Kibler, Br J Sports Med 2013 - Clinical Implications of Scapular Dyskinesis in Shoulder Injury: The 2013 Consensus Statement from the 'Scapular Summit' - Article Summary

Clinical Implications of Scapular Dyskinesis in Shoulder Injury: The 2013 Consensus Statement from the 'Scapular Summit'.

Kibler, Sciascia, et al.·Br J Sports Med·2013·693 citations·Shoulder & Elbow

This 2013 consensus statement synthesizes expert opinion from the second Scapular Summit on scapular dyskinesis across shoulder pathologies. It covers definition, clinical assessment tools (SDT, SAT, SRT), and rehabilitation outcomes across impingement, rotator cuff tears, labral injuries, AC separations, MDI, and scapular muscle detachment. The central question: when does dyskinesis matter, and how do you assess and treat it?

Key Findings

Scapular dyskinesis does NOT distinguish painful from painless shoulders. Prevalence is nearly identical in both groups: 76% vs 77% in scaption and 71% vs 71% in flexion. Treat it as an impairment to characterize, not a diagnosis to make.
The Scapular Dyskinesis Test (SDT) is a yes/no visual observation of winging or dysrhythmia during weighted shoulder flexion and abduction. It achieves inter-rater reliability of 75–82% agreement (κ=0.48–0.61) after brief standardized online training — reliable enough for routine clinical use.
Among type 3 AC separations at mean 28 months, 70.6% had scapular dyskinesis and 58.3% of those met criteria for SICK scapula syndrome, with significantly lower Constant and Simple Shoulder Scores. Dyskinesis after AC injury predicts worse functional outcomes.
Scapular rehabilitation avoided surgery in 80% of chronic full-thickness rotator cuff tear patients and up to 50% of superior labral tear patients across three studies. This is why scapular stabilization comes first in the rehab sequence.
Experimental induction of subacromial pain and rotator cuff nerve block both produced increased scapular upward rotation. This means increased upward rotation seen clinically is likely a compensation, not a cause. Decreased upward rotation is the pattern more likely contributory to dysfunction.

Board PearlScapular dyskinesis affects equal proportions of symptomatic and asymptomatic shoulders — treat it as an impairment to address, not a diagnosis to make.

Kibler, Br J Sports Med 2013 - Clinical Implications of Scapular Dyskinesis in Shoulder Injury: The 2013 Consensus Statement from the 'Scapular Summit'

Clinical Implications of Scapular Dyskinesis in Shoulder Injury: The 2013 Consensus Statement from the 'Scapular Summit'.

Key Findings

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Clinical Implications of Scapular Dyskinesis in Shoulder Injury: The 2013 Consensus Statement from the 'Scapular Summit'.

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Clinical Implications of Scapular Dyskinesis in Shoulder Injury: The 2013 Consensus Statement from the 'Scapular Summit'.

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Clinical Implications of Scapular Dyskinesis in Shoulder Injury: The 2013 Consensus Statement from the 'Scapular Summit'.

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