Asymmetric resting scapular posture in healthy overhead athletes

Context: Observation of the scapular posture is one of the most important components of the physical examination in overhead athletes. Postural asymmetry is typically considered to be associated with injuries. However, asymmetry in the overhead athlete's scapula may be normal due to the dominant use of the limb. Objective: To quantify the differences in resting scapular posture between the dominant and nondominant sides in 3 groups of healthy overhead athletes (baseball pitchers, volleyball players, and tennis players) using an electromagnetic tracking device. Design: Cross-sectional design. Setting: University-based biomechanics laboratory. Patients or Other Participants: A total of 43 players participated, including 15 baseball pitchers, 15 volleyball players, and 13 tennis players. All participants were healthy college-aged men. Intervention(s): Bilateral 3-dimensional scapular kinematics with the arm at rest were measured using an electromagnetic tracking device. Main Outcome Measure(s): Bilateral scapular position and orientation were measured. Between-groups and between-sides differences in each variable were analyzed using separate analyses of variance. Results: In tennis players, the scapula was more protracted on the dominant side than on the nondominant side (P < .05). In all overhead athletes, the dominant-side scapula was more internally rotated (P = .001) and anteriorly tilted (P = .001) than the nondominant-side scapula was. Conclusions: The dominant-side scapula of the overhead athletes was more internally rotated and anteriorly tilted than the nondominant-side scapula. The dominant-side scapula of the tennis players was more protracted than that on the nondominant side. Clinicians evaluating overhead athletes need to recognize that scapular posture asymmetry in unilateral overhead athletes may be normal. Our results emphasize the importance of the baseline evaluation in this population in order to accurately assess pathologic change in bilateral scapular positions and orientations after injury.