Scapular Dyskinesis & Its Treatment With Herbal Remedies

Abstract

Musculoskeletal systems provide shape to the body and help in basic daily activities. Sometimes with injuries, degenerative changes with age and diseased condition lead to improper functioning and painful conditions of the same. Scapular Dyskinesis is loss of normal scapular movements. The reason usually remains an injury due to which loss of movements of the scapula occurs. The symptoms include pain and loss of normal activity. Burkhart gave the acronym SICK to mention the syndrome linked to Scapular Dyskinesis. Full form of SICK is Scapular Malpositioning, Inferior medial border prominence, Coracoid pain and malposition and DysKinesia of the scapular movement. In Ayurveda, Scapular Dyskinesis can be compared with vata dosha vitiation by abhighata (trauma) and vitiated vata dosha. In the following article, we shall discuss Scapular Dyskinesis and its features and management. Let’s look into some details!!

Introduction

‘Dys’ means ‘loss’ and ‘kinesia’ means ‘movement’. Therefore Scapular Dyskinesia means loss of scapular movements. Scapular winging is a cardinal feature of the scapular dyskinesis when the blade of the scapula abnormally comes out of the thorax while the movement is started and stays in there for the whole arm movement. It can also be defined as alteration in the normal dynamic or static motion or position of the scapula while coupled with scapulohumeral movements. Usually the condition of Scapular Dyskinesia is considered to be due to another condition associated and not a condition of its own. Most commonly the reason behind the Scapular Dyskinesia is an injury or the abnormal repetitive use of the shoulder. In Ayurveda, it can be correlated with vata dosha vitiation as vata is the main dosha associated with movement in and of the body.

Common Causes Of Scapular Dyskinesis

• Shortening of pec minor and short head of biceps brachii together results in protraction of scapula with anterior tilt.
• Bony cases can be thoracic kyphosis, shortened clavicle malunion.
• Neurological causes can be nerve palsy like long thoracic nerve. Cervical radiculopathy can also lead to Scapular Dyskinesis.
• Imbalance
• Weakness
• Poor overhead movements
• Overuse of the shoulder
• Repeated motions (throwing)

Risk Factors Of Scapular Dyskinesis

• Sports that involve overhead activities. Overhead athletes – 61% chances of developing Scapular Dyskinesia.
• Loose joints
• Prior shoulder injuries
• Poor strength and flexibility
• Kyphosis (abnormal curvature of the upper back)

Common Signs and Symptoms Of Scapular Dyskinesis

• Tenderness and pain around the scapula while using the arm over the head.
• Pain can get worse by lifting heavy objects.
• Popping and snapping can be sensed by the patient.
• Weakness and strength loss.
• Asymmetrical posture or position (affected side usually goes down)
• Scapular winging.
• Instability of affected shoulder.
• Stiffness is a common symptom of partial tears.

Identification of Scapular Dyskinesis

• SICK posture
• Scapular displace or malposition
• Inferior medial border prominence
• Coracoid malposition and pain
• Improper or loss of scapular movements

Diagnostic Procedures Of Scapular Dyskinesis

• Scapular dyskinesis test: It is advocated to flexion/arm elevation with maximum three to five times to reproduce dyskinesia. Scapular dyskinesis is seen in the descent period of the arm motion. Prominent medial border indicates a positive dyskinesia test.
• Scapular retraction test: The test evaluates the strength of the rotator cuff in Scapular Dyskinesis. Active range of motion and pain are noticed. The test comes out to be positive if the pain is alleviated by applying an external rotation motion and a posterior tilt of the scapula.
• Scapular assistance test: The baseline active range of motion and pain are assessed. Thereafter the therapist applies an assist to the scapular movements. The test comes out to be positive if the pain is reduced or range of motion is increased.
• Isometric scapular pinch test: The patient is asked to stand and is asked to squeeze the scapulae together as much as possible. Positive test reports itself with burning pain.
• Wall pushup test: The patient is asked to perform wall pushups at least 15 to 20 times. Whinging usually shows up with 5 to 10 tests.

Preventive Measures on Scapular Dyskinesis

Warming up before overhead sports.

Management Of Scapular Dyskinesis

• Manual mobilisation grade four to lower tension of the posterior capsule. And stretching of the cross body.
• Stretching and mobilisation of the soft tissue to reduce tension of pectoralis minor.
• Exercises that will lead to serratus anterior activation.
• Physiotherapy exercises including isotonics and isometrics and rehabilitation is of help in the Scapular Dyskinesis.
• Non-steroidal anti-inflammatory drugs like ibuprofen are used to alleviate pain.
• Cold compresses are used to relieve pain and reduce inflammation. Ice Packs can be used.
• Heat can be used before stretching and strengthening exercises. A heat pack can be used.

Herbal Remedies for Scapular Dyskinesis by Planet Ayurveda

Planet Ayurveda is a glorious GMP certified, ISO 9001:2015 certified and US-FDA registered Ayurvedic Company, which is firmly stuck to the idea of producing quality Ayurvedic products as mentioned in a number of ancient texts of Ayurveda. Medicines are manufactured without additives and preservatives and other kinds of chemicals or flavouring agents which causes many ill effects on the human body. Products prepared at Planet Ayurveda are natural, pure and devoid of any kind of adulteration. Planet Ayurveda presents the Classical Ayurvedic formulations which are doing great in managing Scapular Dyskinesis. Following is the list of products victoriously achieving the aim of treating Scapular Dyskinesis

1. Boswellia Curcumin
2. Yograj Guggul
3. Rumogin 5
4. Ashwagandha Capsules
5. Hakam Churna

Products Description

1. Boswellia Curcumin

The main ingredients of this herbal formulation are Shallaki (Boswellia serrata) and Haridra (Curcuma longa). The formulation is beneficial for the musculoskeletal system. It strengthens the bone and nourishes the ligaments, tendons, muscles and improves overall functions of the musculoskeletal system. Therefore by maintaining a proper musculoskeletal system it shows its effectiveness in treating Scapular Dyskinesis.

Dosage: One capsule twice a day with plain water after the meals.

2. Yograj Guggul

It is a polyherbal formulation which has numerous ingredients. The ingredients include Amalaki (Emblica officinale), Bibhitaki (Terminalia bellirica), Haritaki (Terminalia chebula), Pippali (Piper longum), Vidanga (Embelia ribes), Ela (Elettaria cardamomum), rock salt, Marich (Piper nigrum), Shunthi (Zingiber officinale), Gokshur (Tribulus terrestris), Nagaremotha (Cyperus rotundus) and many more. It is beneficial in increasing the motor nervous system which hampers in the Scapular Dyskinesis. In addition to this, the formulation aids the musculoskeletal system and nervous system. It relaxes the muscular stiffness as in the aforesaid condition. It overall provides strength to the muscles which improves the condition of Scapular Dyskinesis.

Dosage: Two tablets twice a day with plain water after the meals.

3. Rumogin 5 Capsules

The formulation includes the beneficial properties of Haridra (Curcuma longa), Sonth (Zingiber officinale), Shallaki (Boswellia serrata), Maricha (Piper nigrum), Pippali (Piper longum). These all blended with each other provides relief in the Scapular Dyskinesis. The formulation has anti-inflammatory properties. The formulation pacifies vata dosha which is the reason for Scapular Dyskinesis. Therefore it justifies the vata dosha vitiation theory of the disease. Furthermore it gives energy to the muscles.

Dosage: One capsule twice a day with plain water after the meals.

4. Ashwagandha Capsules

The capsules contain the useful herb of Ashwagandha (Withania somnifera). It pacifies vata dosha therefore alleviates pain. It possesses anti-inflammatory activity. It is useful in weakness. It has an analgesic property. Being a rasayana, it nourishes all the bodily tissues.

Dosage: One capsule twice a day with plain water after the meals.

5. Hakam Churna

This polyherbal formulation contains four ingredients, which include Chandrashoor (Lepidium sativum), Methi (Trigonella foenumgraecum), Ajwain (Trachyspermum ammi), Kalonji (Nigella sativa). The ingredients possess analgesic, anti-inflammatory properties. It acts as a nervous tonic. Furthermore it pacifies vata dosha. With all these properties Hakam churna s a best formulation which can benefit and fits itself in treating Scapular Dyskinesis.

Dosage: Half tablespoon twice a day after meals with warm water.

Conclusion

As we have discussed Scapular Dyskinesia in a little detail and its management. It comes out to be that Ayurveda is offering much help in treating the aforesaid disease. The formulation prepared by Planet Ayurveda has promising results in managing Scapular Dyskinesia. The formulations benefit the patient on a broader platform and in many health systems related to the disease i.e. nervous system and musculoskeletal system. The medicines provide relief from the symptoms associated with the disease as well as provide nourishment to the bone and muscles. With these properties combined, formulations become an ideal in treating the aforesaid disease. In comparison with the contemporary system of medicine, Ayurveda is doing a great job in vanishing the root cause of a disease with symptomatic relief as well. Thus there is no greater science than Ayurveda who focuses on curing the disease by eliminating the root cause of a disease.