This multicenter RCT compared scapular stabilization exercise tailored to the patient's specific type of scapular dyskinesis against conventional pendulum, wall-climbing, and stick exercises. 90 adults with unilateral shoulder pain and mild pain scores (NRS ≤ 5) trained for 6 weeks with a 6-week follow-up. The primary outcome was the Constant-Murley shoulder function score.
When you see a patient with shoulder pain and scapular dyskinesis, the type of dyskinesis should drive the exercise prescription, not a one-size-fits-all shoulder program. The mental model: each dyskinesis type has a specific pattern of tight and weak muscles. Stretch the tight ones, strengthen the weak ones. Undifferentiated girdle strengthening can make tight muscles tighter and worsen symptoms.
This trial explains why earlier scapular exercise studies gave conflicting results. Those protocols did not match training to dyskinesis type, so the targeting was lost. Practically: conventional exercise still restores range of motion and eases some pain, but only targeted work corrects the scapular pattern and improves stability metrics.
Caveats worth remembering: patients had mild pain (NRS ≤ 5), rotator cuff tears and other structural causes were excluded, and follow-up was only 6 weeks. Long-term durability is untested.
This multicenter RCT compared scapular stabilization exercise tailored to the patient's specific type of scapular dyskinesis against conventional pendulum, wall-climbing, and stick exercises. 90 adults with unilateral shoulder pain and mild pain scores (NRS ≤ 5) trained for 6 weeks with a 6-week follow-up. The primary outcome was the Constant-Murley shoulder function score.
When you see a patient with shoulder pain and scapular dyskinesis, the type of dyskinesis should drive the exercise prescription, not a one-size-fits-all shoulder program. The mental model: each dyskinesis type has a specific pattern of tight and weak muscles. Stretch the tight ones, strengthen the weak ones. Undifferentiated girdle strengthening can make tight muscles tighter and worsen symptoms.
This trial explains why earlier scapular exercise studies gave conflicting results. Those protocols did not match training to dyskinesis type, so the targeting was lost. Practically: conventional exercise still restores range of motion and eases some pain, but only targeted work corrects the scapular pattern and improves stability metrics.
Caveats worth remembering: patients had mild pain (NRS ≤ 5), rotator cuff tears and other structural causes were excluded, and follow-up was only 6 weeks. Long-term durability is untested.