The role of the scapula in the rehabilitation of shoulder injuries.

OBJECTIVE: To present a clinical understanding of the role the scapula plays in the mechanics of shoulder function and specialized techniques for the rehabilitation of injuries around the shoulder girdle. BACKGROUND: The scapular musculature is often neglected in the evaluation and treatment of shoulder injuries. This lack of attention often degenerates into the incomplete evaluation and rehabilitation of scapular dysfunction. Dysfunction or weakness of the scapular stabilizers often results in altered biomechanics of the shoulder girdle. The altered biomechanics can result in (1) abnormal stresses to the anterior capsular structures, (2) the increased possibility of rotator cuff compression, and (3) decreased performance. DESCRIPTION: We review the anatomy and role of the scapula, the pathomechanics of injury and dysfunction, and the evaluation and rehabilitation of the scapula. CLINICAL ADVANTAGE: Knowledge of how the scapular muscles influence function at the shoulder builds a strong foundation for the clinician to develop rehabilitation programs for the shoulder.