SPORTS MEDICINE SPOTLIGHT CARING FOR ATHLETES
to facilitate proper contact of the articulating surfaces. Imbalances may result in improper position- ing of the humeral head, leading to excessive wear and tear on the shoulder. In this two-part article, we discuss assessment of shoul- der function and the most effec- tive forms of injury prevention and rehabilitation. Many athletes can be categorized as having a “SICK” scapula. Accord- ing to Burkhart,1
a SICK scapula is
In sports with a lot of overhead arm movement, athletes should do all they can to protect their shoulders.
A ‘SICK’ Scapula:
Is That Contagious? Part one of a two-part series examines how to avoid shoulder injuries
By Sharon West, ATC, and Lindsay Austin, University of Tennessee at Chattanooga
S 18
houlder injuries are preva- lent among athletes with constant overhead move- ment of their arms and susceptibil- ity increases with the progressively greater demands imposed by a high level of competition. Many young athletes are participating in high- demand overhead activities—such as volleyball and tennis—that in- volve a very high volume of re-
May/June 2013
petitive motions and exertions. The mechanical demands placed on the small contact area of the articulat- ing surfaces can be compared to that of a basketball balancing on a teacup saucer.
The size of the articulating sur- face of the humeral head (i.e., upper arm bone) far exceeds the size of the articulating surface of the glenoid fossa of the scapula (i.e., shoulder blade). As a result, maintaining a balance among the forces that act on the shoulder joint is essential
defined as “Scapular malposition, Inferior medial border prominence, Coracoid pain and malposition, and dysKinesis of scapular movement.” Scapular malposition means that the scapula is incorrectly positioned. Inferior medial border prominence means that the lower inside margin of the scapula projects outwardly. Coracoid pain and malposition refers to the bony prominence beneath the clavicle (i.e., collar bone) is incor- rectly positioned and painful with movement. All of these problems collectively define a SICK scapula. An improperly functioning scapula creates stresses on muscle and bone tissues surrounding the shoulder. This can make an athlete more susceptible to a rotator cuff strain or tear, labral tear or neuro- logical symptoms.2
The SICK scapula could also be a result of various shoulder condi- tions. With an unstable scapula, the athlete has a much greater risk for prolonged recovery and loss of playing time. An injury to the shoulder also affects the athlete’s daily activities. Depending on the injury, it could affect the athlete for the rest of his or her life. If the injury involves neurological pa- thology, improper care could lead to major disability. Overhead athletes are prone to having scapular dyskineses (i.e., SICK scapula) because of demands that are placed upon the shoulder and surrounding articulations. One thing that can contribute to an ath- lete developing shoulder problems
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