Date of Award


Document Type

Capstone Project

Degree Name

Doctor of Physical Therapy (DPT)


School of Health Professions

First Advisor

Lori Walton


Faulty scapulohumeral rhythm can be commonly seen in the outpatient physical therapy setting particularly in patients diagnosed with shoulder pain. This faulty rhythm is more commonly referred to as scapular dyskinesis and described as an alteration in static scapular position and dynamic motion. Such scapular abnormality leads to a loss of proximal stabilization of the upper kinetic chain. The importance of scapular stabilization to establish a proximal base of support for the glenohumeral joint has been investigated extensively.

There is a growing body of literature associating abnormal scapulothoracic kinematics with a variety of shoulder pathologies including: shoulder impingement, rotator cuff tendinopathy, rotator cuff tears, shoulder instability and adhesive capsulitis. Given the contribution of the scapula to the normal movement pattern and stability of the shoulder, assessing scapular movement and position is considered an important part of the clinical examination of the shoulder complex.

Presently, there is a paucity of research regarding the effect of scapular muscle tears on medial scapular border pain, scapular dyskinesis and upper extremity function. The purpose of this study is to examine a one subject case report regarding the differential diagnosis and treatment of a scapular muscle tear and to bring forth preliminary information in the treatment of scapular muscle tears. This will be presented as a single case report based on a patient treated in an outpatient orthopedic setting. The patient was followed for Physical Therapy treatment both pre-operatively and post-operatively. Measuring tools within the case report include: the numeric pain rating scale, manual muscle testing, and the American shoulder and elbow surgeons shoulder scale. Findings in the assessment of scapulohumeral rhythm and manual muscle testing confirmed provocation of the patient’s pain despite the lack of significant findings with MRI. Both the numeric pain rating scale and the American shoulder and elbow surgeons shoulder scale offer data regarding significant decreases in pain and improved upper extremity function post surgically. The duration of treatment for this patient from time of injury to surgical intervention extended over a time frame of approximately two years.

Subject Area

Movement disorders, Scapula--Muscles, Shoulder pain, Shoulder--Muscles--Wounds and injuries