Scapular Downward Rotation

Insufficient scapular upward rotation is the primary movement impairment in this syndrome. The scapular position may be downwardly rotated, adducted, abducted, or normal.  This movement impairment may be evident at any point during the range of motion.  Muscle impairments include dominance, shortness, or stiffness of the downward rotator muscles [e.g., rhomboids, levator scapula, latissimus, pec minor/major] and insufficient activity of the upward rotators [e.g., serratus anterior, trapezius], (Sahrmann, 2004).

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Scapular Depression

The primary movement impairment in this syndrome is insufficient scapular elevation.  Initial scapular alignment may be depressed with a failure to elevate sufficiently during movement, or scapular alignment may be normal. Depression occurs during arm elevation.  Muscle impairments include dominance, shortness, or stiffness of the scapular depressor muscles [e.g., latissimus, pecs, lower trapezius], and insufficient activity or lengthened scapular elevator muscles [e.g., upper trapezius and possibly levator scapula]. (Sahrmann, 2002)

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Scapular Abduction

The primary movement impairment in this syndrome is excessive scapular abduction.  Muscle impairments are a dominance of scapular abductor muscles (pec major, serratus anterior) and insufficient activity of the scapular adductor (primarily trapezius) muscles, primarily their alignment and appearance. (Sahrmann, 2002)

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Scapular Winging and Tilting

The primary movement impairment in this syndrome is excessive scapular abduction.  Muscle impairments are a dominance of scapular abductor muscles (pec major, serratus anterior) and insufficient activity of the scapular adductor (primarily trapezius) muscles, primarily their alignment and appearance. (Sahrmann, 2002)

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Humeral Anterior Glide

Excessive anterior or insufficient posterior glide of the of the humeral head is noted during shoulder motions.  This syndrome may be associated with laxity of the anterior structures and stiffness or shortness of the posterior structures of the GH joint.  The subscapularis is frequently lengthened or weak and the posterior deltoid dominates over infraspinatus and teres minor muscles.  The muscles that attach further from the axis of rotation (e.g., pectoralis major, latissimus, teres major) dominate over the subscapularis. (Sahrmann, 2002)

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Humeral Superior Glide

Excessive superior or insufficient inferior glide of the humeral head is noted during shoulder motions.  This may be associated with stiffness or shortness of the superior or inferior structures of the GH joint.  Insufficiency of the rotator cuff because of weakness, recruitment impairments, or tear is a major causative factor. This disrupts the normal force couple between the rotator cuff and the deltoid. (Sahrmann, 2002)

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