Chronic shoulder pain due to scapular dyskinesia with supraspinatus tendinopathy: what is the cause and what is the consequence? Clinical case with literature review

The presentation of chronic shoulder pain without a prior history of acute trauma is a common reason for consultation in clinical practice, especially amoung young, active adults. While rotator cuff tendinopathies and subacromial impingement syndromes are often emphasized, scapular dyskinesia remains an underappreciated potential cause, frequently overlooked due to incomplete clinical examination or limited knowledge of its presentation. This alteration in scapulothoracic kinematics ultimately disrupts the functional harmony of the shoulder and places abnormal loads on tendons tissus.

 Through an illustrative clinical case report and literature review, we hypothesize a bidirectional relationship between scapular dyskinesia and rotator cuff tendinopathy. The patient is a 33-year-old woman with chronic right shoulder pain persisting since adolescence. Clinical and paraclinical examinations revealed chronic supraspinatus tendinopathy and right scapular dyskinesia with moderate neurogenic involvement of to the dorsal scapular nerve. This case illustrates the implications of dyskinesia on scapulohumeral biomechanics, acting both as an etiology and contributor to the development of shoulder tendinopathies. 

The literature provides datathat that support the premise of one condiiton potentially aggravating the other. It also advocates early early rehabilitation aimed at restoring scapula control  in order to prevent more permanent tendon damage.