Snapping scapula syndrome is most commonly attributed to repetitive overhead movements, however it can also be caused by any repetitive arm-shoulder movement. In fact, we often see this condition present in people that sit in front of a computer during the day and partake in heavy resistance training programs after work.
Snapping scapula syndrome is a collection of signs and symptoms that include grinding, popping, and/or snapping of the scapula (shoulder blade) against the rib cage during movements. Despite these sounds being of concern, the main issue is the dysfunctional movement and tight muscles/tendons that create the sound.
What Causes Snapping Scapula Syndrome?
This condition can be caused by many different but related causes. The two main culprits are the serratus anterior and the subscapularis muscles.
The serratus anterior lays between the ribcage and the shoulder blade and controls the position of the shoulder blade during movements.
The subscapularis, one of the rotator cuff muscles, sits on the front of the shoulder blade and controls the position of the arm by pulling the arm bone (humerus) into the right proper position during movements.
Any injury of these muscles will result in any of the following: poor shoulder blade posture, atrophy of the shoulder muscles, weakness, and formation of scar tissue. When a muscle atrophies, it inevitably becomes weak. With prolonged weakness the muscle can become inflamed especially if it is being compressed or frictioned with movements.
Once any or all of these processes develop, the shoulder blade rubs against the ribcage and can lead to a snapping sound with movement.
What are Signs and Symptoms of Snapping Scapula Syndrome?
As implied by the name, the most common sign of snapping scapula syndrome is the grating, popping and/or snapping heard during movement of the arm and shoulder
In addition, the person may complain of a dull ache that is difficult to pinpoint. The pain is described as dull and achy and is felt around the entire shoulder region.
With movement, the pain continues to be dull, but may cause sharp pain when the arm is overhead or when reaching behind the body, such as putting on a jacket or reaching into the backseat of a car.
Finally, the syndrome inevitably leads to weakness and lack of coordinated movement of the shoulder.
Physiotherapy, Chiropractic and Massage Therapy Treatment For Snapping Scapula Syndrome
There is good news! Snapping scapula syndrome can be healed. The first step, prior to exercise, is to ensure that the tissues are healthy. Depending on the nature and extent of damage, active release techniques (ART), massage therapy, and/or shockwave therapy can all reduce the amount of scar tissue that has formed.
Carefully applied soft-tissue manipulation can not only reduce scar tissue, but can free the shoulder blade from its poor movement pattern in relation to the ribcage.
An alternative, or more aptly put, an additional form of treatment that can aid in regenerating damaged tissue is acupuncture or dry needling. An additional benefit of the precise insertion of needles into damaged tissues to have a positive effect on the nervous system and relaxing tension. Acupuncture and/or dry needling can aid in the restoration of nerve function which will reduce pain and inflammation, improving both strength and coordination.
Finally, a well designed strengthening, proprioception and flexibility around the shoulder and core will ultimately lead to optimal results.
What are Common Exercises for Snapping Scapula Syndrome?
It is best to start a rehab program while treatment is occurring. Correcting snapping scapula syndrome involves the following approach;
1. Correction of Posture
The cat-cow (or cat-camel) exercise is a simple exercise that can be performed anywhere. Not only does it strengthen the lower and upper back, it also strengthens the little muscles that are responsible for informing your body when it is not in the right position.
- Start on all fours and spine in neutral
- Inhale as your arch you spine, squeeze your shoulder blades together, and lift you head up
- Exhale, reverse the movement by rounding your spine and drawing your chin to your chest
2. Strengthening Shoulder Blade Muscles
The two main muscles we want to strengthen are the serratus anterior and lower trapezius. The serratus anterior can be strengthened by doing pullovers. Strengthening the lower trapezius involves performing Y’s.
- Start on your back with your knees bent and spine in neutral
- Extend both arms overhead and pull your shoulder blades down toward your ears
- Raise your arms until they reach the side of your torso while keeping the shoulder blades pinned against the ribcage
- Start by bending over (spine in neutral) with your arms hanging straight down
- Raise both arms up to a 45 degree angle from your torso while simultaneously squeezing your shoulder blades together
- Keep your thumbs pointed to the ceiling (or to the sky, if you’re outside)
Strengthening Rotator Cuff
To strengthen the rotator cuff, it is important to focus on strengthening both the subscapularis and the infraspinatus/teres minor.
- Start by standing (or sitting) with your arms by your side
- Hold on to a band and pull the band by moving your arm towards the front of your body
- Start by standing (or sitting) with your arms by your side.
- Hold on to a band and pull the band by moving your arm towards the back of your body.