Scapular Rotator Dysfunction or “SICK” Scapula Syndrome

In most throwers the scapula moves in an abnormal way. This occurs because of the repetitive use of the shoulder, and the changes that develop in any muscle that is used strenuously again and again. However, these changes are detrimental to shoulder function and can increase the chances of injury. Another very common condition in throwers is contracture / tightness of the shoulder capsule on the back portion (posterior) of the shoulder. This is very common in throwers, and contributes to the “SICK” Scapula problem. Lifting weights, particularly chest exercises such as bench press, can aggravate this condition. The athlete with “SICK” Scapula Syndrome will hold the affected shoulder lower than the other and also rotated forward. This looks like a slouched position, but with one shoulder more slouched than the other. If you look around you will see a lot athletes with this posture.


The patient’s right shoulder sits lower when he has his arms at his side, but rises higher as he raises his arms to the side or to the front. This is a telltale sign of “SICK” Scapula Syndrome.

…”SICK” Scapula responds well to a rehabilitation program, but….
“SICK” Scapula responds well to a rehabilitation program, but often requires the help of a therapist skilled in caring for throwers. Some of the exercises can be done on your own, but some need the supervision of a therapist. The exercises focus on stretching the posterior capsule (behind the shoulder) and strengthening the scapular rotator muscles. However, this requires not just simple strengthening, but also re-training of the muscles so that they get out of the habit of moving the scapula incorrectly. It is common for the pitcher to strengthen these muscles but then go back to his old habits when facing a live hitter. It is that bad habit that must be changed!

Dr. David Lintner - Houston Orthopedic Surgeon