Efficacy of Scapular Focused Treatment for Shoulder Pain

Objective: The purpose of this study is to determine the effect of scapular focused treatment interventions on shoulder pain and biomechanics in patients with non-specific shoulder pain. Design: Systematic literature review of randomized controlled trials. Methods: The literature search was conducted in the databases Ovid MEDLINE, CINAHL, PEDro and Cochrane Library up to July 2020. Randomized controlled trials, cohort studies, and a quasi-experimental design were included; appraised using the Oxford Center for Evidence-Based Medicine (OCEBM) levels of evidence. Results: Ten studies were included (n = 375) describing scapular-based interventions that targeted shoulder pain and assessed changes in shoulder biomechanics. Six studies captured biomechanical measurements and nine studies reported on pain. Two studies showed a statistically significant improvement with upward rotation, three for external rotation, and zero for flexion. Three studies showed a statistically significant reduction in pain. Conclusion: Although scapular based exercise interventions demonstrate a positive impact on pain and perceived disability in patients with shoulder pain, results were inconsistent regarding biomechanical changes and greater improvements were seen when the interventions were combined with a generalized program focused on strength and range of motion (ROM). More high-quality research is needed to understand the effects of these interventions in clinical practice