinesiotaping for Normalizing Scapular Dyskinesis - Full Text View It includes some great animations! British journal of sports medicine. Phase I MAXIMAL PROTECTION (0-4 Weeks Post-Op) Immobilization for 4 weeks using sling. <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 8 0 R/Group<>/Tabs/S/StructParents 1>> Manual resistance of the arm at 130 of flexion (for the serratus anterior), Manual resistance of the arm at 130-150 of abduction (for the lower and middle trapezius), Extension of the arm at the side (for the rhomboid). The effect of long versus short pectoralis minor resting length on scapular kinematics in healthy individuals. Motion of the shoulder complex during multiplaner humeral elevation. Direct 3-dimentional measurement of scapular kinematics during dynamic movements in vivo. [20], Patients with SD can be symptomatic or asymptomatic. Electromyographic analysis of the serratus anterior and trapezius muscles during push-ups on stable and unstable bases in subjects with scapular dyskinesis. o ER in scapular plane to tolerance, respecting soft tissue constraints. Use a small folded towel for padding. Current concepts: scapular dyskinesis. Begin sub-maximal pain-free deltoid isometrics in scapular plane (avoid shoulder extension when isolating posterior deltoid.) The effect of scapular protraction on isometric shoulder rotation strength in normal subjects. endobj Isometric peak torque was greater than slow-speed (90 degrees per second) isokinetic peak torque, which in turn was greater than fast-speed (210 degrees per second) isokinetic peak torque. [26][27][28][29][30], In SRT, the patient is asked to do 90 degrees of flexion with shoulder internal rotation while the examiner stabilizes the medial scapular border with one hand. PDF Total Shoulder Arthroplasty / Hemiarthroplasty Protocol: 4 0 obj Introduction to the second international conference on scapular dyskinesis in shoulder injurythe Scapular summitreport of 2013. Consult with a professional to learn the most appropriate exercises for your situation. PDF Rehabilitation Protocol for Rotator Cuff Repair-Small to Medium Sized Tears Setting: Laboratory setting. PROM. 6 0 obj When refering to evidence in academic writing, you should always try to reference the primary (original) source. [33][34], The structures around the scapula can be assessed for pain, loss of function, soft tissue laxity and muscle power. Available from: De Mey, K.; Danneels, L.; Cagnie, B.; Borms, D.; TJonck, Z.; Van Damme, E.; Cools, A.M. Pirau AL, Pitangui AC, Silva JP, dos Passos MH, de Oliveira VM, Batista LD, de Arajo RC. Analysis of the kinetic chain in asymptomatic individuals with and without scapular dyskinesis. endobj Isometric exercises for tendonopathic problems are gaining increasing evidence to improve collagen type 1 re growth in tend. Begin sub-maximal pain-free deltoid isometrics in scapular plane (avoid shoulder extension when isolating posterior deltoid.) What Muscles Are Worked During Neck Extensions? An isometric shoulder exercise plan may include: Shoulder isometrics can be performed up to three times per day, but be sure to ask your physical therapist about the frequency for your specific condition. British journal of sports medicine. stream Evaluation of clinical assessment methods for scapular dyskinesis. Crosbie J, Kilbreath SL, Hollmann L, York S. Kibler WB, Uhl TL, Maddux JW, Brooks PV, Zeller B, McMullen J. Qualitative clinical evaluation of scapular dysfunction: a reliability study. Does scapular positioning predict shoulder pain in recreational overhead athletes?. PDF Shoulder Rotator Cuff Repair Post-Operative Guidelines Isometric Shoulder Abduction at Wall. xXmo6 >JPhSou7YcbkHr$Rb6r${Q/^j~y7 R BBR%A"`~wy-oU7xy;O>}fR/S'`bCJF".|`` Gq$Y*&OMk=zZLe6!#5GPX'Gw@Thzw(B%t3 626 0 obj <>stream Perform 10 to 15 repetitions, and then move on to the final shoulder isometric exercise: isometric extension. Bethesda, MD 20894, Web Policies 2022 Mar 31;10(3):23259671221084294. doi: 10.1177/23259671221084294. Scapular retraction involves moving the scapula bones backward and inward, like you are trying to squeeze an object between them. Weeks 3 to 6: Progress above exercises. Diagnostic accuracy of the scapular retraction test in assessing the status of the rotator cuff. . 2 0 obj Place a folded towel between your fist and the wall, and gently press your hand into the wall. '06g*]Ie6W <> % Push your arm sideways into the wall, then relax and repeat. Complete two to four repetitions. Complete testing was performed in four normal volunteers before and after a block of the suprascapular nerve. Context in source publication. Begin sub-maximal pain-free deltoid isometrics in scapular plane (avoid shoulder extension when isolating posterior deltoid.) xS* >9![Kt2 . Accessibility % <> 3 Weeks to 6 Weeks: Progress practise listed above. scapation. Shoulder Scapular Retraction Exercise. Use a small towel for a little padding, if needed. The disabled throwing shoulder: spectrum of pathology Part III: The SICK scapula, scapular dyskinesis, the kinetic chain, and rehabilitation. Gently press into the wall as if you are trying to lift your arm out to the side, and hold it there for five seconds. Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy. Franchignoni F, Vercelli S, Giordano A, Sartorio F, Bravini E, Ferriero G. Umehara J, Nakamura M, Nishishita S, Tanaka H, Kusano K, Ichihashi N. Umehara J, Nakamura M, Fujita K, Kusano K, Nishishita S, Araki K, Tanaka H, Yanase K, Ichihashi N. Struyf F, Nijs J, Meeus M, Roussel NA, Mottram S, Truijen S, Meeusen R. Bakurt Z, Bakurt F, Gelecek N, zkan MH. Setup. [4][5][6], SD can be seen in overhead athletes or patients with shoulder pathology such as rotator cuff disease, glenohumeral instability, impingement syndrome, and labral tears as well as in healthy people. [vIVf[nIaZeC6` vn27l4-~X BkY/k d~tEC6 WHozyCBg? By Brett Sears, PT zZFkNBx!>'J,n&WfyGL@|wt$ [U$3P]x9Lk"W5tG. <> Journal of orthopaedic & sports physical therapy. Edouard P, Samozino P, Julia M, Gleizes Cervera S, Vanbiervliet W, Calmels P, Gremeaux V. J Sport Rehabil. The shoulder you're exercising should be near the door opening or corner. Please check with the appropriate physician regarding health questions and concerns. Anatomy, etiology, and management of scapular winging. ER to 60 deg; Begin IR to tolerance NOT to exceed 50 deg; Initiate GH and ST joint mobs ( grade 1 and 2 ) Khazzam M, Gates ST, Tisano BK, Kukowski N. Michener LA, Boardman ND, Pidcoe PE, Frith AM. Very little motion should occur at your shoulder. ! Open Orthop J. Begin sub-maximal, pain-free shoulder isometrics in neutral Begin scapula musculature isometrics / sets Begin active assisted Elbow ROM Pulleys (flexion and . Study Shoulder flashcards. 2011 Aug;20(3):367-83. doi: 10.1123/jsr.20.3.367. d3gf7u?a7car~v`B@L K)lyw[?T+l}~ciRz?*]]z Protect anterior and posterior capsule from stretch, but begin passive ROM. endobj Minimal clinically important difference of the disabilities of the arm, shoulder and hand outcome measure (DASH) and its shortened version (QuickDASH). https://www.physio-pedia.com/index.php?title=Scapular_Dyskinesia&oldid=332603, Medial/lateral sliding around the curvature of the thorax, Posterosuperior scapular pain (may radiate into the ipsilateral para spinous cervical region or radicular/thoracic outlet-type symptoms in the affected upper extremity can be found). [9][10], During the normal overhead upper extremity elevation with internal/external rotation being minimal until 100, primary scapular movement is upward rotation and secondary scapular movement is posterior tilt. Neck-related: Mechanical neck pain syndromes and cervical nerve root-related syndromes. shoulder medial/lateral rotation, horizontal abduction/adduction. Reverse Whole Shoulder Arthroplasty Audit: General Information: Reverse instead Inverse Complete Shoulder Arthroplasty (rTSA) is designed explicitly for this. Hold the band with your elbow bent at a 90-degree angle in front of you. [16], 3. Independent with activities of daily living (ADLs) with modifications and transmitted securely. Shoulder muscle activity and function in common shoulder rehabilitation exercises. Rotator cuff: internal external rotation isometrics, side-lying external rotation, Standing external rotation w/ resistance band , standing internal rotation w/ resistance band . Traumatic Isolated Myotendinous Rupture of the Teres Minor in a Young Athlete - A Unique Case Report. This study demonstrated that both isokinetic and isometric testing in the scapular plane are valid methods for measurement of the strength of external rotation and abduction of the shoulder. Disorders of the scapula and their role in shoulder injury. Copyright 2023 Leaf Group Ltd. / Leaf Group Media, All Rights Reserved. Begin shoulder PROM: o Forward flexion and elevation in the scapular plane in supine to 120 degrees as tolerated. He earned a Master of Science in human movement from A.T. Rehab My Patient. 1 0 obj endstream endobj 580 0 obj <>/Metadata 28 0 R/PageLayout/OneColumn/Pages 577 0 R/StructTreeRoot 47 0 R/Type/Catalog>> endobj 581 0 obj <>/ExtGState<>/Font<>/XObject<>>>/Rotate 0/StructParents 0/Type/Page>> endobj 582 0 obj <>stream PDF Reverse Total Shoulder Crall - Mammoth Ortho FOIA American Journal of Physical Medicine & Rehabilitation. Keeping your elbow close to your side, slowly rotate your arm outward, squeezing your shoulder blades together. The examiner stands behind the patient. V4g]#L Ujd"o}!ob5By%D)[=GbH/ endobj Work with a personal trainer to learn how to do isometric exercises correctly. Contract your abdominal muscles to stabilize your spine, then squeeze your shoulder blades together for five to 10 seconds, moving your arms behind your body. Strengthening Begin submaximal pain-free deltoid isometrics in scapular plane (avoid shoulder extension when isolating posterior deltoid) Goals to Progress to Next Phase 1. Frequent (4-5 times a day for about 20 minutes) cryotherapy. 1993 Aug;75(8):1254. doi: 10.2106/00004623-199308000-00018. stream Gently press into the wall for about five seconds. The rhomboids and trapezius muscles in your upper back help facilitate this movement. https://www.youtube.com/watch?v=Ns6-J8MMMcw, https://www.youtube.com/watch?v=3AZ_iF-_RFE. Physical Therapy Protocols | OrthoVirginia | Rehabilitation after government site. [55]. 6E#+Z1/9l mss,zh/. The scapular plane is defined as the shoulder positioned in 30 degrees of abduction and forward flexion with neutral rotation. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Begin active flexion, IR, ER, elevation in the plane of the scapula pain free ROM AAROM pulleys (flexion and elevation in the plane of the scapula) - as long as greater than 90 of PROM Begin shoulder sub-maximal pain-free shoulder isometrics in neutral Scapular strengthening exercises as appropriate 4 0 obj The effectiveness of scapular stabilization exercise in the patients with subacromial impingement syndrome. Start in the same position as you did for the shoulder packing exercise, but lift your shoulders upward rather than pulling them backward. Begin Sub max pain free isometrics ( avoid shoulder ext ) PROM in a scapular plane. :H A'A7+Q)3$QdW9^oH(CH=?WO[2H8t;p"vpplt,~PWjC%!H0H-H\\vV&Kg To perform isometric shoulder internal rotation: Remember, no motion should occur in your shoulder during the exercise. 1 0 obj 4 0 obj The role of scapular dyskinesis on rotator cuff tears: a narrative review of the current knowledge. <> Evaluation of apparent and absolute supraspinatus strength in patients with shoulder injury using the scapular retraction test. <>>> 4 weeks. Revision of the Shoulder Normalization Tests is required to include rhomboid major and teres major. The supraspinatus and infraspinatus components of the rotator cuff contributed a variable proportion to the total strength of abduction (25 to 50 per cent) and external rotation (50 to 75 per cent) throughout the range of motion. Weeks 3-6: Progress exercises listed above. ?A$WXDj"=@Q> ,"``bd`v N0 t 4 0 obj [(]rvy$ eF (0BslT7 Specific exercises for scapular rehabilitation are [8]: Flexibility exercises: To increase the flexibility of the pectoralis minor and the external rotation and posterior tilt of the scapula, shoulder horizontal abduction at 90 degrees and 150 degrees of elevation. {^Q5|\2$,H7w That is usually the journal article where the information was first stated. Scapular kinematic alterations during arm elevation with decrease in pectoralis minor stiffness after stretching in healthy individuals. Journal of Shoulder and Elbow Surgery. Periscapular: scap retraction, standing scapular setting, supported scapular setting, low row, inferior glide Deltoid: isometrics in the scapular plane Criteria to Progress Gradual increase in shoulder PROM, AAROM, AROM 0 degrees shoulder PROM in to IR Palpable muscle contraction felt in scapular musculature Pain < 4/10 4 0 obj Archives of physical medicine and rehabilitation. Verywell Health's content is for informational and educational purposes only. =gP%`is~;5g$)+h S7P up =[`aPuE@5 Electromyographic study of the scapular rotators during arm abduction in the scapular plane. Strengthening Begin submaximal pain-free deltoid isometrics in scapular plane (avoid shoulder extension when isolating posterior deltoid) Goals to Progress to Next Phase 1. Manual therapy. Scapular dyskinesis: from basic science to ultimate treatment. %%EOF Shoulder horizontal abduction stretching effectively increases shear elastic modulus of pectoralis minor muscle. Progress PROM: Forward flexion and elevation in the scapular plane in supine to 120 degrees. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). Continue cryotherapy 4-5 times daily for 20 minutes. ER in scapular plane to available gentle PROM (as documented in Operative Note) - usually around 30 degrees. <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> xZnF7w Posture-related: Excessive thoracic kyphosis and cervical lordosis, which are the changes that athletes are more tend to show are related causes of SD. Tie the middle of a resistance band to a doorknob and hold the ends. Disclaimer. > e5xN.| .d The .gov means its official. 6+ Stand so the band is to your side and use the arm farthest from it. % The data support standardization of the positions for testing the strength of motions of the shoulder: isometric strength of external rotation should be measured in the scapular plane with the shoulder in 45 degrees of abduction and 45 degrees of internal rotation; isometric strength of abduction, in the scapular plane with the shoulder in 45 degrees of abduction; and isokinetic strength of external rotation and abduction, in the scapular plane at 90 degrees per second. [50][51], Shrug exercises activate the upper and lower trapezius and increase the upward rotation angle. A physical therapist can prescribe a set of moves specific to your needs and show you how to do them properly. Jacquot A, Genest J, Fronzaroli E, Lux G, Mole D. J Orthop Case Rep. 2019;9(3):52-56. doi: 10.13107/jocr.2250-0685.1418. Journal of Electromyography and Kinesiology. AC joint can be assessed for anterior-posterior (AP) laxity by mobilizing the acromion in an AP direction while stabilizing the clavicle. Would you like email updates of new search results? Review of scapular movement disorders among office workers having ergonomic risk. 3 0 obj Mullaney, M. J., Perkinson, C., Kremenic, I., Tyler, T. F., Orishimo, K., & Johnson, C. (2017). For all exercises, stand with good posture by pulling your shoulder blades slightly down and . Stand about six inches away from a wall with your back facing it. Begin sub-maximal pain-free deltoid isometrics in scapular plane (avoid shoulder extension when isolating posterior deltoid). <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> %PDF-1.5 [3], A review article about the effects of Kinesio taping [8] concluded that Kinesio taping over the upper and lower trapezius could improve the scapular muscle balance and increase the upward scapular rotation in patients with type 2 SD. <>>> 2007 Nov-Dec;16(6):815-20. doi: 10.1016/j.jse.2007.02.120. Shoulder packing is another isometric exercise that works the rhomboids and trapezius muscles. Interrater reliability of the modified scapular assistance test with and without handheld weights. +7u1]&oMOEAm. 5Cg=Cgu1?ZF{I V1j;EA'?>S0HVD%ApwBKVBqr>Po//!Nf/? If the pain felt by the patient is decreased or the strength is increased with the assistance the test is positive. endobj Move them as close to your ears as possible and hold for at least five seconds. The patient is asked to do slight arm extension and resist the movement of the arm into flexion. Resting position variables at the shoulder: evidence to support a posture-impairment association. Journal of shoulder and elbow surgery. Unauthorized use of these marks is strictly prohibited. J Bone Joint Surg Am. Frequent (4-5 times a day for about 20 minutes) cryotherapy. Shoulder Isometric Scaption (Elevation in Scapular Plane) PDF Reverse Total Shoulder Replacement Therapy Protocol [18][19][12], 2. Progress PROM: Forward flexion and raise in the scapular plane in passive to 120 graduate. 2 0 obj eCollection 2022 Mar. Do 10 to 15 repetitions, and then start the next rotator cuff isometric exercise. National Library of Medicine [1][2][3] One of the other terms used for SD is scapular winging, but it is a different condition that results in scapular dyskinesia usually after a long thoracic or spinal accessory nerve injury. [38]. endobj Progress PROM: Restore active range of motion (AROM) of elbow/wrist/hand 3. Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy. So they are useful for the patient with SD and corresponding scapular downward rotation syndrome. Limit FE (supine forward elevation in the scapular plane) to 90 degrees. 1994 Jul;(304):108-15. <> Call for an appointment (03) 6231 2477. <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 14 0 R 15 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>>