The Scapular Assistance Test: A New Tool to Determine the Role of Scapular Dyskinesia as a Cause for Shoulder Pain

Background: scapular dyskinesia has been implicated in several shoulder pathologies. Although its presence is typically ascertained by visually inspecting shoulder movement, this type of analysis is fraught by limited reliability and questionable validity. Furthermore, no cause-and-effect has been established between scapular dyskinesia and shoulder pain.

The scapular assistance test (SAT) is specifically designed to implicate altered scapular movement in the mechanism leading to shoulder pain. The SAT is performed by manually assisting scapular upward rotation during arm elevation and determining its effect on symptoms. The purpose of this study was to determine the prevalence of a positive SAT among patients with different shoulder pathologies.

Methods: one hundred and two patients (25 females) referred to an outpatient shoulder service were recruited for this study. Patients received the SAT by an experienced physical therapist, and had their diagnosis determined by an experienced shoulder surgeon, based on history, physical examination and review of MRI scans.

Results: 51 patients were diagnosed with rotator cuff disease, 22 patients with shoulder instability, 24 patients with SLAP tears, and 5 patients with various other pathologies. A total of 38 patients (37.3%) presented with a positive SAT, including, 19 patients (37.3%) with rotator cuff disease, 9 patients (40.9%) with shoulder instability, 8 patients (33.3%) with SLAP tears, and 2 patients (40.0%) with other pathologies. No significant differences were noted between the prevalence of a positive SAT among the different shoulder pathologies (P > 0.05).

Conclusion: over a third of patients with various shoulder pathologies present with evidence suggesting altered scapular movement as a cause for shoulder pain. Physicians and physical therapists can use the SAT to guide the conservative, as well as post-operative management of patients with various shoulder pathologies