Subacromial impingement syndrome related to scapular dyskinesis: a case report

Background and Purpose: Chronic scapular dyskinesis is believed to have caused subacromial impingement syndrome (SAIS) in this patient. The focus of this case report is to see how scapular-focused interventions can be used in the treatment of SAIS, and how the literature of these interventions to an acute population can also be applied to a chronic population. Case Description: The patient comes to physical therapy because he is unable to perform his normal work-related tasks without pain. The patient performs repetitive lifting, pushing and pulling, and repetitive overhead reaching and stowing of boxes at work. Initial examination reveals a mispositioned scapula, faulty scapulohumeral kinematics, and pain and weakness with resisted external rotation, flexion, and abduction of the shoulder. Plan of care focuses on scapular stability interventions to bring the scapula to an anatomically correct resting position and decrease the pain the patient is experiencing related to SAIS. Outcomes: The patient regains near full range of motion of the right shoulder and can safely perform work-related activities with decrease in pain. Muscle strength of the rotator cuff and periscapular muscles is improved, but there remains room for more progress in the future. Discussion: Scapular-focused interventions can help decrease pain and improve daily function in patients with SAIS. Future research can focus on long-term outcomes and compare outcomes of acute SAIS conditions with chronic SAIS conditions.