This is an uncontrolled cohort study of a 10-week scapular motor control retraining program in young adults with subacromial impingement signs. It asks whether re-educating scapular muscle recruitment improves pain, function, muscle activation timing, and scapular kinematics. Sixteen patients were compared to their own pre-intervention state and to 16 healthy controls.
When a young overhead athlete presents with a positive Hawkins-Kennedy, Neer's, and painful arc but no cuff tear on ultrasound, the scapula is often the problem, not the cuff. This study localizes the deficit: serratus anterior and lower trapezius fire late and shut off early, losing the posterior tilt and upward rotation that keep the subacromial space open.
Retraining scapular orientation for 10 weeks normalized both the muscle timing and the kinematics while cutting SPADI by a clinically meaningful 10 points. The practical lesson is to target serratus anterior and lower trapezius specifically, since upper and middle trapezius were unaffected.
Weigh the evidence appropriately: this is a small, unblinded, uncontrolled cohort with a ceiling effect, so it demonstrates a plausible mechanism rather than proven efficacy. The authors themselves call for a randomized controlled trial.
This is an uncontrolled cohort study of a 10-week scapular motor control retraining program in young adults with subacromial impingement signs. It asks whether re-educating scapular muscle recruitment improves pain, function, muscle activation timing, and scapular kinematics. Sixteen patients were compared to their own pre-intervention state and to 16 healthy controls.
When a young overhead athlete presents with a positive Hawkins-Kennedy, Neer's, and painful arc but no cuff tear on ultrasound, the scapula is often the problem, not the cuff. This study localizes the deficit: serratus anterior and lower trapezius fire late and shut off early, losing the posterior tilt and upward rotation that keep the subacromial space open.
Retraining scapular orientation for 10 weeks normalized both the muscle timing and the kinematics while cutting SPADI by a clinically meaningful 10 points. The practical lesson is to target serratus anterior and lower trapezius specifically, since upper and middle trapezius were unaffected.
Weigh the evidence appropriately: this is a small, unblinded, uncontrolled cohort with a ceiling effect, so it demonstrates a plausible mechanism rather than proven efficacy. The authors themselves call for a randomized controlled trial.