Medial Scapular / Interscapular Pain

«Understanding the condition (definition, symptoms, epidemiology, stages, absolute surgical indications)» slot — content in preparation.

«How surgery and SART complement each other» slot — content in preparation.

These are the evidence candidates assigned to this topic. The citations to be used are finalised by the author when the page is published.

• EV-075★★★L3 · Retrospective cohort / case-control / cross-sectional

  Forward head posture alters the activation patterns of the shoulder and neck muscles

  Electromyography confirmed that forward head posture produces overactivity of the upper trapezius and altered activation of the scapular stabilisers.

  Weon JH (2010) · Influence of forward head posture

• EV-084★★★L3 · Retrospective cohort / case-control / cross-sectional

  Connective tissue is a body-wide signalling network, and stretching reduces inflammation and remodels tissue

  Connective tissue (fascia) functions as a body-wide mechanical and biochemical signalling network, and experimental work shows that stretching reduces connective tissue inflammation and remodels cells.

  Langevin HM · Connective tissue: A body-wide signaling network?; research on stretching and inflammation

• EV-020★★L4 · Cadaveric / biomechanical model / basic experimentfoundational

  Fascia is the body's largest sensory organ, and when gliding between its layers is blocked, pain and dysfunction follow

  Fascia is layered, with hyaluronic acid allowing the layers to glide over one another. When that lubrication dries out (fixation), gliding is blocked and pain and altered sensation result. Anatomical work established fascia as a sensory organ with rich sensory innervation.

  Stecco C (2015) · Functional Atlas of the Human Fascial System

• EV-042★★L4 · Cadaveric / biomechanical model / basic experimentfoundational

  Fascia is a continuous gliding network, and that sliding is the substrate of movement

  Endoscopic imaging of living fascia captured its polyhedral microarchitecture and continuous gliding. Fascia is not a set of separated layers but a continuous water-filled web that slides upon itself.

  Guimberteau JC (2015) · Architecture of Human Living Fascia

• EV-057★★L4 · Cadaveric / biomechanical model / basic experimentfoundational

  Fascia is a sensory and contractile tissue that actively regulates its own tension

  Fascia contains myofibroblasts along with rich sensory and autonomic receptors, allowing it to regulate its own tension and to respond to autonomic state.

  Schleip R · Fascia: The Tensional Network of the Human Body

• EV-014★L5 · Expert opinion / classical theory / mechanistic hypothesisfoundational

  Imbalance between postural and phasic muscles produces predictable patterns

  Certain muscles become tight and shortened while others weaken, in predictable patterns of imbalance (upper and lower crossed syndromes). This is the muscular mechanism behind postural syndromes such as forward head posture and rounded shoulders.

  Janda V · Muscles and Motor Control

• EV-017★L5 · Expert opinion / classical theory / mechanistic hypothesisfoundational

  The thorax is not a rigid cage but a stack of mobile rings, and when one ring twists the structures above and below are affected

  The thorax is modelled as a stack of individual rings (rib segments); when a particular ring rotates or translates, the structures above it — shoulder and cervical spine — compensate.

  Lee D (2015) · The Thoracic Ring Approach