Snapping scapula syndrome is a condition that involves the popping, grating, grinding, or “snapping” of bones and tissue in the scapula (shoulder blade) area when lifting and moving the arm. The snapping symptoms may be painful, and are sometimes audible. Snapping scapula syndrome is most commonly diagnosed in young, active individuals who perform repetitive overhead movements, such as stocking shelves at the local store, or engaging in sports like weight-lifting, swimming, or baseball. Other causes can include scapula or rib-cage bone conditions, such as fractures, muscle weakness or atrophy, or tumors. Snapping scapula syndrome is usually the result of overuse of the arm, poor posture during sport activities, or incorrect joint motion, but can also be caused by a single episode of trauma to the scapula area. A physical therapist treats the pain, muscle weakness, loss of arm motion, and swelling of soft tissue that can occur with snapping scapula syndrome. What is Snapping Scapula (Shoulder Blade) Syndrome?
Snapping scapula syndrome is a condition that involves the popping, grating, grinding, or “snapping” of bones and tissue in the scapula area when lifting and moving the arm. It may be caused by a number of bone or soft tissue problems.
Bones can be malformed from birth, or fractured, causing them to be misshapen. When the scapula moves, it may bump against a misshapen bone as it glides over it, causing a grinding or grating feeling, or sound. Soft tissues include muscles and bursae.
The muscles between the scapula and the rib cage (subscapularis and serratus anterior) can become tight, shrunken, scarred, inflamed, or weak. As a result, the scapula will become positioned too close to the rib cage, and may rub painfully on the ribs during arm movement. Bursae are fluid-filled sacs that act as cushions and normally reduce friction between the scapula and the rib cage, or between the scapula and the muscles. The scapula may rub and irritate a bursa cushion.
Popping or snapping can occur from a bursa becoming inflamed, from being rolled over during scapula motion, or from inadequate reduction of friction by a bursa. How Does Snapping Shoulder Blade Syndrome Feel?
A person with snapping scapula syndrome may experience:. Pain in the back or top of the shoulder when lifting the arm overhead or shrugging the shoulders. A snapping, grinding, grating, or popping sensation or sound in the scapula area when lifting the arm. A feeling of weakness in the arm. “Winging” of the scapula, which makes it appear as if 1 edge is poking out away from the body.
Difficulty performing overhead arm motions due to pain or weakness in the scapula area. A visible difference in how the painful scapula moves. How Is Snapping Shoulder Blade Syndrome Diagnosed? If you see your physical therapist first, your therapist will conduct a thorough evaluation that includes taking your health history. Your therapist will also ask you detailed questions about your injury, such as:. How and when did you first notice the pain?.
Do you hear or feel any popping, grinding or snapping when moving your arm? What activities are you performing when you hear or feel these symptoms?. Do you have any pain or stiffness in your neck?.
Does your shoulder area feel weak or “tired”? Your physical therapist will perform special tests to help determine the likelihood that you have snapping scapula syndrome.
Your physical therapist also will determine whether your pain is coming from your neck, shoulder joint, or other areas, or if it is limited to your scapula. To provide a definitive diagnosis, your therapist may collaborate with an orthopedic physician or other health care provider, who may order further tests, such as an x-ray, to confirm the diagnosis and to rule out other damage to the spine, ribs, and scapula. An x-ray test is not required in all cases.
How Can a Physical Therapist Help Treat a Snapping Shoulder Blade? Your physical therapist will work with you to design a specific treatment program that will speed your recovery, including exercises and treatments you can do at home.
Physical therapy will help you return to your normal lifestyle and activities. The First 24-48 Hours Your physical therapist may advise you to:. Rest the area by avoiding lifting your arm overhead or performing other movements that cause pain. Apply ice packs around the scapula area for 15–20 minutes every 2 hours. Make sure you keep your spine in an upright posture when sitting or standing.
Consult with a physician for further services, such as medication or diagnostic tests. Reduce Pain Your physical therapist may use different types of treatments and technologies to control and reduce your pain and symptoms, including ice, heat, ultrasound, diathermy, laser, iontophoresis, electrical stimulation, taping, exercises, and hands-on therapy, such as massage. Improve Motion Your physical therapist will choose specific activities and treatments to help restore normal movement in the shoulder, neck, and spine. These might begin with “passive” motions that the physical therapist performs for you to gently move your arm, shoulder, neck, and scapula, and progress to active exercises and stretches that you do yourself.
Improve Flexibility Snapping scapula syndrome is often related to tight muscles in the chest wall, shoulder, and neck. Your physical therapist will determine if these, or any other muscles, are tight, and teach you how to gently stretch them. Your physical therapist may apply hands-on techniques, such as massage and trigger-point release, to help loosen and stretch the muscles. Improve Strength and Speed Recovery Time Certain exercises will aid healing at each stage of recovery; your physical therapist will choose and teach you the correct exercises and equipment to steadily restore your strength and agility. Your physical therapist is trained and experienced in choosing the right treatments and exercises to help you heal, return to your normal lifestyle, and reach your goals faster than you are likely to do on your own.
Return to Activities Your physical therapist will discuss your goals with you and use them to set your work, sport, and home-life recovery goals. Your treatment program will help you reach those goals in the safest, fastest, and most effective way possible. Prevent Future Injury Your physical therapist can recommend a home exercise program to strengthen and stretch the muscles around your shoulder and arm to help prevent future injury. These may include strength and flexibility exercises for the muscles of the neck, shoulder, arm, and scapula. If Surgery Is Necessary Surgery is not frequently needed in the case of snapping scapula syndrome. If surgery is needed, you will follow a postsurgery recovery program over several weeks guided by your physical therapist.
Your therapist will help you minimize pain, regain motion and strength, and return to normal activities in the speediest manner possible after surgery.
Shoulder Bursitis
Educational video describing the condition known as snapping scapula syndrome and its treatment methods. What is snapping scapula syndrome? Snapping scapula syndrome is a condition causing painful grinding, clicking or snapping of the shoulder blade.
Popping Sound In Shoulder Blade Game
Snapping scapula occurs at the scapulothoracic joint and is different from other shoulder related problems. Over 1/3 of the shoulder movement occurs between the scapula and the thoracic cage.
Popping Under Shoulder Blade
The shoulder blade serves as an anchor for the subscapularis and serratus anterior muscles. These muscles as well as the bursa provide for smooth movement of the shoulder. With muscle weakness or inactivity, the scapula may rub on the rib bones during movement.
Snapping scapula can be caused by repetitive motions that lead to inflammation of the bursa or atrophy of the muscles under the scapula. When the scapula cannot easily glide along the chest wall, the bones rub together and produce characteristic noise sensation, painful clicking and grinding. Snapping scapula can be a secondary symptom to shoulder instability, such as dislocation or nerve disorders which may lead to atrophy and weakened muscles. The patient may develop scarring and fibrosis of the bursa, as well as painful scapular crepitus when moving the shoulder blade. Common causes of snapping scapula syndrome:.Weakness, wasting or atrophy of the scapular stabilizing muscles.Bursitis.Osteochondroma.Rib or scapular fractures. Differential diagnosis of snapping scapula syndrome.Snapping noise may originate from other areas of the shoulder such as.Biceps tendon subluxation: a condition where the biceps tendon subluxes out of its groove in the humeral head and slips forward casuing a snapping sensation.Labral tear: condition causing pain often deep in the shoulder that can be associated with a clicking sound during movement of the shoulder.
Treatment of snapping scapula includes: Physiotherapy to improve stability and coordination of the scapular muscles. Injection of the bursa.arm is usually held in a position of extension, internal rotatin and adduction with the patient lying prone.Needle should be placed under the scapular and avoid puncturing the pleura.May need chest x-ray.Needle inserted into the scapulothoracic joint under fluoroscopy with the aid of scapular “Y” view x-ray.The contour of the scapula projects as the letter Y on the x-ray Surgery is rare for debridment of the bursa or removal of bony lump. Debridment is done either open or arthroscopically.