Background It is unclear whether the presence of scapular dyskinesis increases the risk of developing shoulder pain in asymptomatic athletes. Objectives To determine whether the presence of scapular dyskinesis in asymptomatic athletes increases the risk of developing shoulder pain by systematic review and meta-analysis. Methods A systematic search was conducted in the Cochrane Library, Embase, PubMed, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database and SPORTDiscus. Prospective studies that assessed athletes for scapular dyskinesis and recorded incidents of shoulder pain were included. Study quality was assessed using the Downs and Black checklist. Meta-analysis was conducted to derive a pooled risk ratio (RR) for the development of shoulder pain in athletes with scapular dyskinesis compared with those without scapular dyskinesis. Results Five studies were included with a total of 419 athletes. Of the athletes with scapular dyskinesis, 35% (56/160) experienced shoulder pain during the follow-up, whereas 25% (65/259) of athletes without scapular dyskinesis experienced symptoms. The presence of scapular dyskinesis at baseline indicated a 43% increased risk of a shoulder pain event over a 9 to 24 months follow-up (RR=1.43, 95% CI 1.05 to 1.93). Conclusions Athletes with scapular dyskinesis have 43% greater risk of developing shoulder pain than those without scapular dyskinesis.

The relationship between subacromial pain syndrome (SAPS) and altered scapular movement has been previously reported. The purpose of this review was to determine the effect of interventions that focus on addressing scapular components to improve shoulder pain, function, shoulder range of motion (ROM), and muscle strength in adults with SAPS. Databases searched in September 2016 were: PubMed, the Cochrane Central Register of Controlled Trials [Central], EMBASE [via Ovid] and PEDro. All studies selected for this review were randomized controlled trials. In total, six studies met the inclusion criteria and were included in the meta-analyses. In adults with SAPS, scapular focused interventions significantly improved pain with activities (MD [95% CI] = −0.88 [−1.19 to −0.58], I² 43%) and shoulder function (−11.31 [−17.20 to −5.41] I² 65%) in the short term. No between-group difference in shoulder pain and function were found at follow up (4 weeks). A between-group difference in shoulder abduction ROM in the short term only was found (12.71 [7.15 to 18.26]°, I² 36%). No between-group difference in flexion ROM, supraspinatus muscle strength, pectoralis minor length or forward shoulder posture were found. In conclusion, in adults with SAPS, scapular focused interventions can improve short-term shoulder pain and function.

To determine whether subacromial space (i.e. acromiohumeral distance; AHD, and/or occupation ratio percentage) differs between people with subacromial pain syndrome (SAPS) and those without. To investigate whether there is a correlation between subacromial space and pain or disability in adults with SAPS and whether temporal changes in pain or disability are accompanied by changes in subacromial space. Systematic review and meta-analysis. Fifteen studies with a total of 775 participants were included. Twelve studies were of high quality and three studies were of moderate quality using the modified Black and Downs checklist. There was no between group difference in AHD in neutral shoulder position (mean difference [95% CI] 0.28 [−0.13 to 0.69] mm), shoulder abduction at 45° (−0.02 [−0.99 to 0.96] mm) or 60° (−0.20 [−0.61 to 0.20] mm). Compared to the control group, a greater occupation ratio in neutral shoulder position was demonstrated in participants with SAPS (5.14 [1.87 to 8.4] %). There was no consistent pattern regarding the correlation between AHD and pain or disability in participants with SAPS, and no consistent increase in subacromial space with improvement in pain or disability over time. The results suggest that surgical (e.g. sub-acromial decompression) and non-surgical (e.g. manual therapy, taping, stretching and strengthening) management of subacromial pain syndrome should not focus solely on addressing a potential decrease in subacromial space, but also on the importance of other biopsychosocial factors.

The aims of this study were to determine whether scapular and humeral head position can predict the development of shoulder pain in swimmers, whether those predictors were applicable to non-swimmers and the annual rate of shoulder pain in adolescent swimmers and non-swimmers. Forty-six adolescent swimmers and 43 adolescent non-swimmers were examined prospectively with a questionnaire and anthropometric measures. The questionnaire examined demographic and training variables. Anthropometric measures examined the distances between the T7 spinous process and the inferior scapula (Inferior Kibler) and T3 spinous process and the medial spine of the scapula (Superior Kibler), humeral head position in relation to the acromion using palpation, BMI and chest width. Shoulder pain was re-assessed 12 months later by questionnaire. Shoulder pain in swimmers was best predicted by a larger BMI (OR = 1.48, P = 0.049), a smaller Inferior Kibler distance in abduction (e.g. OR = 0.90, P = 0.009) and a smaller horizontal distance between the anterior humeral head and the anterior acromion (OR = 0.76, P = 0.035). These variables were not significantly predictive of shoulder pain in non-swimmers. Annual prevalence of shoulder pain was 23.9% in swimmers and 30.8% in non-swimmers (χ ² = 0.50, P = 0.478).

Cross sectional. To compare the strength and range of motion of the dominant and nondominant shoulders of adult female amateur tennis players. The secondary purpose of the study was to examine whether there were any differences in the observed relationships between women with a past history of shoulder pain and those with no history of shoulder pathology. Information on characteristics of the shoulder in amateur female tennis players is scarce, as research has concentrated on highly skilled or male players, despite the cumulative prevalence of shoulder pain in this group. Fifty-one female competitive, amateur tennis players (average age, 45 years) were tested bilaterally for shoulder internal/external rotation passive range of motion and isokinetic concentric strength. Shoulder range of motion and strength ratios were comparable between sides. In the dominant arm, the total rotational range of motion was 221 degrees, with an internal to external rotator peak torque ratio of 1.05. External rotator strength was significantly greater in the dominant arm of individuals with no history of pain. Range of motion and strength adaptations widely reported in highly skilled tennis players were not apparent in amateur female players. In assessment and management, clinicians should regard the amateur female tennis player as a separate entity from the highly skilled player.