Snapping scapula syndrome is a common disorder that causes a snapping, grinding, or clicking sound when the shoulder blade movements. It is often caused by repetitive overhead activities, but can also come from trauma or anatomical variations. Symptoms can include pain, weakness, and limited range of motion. Treatment typically includes physical therapy, with specific exercises designed to relax tight muscles, stretch the shoulder girdle, and strengthen the scapular muscles.
causes of snapping scapula
There are several factors that can lead to snapping scapula:
- depressed shoulder girdle: When the shoulder blade is pulled downwards, it can squash the soft tissues between the scapula and rib cage, increasing the chance that the shoulder blade will rub against the structures beneath it.
- atrophy of the muscles underneath scapula: A reduction in the muscle bulk of the subscapularis and serratus anterior will reduce the amount of cushioning between the shoulder blade and rib cage.
- increased tension in erector spinae muscles: Increased tension in these muscles can cause a snapping sensation as the shoulder blade rolls on top of them.
- changes in bone structure: Changes in the shape of the rib cage or scapula can result in increased friction between the surfaces.
- postures that affect the rib cage: Certain postures may affect the ability of the shoulder blade to sit evenly onto the rib cage, such as flat back or twisted torso.
testing for snapping scapula
If you suspect you have snapping scapula, it can be tested with a simple self-assessment. Here's a video that演示了如何在家进行测试：
- Pain and functional questionnaires / health assessment: Questions can range from activities, MOI (mechanism of injury), pain, stiffness with overhead movements, etc.
- physical examination: The examiner may observe asymmetry of the scapulas, scapular winging, poor posture, and the clicking, clicking and crepitus with movement.
- range of motion: Active and passive range of motion can be measured, looking at the motion quality, quantity, coordination, and whether symptoms are reproduce.
- joint accessary motion: The examiner may perform special tests to rule out other shoulder pathologies.
- palpation: Feel for bony deviations, soft tissue atrophy, or palpable crepitus.
- diagnostic imaging: X-rays or MRIs can show bony abnormalities or soft tissue inflammation between the ribs and scapula.
treatments for snapping scapula
Treatment typically includes physical therapy. Some of the exercises designed to treat snapping scapula include:
- releases: To relax tight muscles, such as the pectorals major/minor, subclavius, latissimus dorsi, serratus anterior, lower trapezius, etc.
- stretches: For the chest, serratus anterior, latissimus dorsi, lower trapedzius, etc.
- increase padding behind scapula: To increase cushioning and reduce friction between the rubbing surfaces, such as the serratus anterior or subscapularis.
- scapula control: To control the scapula, including posterior tilt, retraction, and elevation.
- strengthening exercises: To engage the appropriate muscles that help place the scapula into the correct position, such as elbows flare, arm lift (prone), wall angel exercise, shrugs.
- correct shoulder position: To place the shoulders into a better position, such as elevation, upward rotation, retraction, posterior tilt.
- address posture: To correct certain postures that may encourage the shoulder blade to rub against the structures beneath it, such as hunchback posture or flat thoracic spine.
- surgery: For structural changes to the bony surfaces of the rib and/or scapula, scapulothoracic bursitis from trauma or repetitive movements.
how to start treating snapping scapula
To start treating snapping scapula, it's important to seek guidance from a healthcare professional. They may recommend physical therapy, with specific exercises designed to relax tight muscles, stretch the shoulder girdle, and strengthen the scapular muscles. It's also important to maintain an upright posture, avoid slumping, and use appropriate techniques when performing overhead arm movements.
Remember to always listen to your body and start gradually, making sure to warm up before and cool down after any exercise. With consistent treatment, many people with snapping scapula can find relief and improve their shoulder function.
