SNAPPING SCAPULA

Snapping scapula syndrome, also known as scapulocostal syndrome or scapulothoracic syndrome is characterized by a grating, grinding, popping or snapping sensation of the scapula (shoulder blade) onto the back side of the ribs or thoracic area of the spine. The scapula is a broad triangular bone attached to the body by strong muscles. It forms the foundation for movements of the arm. Over one third of shoulder movement occurs between the scapula and the ribcage. This movement occurs as a result of frictionless fluid-filled sacs, known as bursae. These form the articulation known as the scapulothoracic joint.

Causes

Snapping scapula is caused by problems in the soft tissues or bones of the scapula and chest wall. It can start when the tissues between the scapula and thoracic area thicken from inflammation. The inflammation is usually caused by repetitive movements. Certain motions of the shoulder done over and over again, such as the movements of pitching baseballs, swimming, or hanging wallpaper, can cause the tissues of the joint to become inflamed.

In other cases, the muscles under the scapula have shrunk (atrophied) from weakness or inactivity. The scapula bone then rides more closely to the rib cage. This means the scapula bumps or rubs on the rib bones during movement.

Changes in the alignment or contour of the bones of the scapulothoracic joint can also cause snapping scapula. When a fractured rib or scapula isn't lined up just right, it can cause a bumpy ridge that produces the characteristic grind or snap as the scapula moves over the chest wall.

Physical Therapy

A physical therapist can diagnose and treat snapping scapula.  He/she will evaluate the posture of your scapula, mechanics of how your shoulder and scapula move together, and strength of the surrounding muscles.  Treatment may include manual therapy to mobilize your shoulder and scapula to promote proper posture and alignment.  Postural stretching and strengthening will also improve the mechanics of your shoulder and scapula.  Ultimately your physical therapist will put you through a scapular stabilization exercise program strengthening muscles of your shoulder and shoulder blade to help stabilize during repetitive movements allowing you to get back to your normal everyday lifestyle without pain.

If you are experiencing any of these symptoms of shoulder pain for any reason, make an appointment with your doctor and or physical therapist for evaluation and treatment.