What is snapping scapula syndrome? Causes, symptoms, treatment, and exercises

Snapping scapula syndrome is a condition where an individual can experience grinding or clicking sounds originating in the shoulder area. The precise anatomical location is the scapulothoracic joint, and it’s located in the area where the scapula rests against the chest wall.

When you move the muscles in the shoulder, a grinding, grating, and thumping sound can be appreciated in those suffering from snapping scapula syndrome.

What are the causes and symptoms associated with snapping scapula syndrome?

There are many reasons for snapping scapula syndrome to develop. They all involve the bones located in the shoulder area and the tissues of the anatomy of the scapula joint. The following are some of the causes for the condition:

Inflammation: Repetitive movements can cause the tissues between the scapula and shoulder blade to thicken from inflammation. These movements include motions over the shoulder, such as pitching a ball or hanging wallpaper.

Inactivity: When muscles are not used for extended periods of time, they begin to shrink or atrophy. This can occur from weakness or inactivity. Because the scapula is in close proximity to the rib bones, the lack of robust tissue leads these bones to rub up against each other, producing sound.

Alignment/contour change: Changing the alignment or shape of bones of the scapulothoracic joint can cause snapping scapula syndrome. This may occur due to a fractured rib or scapula that hasn’t healed correctly, leading to misalignment of its position in relation to the other bones around it. Having abnormal bumps, curves, or ledges on the upper edge of the scapula can also lead to a grinding and snapping sound.

Dislocation: Suffering an accident that causes a dislocation of the shoulder joint may lead to a rearrangement of the bone structure and may also cause pain.

Symptoms of snapping scapula syndrome include:

• Grating, popping, and snapping sounds heard and felt along the shoulder (medically known as crepitus)
• Popping sounds are heard during movement and may or may not be accompanied by pain
• It may be very painful with the inability to move the shoulder
• Pain may be experienced over the should with the sensation felt and increased with touch at the scapula joint

How to diagnose snapping scapula syndrome?

It is a good idea to report all acute cases of snapping scapula syndrome to your local doctor right away, as they will be able to rule out any serious shoulder related conditions.

When seeing a doctor, they will take a past history to see if you have encountered any similar symptoms before. This will include any previous shoulder related injuries you may have suffered. To get a better appreciation of the sounds produced, a stereoscope will be placed on the joint in question while you move it. Pain will be noted if experienced during this assessment.

Once this initial evaluation in completed, more precise testing will be needed and come in the form of imaging scans. This may include a computer tomography scan (CT) or a magnetic resonance imaging study (MRI). Both are great for taking a detailed look at the joint. However, MRIs are better for looking at soft tissue compared to CT.

Treating snapping scapula syndrome

When a case of snapping scapula syndrome first appears, many medical professionals recommend doing the following within the first 24 to 48 hours.

• Rest the area. Refrain from lifting your arm overhead or performing movement that leads to pain
• Apply ice packs around the scapula for 15-20 minutes every 2 hours
• Insure upright posture when sitting or standing
• Seek the care of a doctor

Depending on your particular cause for the condition, treatment options may vary. Fortunately snapping scapula syndrome is a treatable condition, with non-surgical treatments being the most commonly used methods. This includes the use of anti-inflammatory medication, such as aspirin or ibuprofen. Physiotherapy can be tailored to fit a specific individual and their needs. Physiotherapy will help in the following areas:

• Reducing pain
• Improve motion
• Improve flexibility
• Improve strength
• Speed up recovery time
• Prevent future injury

While surgery is rarely needed in this condition, it may be an option for severe cases of snapping scapula syndrome. Causative issues related to the bone of the scapula joint may require bone resection in the operating room, however, surgery does not guarantee that the syndrome will not appear again at a later time.

Snapping scapula syndrome exercises

The goals of rehabilitation in snapping scapula syndrome are improving muscle strength and balance, addressing postural conditions, and core strengthening.

Having poor posture, with the head tilted forward, is thought to cause the posterior scapular stabilizer muscles to weaken in comparison to the anterior pectoral muscles. This can lead to imbalances that may change the scapular resting position and decrease scapular elevation.

With the aid of a trained physiotherapist, exercises to help boost strength and stability of the shoulder may help mitigate the symptoms of snapping scapula syndrome.

Some exercises include:

• Exercises that selectively restore trapezial muscle balance
• Slide-lying forward flexion
• Side-lying external rotation
• Prone abduction and external rotation

Related: Pain between shoulder blades: Causes, symptoms, and treatments

---