Welcome to Orleans Physiotherapy's patient resource about Snapping Scapula Syndrome.
The scapulothoracic joint is located where the shoulder blade (also called the scapula) glides along the chest wall (the thorax). When movement of this joint causes feelings or sounds of grating, grinding, popping, or thumping, doctors call it snapping scapula syndrome.
Snapping scapula syndrome is fairly rare. When it happens, the soft tissues between the scapula and the chest wall are thick, irritated, or inflamed. Snapping scapula syndrome can also happen if the bones of the shoulder blade or rib cage grate over one another.
This article will help you understand:
what causes snapping scapula syndrome
how doctors treat this condition
Hear from some of our patients who we treated for Shoulder Pain
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My shoulder was recently badly inflamed and any movement was very painful to the point where i could not lift my arm more than shoulder height. I made an appointment with Clifton Charie who used... ”
“ My shoulder was recently badly inflamed and any movement was very painful to the point where i could not lift my arm more than shoulder height. I made an appointment with Clifton Charie who used acupuncture needles and physiotherapy. Within a day my shoulder was much improved. By 2 days the pain was gone. We are so fortunate to have this resource in our community. ”
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Clint is an amazing Physiotherapist and you can tell he truly cares about your well being. He has helped me so much with my shoulder and hip. All the staff there are super friendly and so kind. I feel... ”
“ Clint is an amazing Physiotherapist and you can tell he truly cares about your well being. He has helped me so much with my shoulder and hip. All the staff there are super friendly and so kind. I feel very well cared for. ”
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Clint Dulude physiotherapist, this clinic has ample parking the staff is super friendly and they have helped me to rehabilitate my shoulder. I highly recommend they are knowledgable and take the time... ”
“ Clint Dulude physiotherapist, this clinic has ample parking the staff is super friendly and they have helped me to rehabilitate my shoulder. I highly recommend they are knowledgable and take the time and effort to get you back to your original state of health prior to an injury ”
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After many months of poor sleep and debilitating shoulder pain, I met with Jag. She is incredibly gentle, explains very well what is happening and makes suggestions. On my first appointment... ”
“ After many months of poor sleep and debilitating shoulder pain, I met with Jag. She is incredibly gentle, explains very well what is happening and makes suggestions. On my first appointment (evaluation), I was there for nearly 2 hours, which I didn't expect. She is very thorough and I am confident that with her continued care, the pain will abate. I am extremely satisfied with the service and level of care, and definitely recommend. ”
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I can’t recommend Orleans physiotherapy highly enough! The atmosphere and people there, are friendly and welcoming. I have been under the care of Clint Delude, an incredible, knowledgeable... ”
“ I can’t recommend Orleans physiotherapy highly enough! The atmosphere and people there, are friendly and welcoming. I have been under the care of Clint Delude, an incredible, knowledgeable physiotherapist, for the last 10 years or so, (having been to other practices without success). He is also an extremely good diagnostician, and was spot on for my shoulder injury long before my X-ray and imaging. I have seen him for pre-and post operative treatment, chronic pain, and accidents as well. He is very professional and extremely well-versed in his field. He shows a generosity of spirit in his dealing with clients. His email follow-up exercises are a great help. He has also treated family members. Clint goes above and beyond. Very impressed. Deborah ”
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Natasha provided evidence-based treatment and advice at every stage of rehab for my rotator cuff condition. The treatments gave excellent pain relief, which was especially important early on. The... ”
“ Natasha provided evidence-based treatment and advice at every stage of rehab for my rotator cuff condition. The treatments gave excellent pain relief, which was especially important early on. The exercises helped me to gain strength and regain mobility for ordinary tasks. She adapted the plan perfectly as I progressed and I feel well-prepared to restart activities I enjoy. Many thanks! ”
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I had the chance to do several months of physiotherapy, with Clint Dulude, following shoulder surgery. The service of all staff members at Orléans Physio is professional, courteous and helpful. In... ”
“ I had the chance to do several months of physiotherapy, with Clint Dulude, following shoulder surgery. The service of all staff members at Orléans Physio is professional, courteous and helpful. In addition, the staff offers service in French. Thanks to the whole team. ”
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I have been to this clinic prior to this series of treatments and was always satisfied. This time, I was seen by Natasha Greene who is very professional and an excellent physiotherapist. She was... ”
“ I have been to this clinic prior to this series of treatments and was always satisfied. This time, I was seen by Natasha Greene who is very professional and an excellent physiotherapist. She was committed to helping me resolve my shoulder pain issues and always provided me with the best treatment experience possible. I highly recommend Natasha. ”
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(Translated by Google) I had the chance to do several months of physiotherapy, with Clint Dulude, following shoulder surgery. The service of all staff members at Orléans Physio is professional,... ”
“ (Translated by Google) I had the chance to do several months of physiotherapy, with Clint Dulude, following shoulder surgery. The service of all staff members at Orléans Physio is professional, courteous and helpful. In addition, the staff offers service in French. Thanks to the whole team. (Original) J'ai eu la chance de faire plusieurs mois de physiothérapie, avec Clint Dulude, suite à une chirurgie à l'épaule. Le service de tous les membres du personnel chez Orléans Physio est professionnel, courtois et serviable. En plus, le personnel offre un service en français. Merci à toute l'équipe. ”
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I am thrilled to say how pleased I am with the amazing, professional, knowledgeable and always up-to-date staff at Orleans Physiotherapy from the front desk staff to the health care professionals. I... ”
“ I am thrilled to say how pleased I am with the amazing, professional, knowledgeable and always up-to-date staff at Orleans Physiotherapy from the front desk staff to the health care professionals. I had gone to see them 15 years ago for a back issue and later a knee issue. I am now there for neck, shoulder, arm pain. Natasha Green is one of the newer members on the team and I cannot say enough about her expertise, compassion and knowledge. She uses techniques that work magic on my pain - dry needling, manual therapy (where she pinpoints precisely the area of need), laser etc. And of course, Orleans Physiotherapy follows all Covid protocols to ensure everyone is safe. I highly recommend Orleans Physiotherapy! ”
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Thank you to Courtney who scheduled me on short notice with Clint!! My pain level was so intense that it felt like I got hit with a basrball bat across my shoulder blades and neck!! Clint's treatment... ”
“ Thank you to Courtney who scheduled me on short notice with Clint!! My pain level was so intense that it felt like I got hit with a basrball bat across my shoulder blades and neck!! Clint's treatment provided immediate relief from day one. He also provided some exercise to strengthen my neck, suggested follow-up treatment which Courtney scheduled with grace and a smile!! I value Clint's expertise and appreciate the excellent service received by staff of this clinic. I always know I'm in good hands with the staff at Orleans Centre for Physiotherapy!! Thank you!! ”
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I went to see Clint for my shoulder pain due to an RSI. I am a relatively fit active person with an educational background in rehabilitation. I can assuredly say that Clint is very knowledgeable and... ”
“ I went to see Clint for my shoulder pain due to an RSI. I am a relatively fit active person with an educational background in rehabilitation. I can assuredly say that Clint is very knowledgeable and friendly. He makes treatments a pleasant experience, and I'm already seeing some relief after just a few treatments. I highly recommend him! ”
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I have used Orleans Physiotherapy for about 10 years. Clifton Charie and Clint Dulude have been my physiotherapist who have provided excellent treatment for neck and shoulder problems. Their service... ”
“ I have used Orleans Physiotherapy for about 10 years. Clifton Charie and Clint Dulude have been my physiotherapist who have provided excellent treatment for neck and shoulder problems. Their service has been outstanding and has enabled me to recover from each episode and to continue to work. ”
What parts of the body are involved in this condition?
The shoulder is made up of three bones: the humerus (upper arm bone), the clavicle (collarbone), and the scapula (shoulder blade). Two large muscles attach to the front part of the scapula where it rests against the chest wall. One of them, called the subscapularis muscle, attaches over the front of the scapula where it faces the chest wall. The serratus anterior muscle attaches along the edge of the scapula nearest the spine. It passes in front of the scapula, wraps around the chest wall, and connects to the ribs on the front part of the chest.
Scapula Muscles
A bursa is a fluid-filled sac that cushions body tissues from friction. A bursa sits between the two muscles of the scapula. There is also a bursa in the space between the serratus anterior muscle and the chest wall. When bursa sacs become inflamed, the condition is called bursitis.
Bursa
Scapulothoracic bursitis refers to inflammation in the bursa under the shoulder blade. This type of bursitis is most common in the upper corner of the scapula nearest the spine. It also occurs under the lower tip of the scapula. In either case, it can cause the sounds and sensations of snapping scapula syndrome. A person can have bursitis in the joint without any grinding or popping.
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 shoulder blade 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 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.
Grinding and snapping can also happen if there are any abnormal curves, bumps, or ledges on the upper edge of the scapula closer to the center of the back. (These abnormalities are called Luschka's tubercles.) Any time there is an abnormality in the bone, one of the body's possible responses is to form a bursa. The new bursa may then become inflamed, causing the symptoms of bursitis.
Symptoms
What symptoms does snapping scapula cause?
Grating, grinding, or snapping may be heard or felt along the edge or undersurface of the scapula as it moves along the chest wall. These grinding sensations are also called crepitus. Sometimes the joint pops or thumps during movement. Often, these sensations cause no pain.
Scapulothoracic bursitis, on the other hand, is painful whether or not there is any crepitus in the joint. The sore bursa is usually tender to the touch, and the tissue in the sore area often feels thick.
Diagnosis
When you visit Orleans Physiotherapy, our physiotherapist will ask many questions about your medical history. Our goal is to find out if you've had similar problems in the past, if you've injured your scapula, and if any of your activities require repetitive shoulder movements.
Our physiotherapist will also do a physical exam. He or she will check the alignment of the scapula, and will listen with a stethoscope while you move your shoulder and scapula. You may feel pain as you move, but it is important that our physiotherapist knows exactly where your problem is coming from. By feeling the tissues around the scapula, we can find out if the bursa is tender or thickened from inflammation.
Some patients may be referred to a doctor for further diagnosis. Once your diagnostic examination is complete, the physiotherapists at Orleans Physiotherapy have treatment options that will help speed your recovery, so that you can more quickly return to your active lifestyle.
Orleans Physiotherapy provides services for physiotherapists in Orleans.
Our Treatment
Non-surgical Rehabilitation
Nonsurgical treatment is preferred for patients with snapping scapula. These types of treatments are generally successful, especially when the problem is coming from soft tissues. Your physiotherapist at Orleans Physiotherapy may start by recommending nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen. Rest and ice also help reduce inflammation and ease pain.
Our physiotherapist will also evaluate your posture to make sure that your spine and shoulder bones are in their best alignment. We may also have you do a strengthening program to bulk up the muscles under the scapula. This can help pad and cushion the soft tissues between the scapula and rib cage.
Post-surgical Rehabilitation
Therapy is more involved after surgery. Patients wear a sling following scapula surgery. Your physiotherapist will have you begin passive shoulder movements soon after surgery. But there should be no active exercises for about eight weeks, to make sure the muscles are firmly healed where they were sewn back into the drill holes in the scapula. Our post-surgical patients usually start doing resistive exercise and activities after 12 weeks.
At Orleans Physiotherapy, our goal is to help speed your recovery so that you can more quickly return to your everyday activities. When your recovery is well under way, regular visits to our office will end. Although we will continue to be a resource, you will be in charge of doing your exercises as part of an ongoing home program.
Orleans Physiotherapy provides services for physiotherapy in Orleans.
Surgery
Doctors usually recommend surgery only if nonsurgical treatments have failed. Surgery may be needed if the problem is caused by a bone abnormality. In the most common surgery for snapping scapula, the surgeon takes out a small piece of the upper corner of the scapula nearest to the spine.
Bone Resection
To remove a small piece of the scapula, an incision is made just below the bone's top edge. The surgeon pulls aside the tissues to show the prominent section of the bone, called the:
Spine of the Scapula
The tissues that attach muscles to the upper part of the scapula are carefully detached and moved out of the way. Then the surgeon uses a special tool to:
Remove the Corner of the Scapula
Drill holes are made into the spine of the scapula. Then the ends of the upper scapular muscles are:
Sewn Back
onto the spine of the scapula, and the incision is closed up.
Arthroscopic Bursectomy
Surgeons sometimes do arthroscopic surgery to take out an inflamed scapulothoracic bursa. Removing a bursa is called bursectomy. Small incisions allow the surgeon to insert a small TV camera, called an arthroscope, into the joint. Through another small incision, the surgeon uses special instruments to remove the inflamed bursa while the arthroscope shows what is happening.
