[Scapulothoracic dysbalance in overhead athletes. Causes and therapy strategies].

A key element for movement of the arm is the position and motion of the scapula. A stable basis for efficient arm function is only possible if the scapula makes three dimensional movements coordinated with the upper arm.This article presents a discussion of causes, diagnosis and therapy options for scapular dyskinesis.The article is based on a literature search in the PubMed database and taking own experience into account.Soft tissue and bony injuries, muscle insufficiency and dysbalance can alter the position and function of the scapula. This pathological position and motion is called scapular dyskinesis. This clinically presents as a prominent medial border and malrotation (lacking external rotation and posterior tilt) of the scapula when raising the arm. The clinical examination includes a visual inspection followed by clinical tests of the scapula at rest and during movement. Specific exercises of the musculature surrounding the scapula and specific techniques for schooling the senses for positioning and movement can harmonize the sequence of movements and restore the dynamic scapular stability.A conservative stepwise and stage-adapted exercise program can be used to treat scapular dyskinesis with good results.