Effects of Scapular Dyskinesis on Overhead Athletes' Shoulder Pain and Function: A Review

Abstract

Background: Scapular dyskinesis is an alteration in scapular position or motion that may disturb scapulohumeral rhythm, reduce dynamic shoulder stability, and impair force transmission during overhead activity. Because overhead athletes repeatedly expose the shoulder complex to high-velocity and high-volume loading, altered scapular control may contribute to shoulder pain, functional limitation, performance decline, and injury susceptibility. Objective: This systematic review aimed to synthesize recent evidence on the effects of scapular dyskinesis on shoulder pain, shoulder function, biomechanics, athletic performance, rehabilitation response, and injury risk in overhead athletes. Methods: A structured literature search was conducted using PubMed and Google Scholar for studies published between 2020 and 2025. Search terms included scapular dyskinesis, scapular kinematics, scapulohumeral rhythm, shoulder pain, shoulder function, overhead athletes, rotator cuff, subacromial impingement, sports injury, biomechanics, neuromuscular control, and rehabilitation. Eligible studies included randomized controlled trials, cohort studies, cross-sectional studies, systematic reviews, and meta-analyses involving adult overhead athletes or physically active adults in whom scapular dyskinesis was assessed in relation to pain, function, biomechanics, performance, injury risk, or rehabilitation outcomes. Findings were synthesized qualitatively because of heterogeneity in study design, populations, assessment methods, and outcome measures. Results: The included evidence showed that scapular dyskinesis is common in overhead athletes and is associated with altered scapular kinematics, abnormal activation of scapular stabilizers, impaired neuromuscular control, reduced shoulder strength and endurance, and decreased functional performance. Dyskinesis was also associated with shoulder pain, particularly in rotator cuff-related and subacromial impingement-related conditions; however, its presence in asymptomatic athletes indicates that it should not be interpreted as pathological in isolation. Scapular-focused rehabilitation, including stabilization exercise, neuromuscular control training, and sport-specific movement retraining, was generally associated with improved pain, function, and movement quality. Conclusion: Scapular dyskinesis is a clinically relevant but context-dependent contributor to shoulder pain and dysfunction in overhead athletes. Comprehensive assessment and individualized rehabilitation targeting scapular control, muscular balance, load management, and sport-specific reintegration may improve functional outcomes and support safer return to overhead activity.