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Description
Snapping scapula syndrome is a condition that causes the scapula/shoulder blade to make a popping or snapping sound or sensation during movement. This condition can be painful and irritating, but with early intervention and management, it can be treated effectively.

Anatomy of the Scapula
The scapula is a triangular-shaped bone located on the upper portion of the back. The scapula forms a false joint with the back of the rib cage referred to as the scapulothoracic joint. The front of the scapula is lined by the subscapularis and serratus anterior muscles. The scapula has 3 bursa which are fluid filled sacs that prevent friction between bone and the muscle attachments.

Who is commonly affected by SSS?

  • Young active patients.
  • Overhead athletes.
  • Repetitive overhead overuse.

Causes:

  • Anatomical/bony variations.
  • Repetitive trauma.
  • Increased thoracic kyphosis/curvature.
  • Uncoordinated movement of shoulder muscles

Symptoms

  • Pain with overhead movements.
  • Audible and palpable sounds with shoulder movements.
  • Pain located at the upper and inner part of the shoulder blade.

Diagnosis

Diagnosis is made clinically. Imaging in the form of x-rays and/or MRI is useful in detecting the exact cause of the condition.

Physiotherapy Management of Snapping Scapula Syndrome

  • Education on avoidance of painful activities.
  • Optimizing range of motion at the neck and upper back.
  • Strengthening of muscles acting on the shoulder and scapula.
  • Advised for 3-6 months in conjunction with anti-inflammatories.

Invasive management:

  • Corticosteroid injection into the bursa.
  • Shockwave therapy which enhances blood flow and encourages healing at the site of injury.
  • Bursectomy in which the bursa is removed.

If you are battling with shoulder pain, it is advised to have it assessed by an experienced physiotherapist. Call 011 027 211 to do so.

References

1.Baldawi, H. et al. (2021) ‘Diagnosis and treatment of snapping scapula syndrome: A scoping review’, Sports Health: A Multidisciplinary Approach, 14(3), pp. 389–396. doi:10.1177/19417381211029211. 
2.Carvalho, S.C. et al. (2019) ‘Snapping scapula syndrome: Pictorial essay’, Radiologia Brasileira, 52(4), pp. 262–267. doi:10.1590/0100-3984.2017.0226. 
3.Kibler, W.B. and Sciascia, A. (2019) ‘Evaluation and management of Scapular dyskinesis in overhead athletes’, Current Reviews in Musculoskeletal Medicine, 12(4), pp. 515–526. doi:10.1007/s12178-019-09591-1. 
4.McClure, P. et al. (2009) ‘A clinical method for identifying scapular DYSKINESIS, part 1: Reliability’, Journal of Athletic Training, 44(2), pp. 160–164. doi:10.4085/1062-6050-44.2.160. 
5.Nascimento, A.T. and Claudio, G.K. (2018) ‘Snapping scapula syndrome: Arthroscopic surgical treatment’, Revista Brasileira de Ortopedia (English Edition), 53(6), pp. 728–732. doi:10.1016/j.rboe.2017.09.012.