II. Causes
- Overhead throwing athlete
III. Pathophysiology
- Weakness of the Scapula stabilizers
- Serratus anterior muscle
- Infraspinatus muscle
- Deltoid muscle
- Trapezius muscle
- Tension on muscles opposing the Scapular stabilizers
- Levator Scapulae muscle
- Upper trapezius muscle
- Pectoralis muscle
- Results in malpositioning of the Scapula (Mnemonic SICK)
- Scapula malposition (rotated counter-clockwise)
- Inferior medial border prominent
- Coracoid process pain and malposition
- Dyskinesis of Scapular movement
- Increased angulation of Humerus at glenoid
- Decreased subacromial space (risk of Shoulder Impingement)
IV. Symptoms
- Pain at coracoid process (especially with throwing motion)
V. Management
- Modified activity
- Physical Therapy: Pectoralis muscle stretch
- Patient lies supine over a towel (or foam roll) positioned parallel with the Thoracic Spine
- Patient presses the Shoulders posteriorly
