Snapping Scapula

ExitCare ImageSnapping scapula is a condition that is marked by persistent "snapping" of the shoulder blade (scapula). You may feel a snapping sensation or hear a snapping sound. You may feel shoulder pain or discomfort. The scapula rubbing against the ribs of the chest wall causes the snapping sensation/sound. Fluid-filled sacs (bursae) exist under the scapula to reduce the friction between the scapula and the ribs. If these sacs become irritated, a condition known as inflammation of the bursae (bursitis) may occur. This may cause pain.

SYMPTOMS

  • Snapping, grating, or popping of the shoulder or scapula heard and/or felt.

  • Pain or discomfort in the area of the scapula.

  • Bump felt on the scapula.

  • Affected scapula may be more prominent. It may hurt to sit on a chair with a high back.

CAUSES

Snapping scapula may be caused by:

  • Bony alterations of the scapula.

  • Soft tissue growths (normal variants or benign or malignant tumors).

  • Muscle atrophy that produces scapular instability.

Repetitive shoulder motions that cause inflammation of the bursae that lie beneath the scapula may worsen the condition. Direct injury may result in bursitis.

RISK INCREASES WITH:

  • Contact or collision sports, sports with inadequate protection of exposed areas.

  • Poor shoulder strength and flexibility.

  • Inadequate warm-up before practice or play.

  • Muscular imbalance or atrophy of the muscles of the scapula.

  • Previous fracture of the scapula or ribs.

PREVENTION

  • Wear properly fitted and padded protective equipment.

  • Allow time for enough rest and recovery between activities.

  • Warm up and stretch properly before activity

  • Learn and use proper techniques to stabilize the shoulder during athletics.

  • Maintain physical fitness:

  • Capsular muscle strength.

  • Endurance and flexibility.

  • Cardiovascular fitness.

PROGNOSIS

With proper treatment symptoms usually resolve.

RELATED COMPLICATIONS

  • Prolonged healing time if not properly treated or if not given adequate time to heal.

  • Chronically inflamed bursa, causing persistent pain with activity that may progress to constant pain.

  • Recurrence of symptoms if:

  • Activity is resumed too soon.

  • There is overuse.

  • There is a direct blow.

  • Poor technique is used.

TREATMENT

Treatment initially involves ice and medicine to help reduce pain and inflammation. It is often helpful to:

  • Complete strength and stretching exercises.

  • Modifying activities that cause symptoms to get worse.

Exercises may be completed at home or with a therapist. Occasionally, the shoulder will be injected with a corticosteroid to reduce inflammation. For severe cases, surgery may be advised to remove the inflamed bursa. Surgery will only be considered if greater than 6 months of non-surgical treatment does not help.

MEDICATION

  • If pain medicine is necessary, then nonsteroidal anti-inflammatory medicines, such as aspirin and ibuprofen, or other minor pain relievers, such as acetaminophen, are often recommended.

  • Do not take pain medicine for 7 days before surgery.

  • Prescription pain relievers are usually only prescribed after surgery. Use only as directed and only as much as you need.

  • Corticosteroid injections may be given. However, this is only for extreme cases. There is a limited number of injections one may receive.

HEAT AND COLD

  • Cold treatment (icing) relieves pain and reduces inflammation. Cold treatment should be applied for 10 to 15 minutes every 2 to 3 hours for inflammation and pain and immediately after any activity that aggravates your symptoms. Use ice packs or massage the area with a piece of ice (ice massage).

  • Heat treatment may be used prior to performing the stretching and strengthening activities prescribed by your caregiver, physical therapist, or athletic trainer. Use a heat pack or soak your injury in warm water.

SEEK MEDICAL CARE IF:

  • Symptoms get worse or do not improve in 2 weeks despite treatment.

  • New, unexplained symptoms develop (drugs used in treatment may produce side effects).