Since when is rehabilitation a one size fit all? The National Athletic Trainer’s Association Executive Council on Education describes rehabilitation proficiency as the ability to: “Select, apply and evaluate the effectiveness of therapeutic interventions using the best evidence to guide those decisions.” This is great benchmark, in that allows creativity and ability to choose. In my education rehabilitation has been about adapting exercise and interventions to meet patient goals without using a “cookie-cutter” approach. I have learned to have lots of options and base my progress on patient feedback.
In 2013, during the Scapular Summit, all the greatest minds in this area of research discussed concepts of prevention, diagnosis, and rehabilitation.1 Their lengthy and detailed conversation yielded the same questions most of us clinicians have been asking for quite some time… What comes first, the chicken (the dyskinesis) or the egg (concomitant pathology)? Without a thorough understanding of the causative factors associated with scapular dyskinesis, it is difficult to plan for rehabilitation.
Most clinicians focus on retraining the scapula after surgical intervention or as a means to decrease symptoms for a chronic problem. But, what if we focused less attention on strength and more on neuromuscular control? As part of my thesis, we are evaluating certain exercises, that are theorized in the literature, to focus specifically on the sequencing of muscle activation or that coordination of movement called neuromuscular control. What we are finding is that uniplanar motions typical of a “cookie-cutter” approach to rehabilitation are not effective at coordinating movement and as such, we need more creative and advanced approaches to managing scapular dyskinesis.
Which of the following exercises are focused on neuromuscular control?
I, Y, T, Ws
Pushup/Pushup Plus
Wall Washes
Body Blade in Overhead/Sport Specific Position
Impulse in Overhead/Sport Specific Position
Plyo-rebounder
Theraband RC exercises (Internal Rotation, External Rotation, D1, D2, Flexion, Extension)
Weight Shifts
Theraband Rows
Theraband Serratus Punch
Prone T Ball Flip
-Austin Krause LAT, ATC
References
1. Kibler BW, Ludewig PM, McClure PW, Michener LA, Bak K, Sciascia AD. Clinical implications of scapular dyskinesis in shoulder injury: The 2013 consensus statement from the ‘scapular summit’. Br J Sports Med. 2013;00:1-12
In 2013, during the Scapular Summit, all the greatest minds in this area of research discussed concepts of prevention, diagnosis, and rehabilitation.1 Their lengthy and detailed conversation yielded the same questions most of us clinicians have been asking for quite some time… What comes first, the chicken (the dyskinesis) or the egg (concomitant pathology)? Without a thorough understanding of the causative factors associated with scapular dyskinesis, it is difficult to plan for rehabilitation.
Most clinicians focus on retraining the scapula after surgical intervention or as a means to decrease symptoms for a chronic problem. But, what if we focused less attention on strength and more on neuromuscular control? As part of my thesis, we are evaluating certain exercises, that are theorized in the literature, to focus specifically on the sequencing of muscle activation or that coordination of movement called neuromuscular control. What we are finding is that uniplanar motions typical of a “cookie-cutter” approach to rehabilitation are not effective at coordinating movement and as such, we need more creative and advanced approaches to managing scapular dyskinesis.
Which of the following exercises are focused on neuromuscular control?
I, Y, T, Ws
Pushup/Pushup Plus
Wall Washes
Body Blade in Overhead/Sport Specific Position
Impulse in Overhead/Sport Specific Position
Plyo-rebounder
Theraband RC exercises (Internal Rotation, External Rotation, D1, D2, Flexion, Extension)
Weight Shifts
Theraband Rows
Theraband Serratus Punch
Prone T Ball Flip
-Austin Krause LAT, ATC
References
1. Kibler BW, Ludewig PM, McClure PW, Michener LA, Bak K, Sciascia AD. Clinical implications of scapular dyskinesis in shoulder injury: The 2013 consensus statement from the ‘scapular summit’. Br J Sports Med. 2013;00:1-12
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