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ScapuloThoracic Abnormal Motion (“STAM”) explains so much about why our patients have pain….

Dear CSS Colleagues:

Recently we discussed Scapulothoracic dyskinesis vs STAM (ScapuloThoracic Abnormal Motion) at our weekly Indications Conference at MGH. The latter terms was coined by Dr. Bassem ELHassan and the former predates him and was proposed by Robert Leffert. To be sure Bassem has taught us so much about scapular mechanics and dynamic motion and has proposed many novel treatments for abnormal scapular motion (See video link below).

Enclosed is an article I authored in 1990 after I finished a Pediatric Sports Medicine fellowship at Children’s hospital with Dr. Lyle Micheli. At the time I was struck by how many patients with a diagnosis of instability or rotator cuff disease demonstrated abnormal scapular motion; but there was no real way to document this. Thus, I used a method for Scoliosis analysis called Moiré Topography. As the article shows, this is an imaging method which projects a pattern on the back of a patient which allows one to see the degree of asymmetric scapular motion. I share this with you as a perspective for what I’ve learned over the years. I learned a great deal from Robert Leffert, who was Director of The Upper Extremity Unit at MGH (There was no Shoulder Service at MGH the time) and Claire McCarthy, PT, Head of Physical Therapy at Children’s Hospital. Most recently, Bassem has shown us the subtle diagnostic steps to identify STAM and he is also re-defining treatment for these problems.

Kind Regards,

“JP” Warner, MD

Founder, The CSS

Here is a link to Dr. Bassem ELHassan’s video on Examination of the Scapula:

Warner et al, Clinical Orthopaedics and Related Research, 1991- Scapulothoracic Motion in
Download • 4.46MB

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