肩胛運動異常是肩胛骨位置與動作異常改變的現象，許多文獻發現肩峰下疼痛症候群、旋轉肌群斷裂、關節內夾擠、肩關節唇撕裂、肩關節不穩定或肩峰鎖骨關節等問題的病患會與肩胛運動學變化相關。探討肩胛運動異常所產生的生物力學影響，除了與肩膀疾患類型外，也必須考量肩膀疾患適應性變化、中間調節因子或肩膀負荷等因素，其因果關係性相對複雜。本篇文獻整理造成肩胛運動異常的可能原因，提供物理治療師評估的參考。可能原因有(1)肌肉骨骼結構損傷和姿勢問題、(2)肌肉活動與協調問題和(3)肩膀周圍軟組織緊縮。評估上需要先確認肌肉骨骼結構和神經有無損傷需要轉介給醫師進行處置，接著進行全身性評估如是否有全身性關節活動度過大以及脊椎排列問題，再進行肩胛運動異常之評估。其中肩胛徒手矯正測試可以確認肩胛運動異常是否影響肩膀疼痛，可作為是否介入之依據。肩胛運動異常之評估可以用直接觀察確認肩胛運動異常之型態，配合客觀量測肩胛位置以及胸小肌和後側肩膀緊縮程度，確認肩胛運動異常之可能原因，並給予適當治療。

Scapular dyskinesis is defined as altered scapular position and movement during static positions or arm movements. Several studies have shown that shoulder disorders including subacromial pain syndrome, rotator cuff tear, internal impingement, labral lesions, shoulder instability or acromioclavicular joint impairments are associated with altered scapular kinematics. Despite these associations, the cause-effect relationships between scapular dyskinesis and biomechanical changes are complex. In addition to risk factors, it could be the results of movement adaptations or interactive factors. Possible factors of scapular dyskinesis are: (1) musculoskeletal structural impairments and posture problems, (2) muscle activation and coordination problems and (3) surrounding shoulder soft tissues tightness. In evaluation, identification of musculoskeletal structural impairments and nerve injuries should refer to physicians for management. After performing systematic assessment for hypermobility syndrome and posture alignment of spine, therapist can focus on scapular dyskinesis assessment. Direct observation of scapular movement to identify scapular dyskinesis patterns during arm elevation and objective measurements of scapular positions, length of pectoralis minor and posterior shoulder tightness can be used to clarify the possible factors related to scapular dyskinesis. Additionally, using corrective maneuvers to confirm the relationship of scapular dyskinesis and shoulder pain may help clinician to determine the choice of intervention.