Snapping scapula is characterized by a “snapping” of the shoulder blade (scapula) that can often be heard or felt by the patient when rolling the shoulder. This condition typically results from abnormal movement of the scapula. The snapping may be painful and affect shoulder function, or there may be little or no pain with normal function.
What Is Snapping Scapula Syndrome?
The snapping is caused by inflamed and swollen bursal tissue catching between the scapula and the chest wall ribs. The bursal tissue between the scapula and chest wall serves to protect structures as they glide back and forth against each other.
The bursa may become inflamed as the scapula moves back and forth, resulting in bursitis and producing the “snapping” sensation. Muscle atrophy and poor scapular mechanics are the most common cause for the shoulder blade to move abnormally and rub against the chest wall, aggravating the bursa.
Causes and Risk Factors
Causes and risk factors for snapping scapula can include:
- Prominent bony alterations of the scapula or soft tissue growths
- Muscle atrophy and poor scapular mechanics
- Repetitive motion that causes inflammation, thickening, and scarring of the bursa
- Direct injury that results in bursal inflammation
- Repetitive overhead activities, such as swimming or throwing
- Poor physical conditioning, including 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
- Compensation for another shoulder injury
- Prolonged shoulder inactivity or sling immobilization that results in abnormal scapular movement and subsequent bursitis
A benign soft-tissue growth called an elastofibroma can also form under the scapula and cause symptoms.
Symptoms
Frequent signs and symptoms of snapping scapula include:
- Snapping, grating, or popping of the shoulder or scapula that can be felt on the back or chest wall
- A feeling that the scapula is “jumping” out of place
- Pain from the scapula
- The affected scapula may be more prominent
Diagnosis
Snapping scapula is characterized by snapping of the shoulder blade that can often be heard or felt when rolling the shoulder. The snapping may be painful and affect shoulder function, or there may be little or no pain with normal function.
Treatment
Initial treatment consists of stretching and strengthening exercises and avoiding the activity that initially caused the problem. Referral to a physical therapist or athletic trainer for treatment is often necessary.
An injection of cortisone into the inflamed scapular bursa may be recommended.
Surgery to remove the bursa, bony prominence, or soft tissue mass may be recommended, but this is usually considered only after conservative treatment has failed.
Recovery and Outcomes
Outcomes are generally good with time and appropriate treatment. Most patients improve with conservative measures, including rest and physical therapy to restore proper scapular mechanics.
In some cases, injections or surgery may be necessary.
When to See Dr. Chudik
If snapping, grating, or popping of the shoulder blade is painful, affects shoulder function, or symptoms persist or worsen despite conservative treatment, contact Dr. Chudik’s office for an evaluation.
Call 630-324-0402, email contactus@chudikmd.com, or request an appointment online.