Subacromial impingement syndrome and scapular orientation
Subacromial impingement syndrome (SIS) is considered one of the main sources of shoulder pain. Alterations in scapular orientation and dynamic control have been consistently accused for their contribution to SIS and constitute a primary target for non-surgical management of SIS.
The aim of this study was to systematically examine the literature regarding the relation of scapular orientation and symptoms attributed to SIS. Ten RCTs comparing scapular orientation in SIS patients and a control group were included. The findings of these studies were contradictory, and thus unable to provide sufficient evidence for the role of scapular orientation in the development and existence of SIS.
Even though this variability may be a reflection of the multifactorial nature of SIS, it raises questions regarding the concept of “normal” scapular position and its relevance to SIS. The notion of rehabilitation of the scapula towards an idealized normal posture is currently not supported by the available literature.