On Sunday, the 76ers released an update on guard Markelle Fultz's right shoulder injury.  They stated that after a visit with Dr. Ben Kibler in Lexington, Ky, it was confirmed that Fultz did not have any structural impairment but he would be out indefinitely with soreness and scapular muscle imbalance.

Scapular muscle imbalance, also known as scapular dyskinesis, is an asymmetry of the shoulder blades characterized by an abnormal movement pattern of the overused side.  This is often seen in baseball pitchers and tennis players due to the repetitive overuse of the throwing or hitting arm.  Although typically in basketball, shoulder injuries occur when the arm is blocked during a shot or hits the rim after a dunk.

Media reports stated that Fultz had a cortisone injection earlier in October.  These are typically used to reduce inflammation and pain but with Fultz's continued symptoms, we can assume that the injection didn't have significant benefit.  This supports the scapular dyskinesis diagnosis as injections generally don't offer relief for this problem.

Return to play can be very difficult to predict, especially with the diagnosis of scapular dyskinesis.  Some athletes respond to rehab in a few weeks whereas others require months of work.  Rehab focuses on improving scapular stability and movement patters, but also addressing any kinetic chain dysfunctions that may be contributing to the shoulder issue.  Sometimes another injury, such as Fultz's previous ankle sprain, can cause certain muscle groups to overcompensate, resulting in dysfunction elsewhere in the body, like Fultz's shoulder injury.  Think of it as your car's alignment being off.

The good news in all of this is that the injury appears to be non-surgical.  The Sixers will be on top of Fultz's rehab and will have him back on the court once the scapular dyskinesis and any other movement dysfunctions are addressed.  Correcting these dysfunctions will allow Fultz to return to his previous level of performance while minimizing his risk of re-injury.

Justin Shaginaw, PT, DPT, LAT, ATC, is an athletic trainer at Aria 3B Orthopaedic Institute and for the US Soccer Federation.