Physical Therapy in North Aurora, Batavia and Aurora for Shoulder
Welcome to Physical Therapy Advantage'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
“
Shea, Tracy, and the rest of the team at Physical Therapy Advantage helped me through a recurring problem I had with my shoulder/arm. Their knowledge of anatomy and ability to clearly describe what... ”
“ Shea, Tracy, and the rest of the team at Physical Therapy Advantage helped me through a recurring problem I had with my shoulder/arm. Their knowledge of anatomy and ability to clearly describe what was causing my pain was impressive and spot on. The dry needling therapy with Tracy helped relieve tension and knotting in muscles around my shoulder area.The stretching & exercises were also highly effective and I couldn’t be happier with the service. I went through nearly 2 months of therapy and it helped get my shoulder back to full strength. I still use the stretching techniques & exercises they taught me to loosen up before I work out. ”
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North Aurora office is terrific! Was referred in 2019 for an ankle issue that Joe fixed in a few sessions. When I started having rotator cuff issues and didn't immediately want surgery, I didn't... ”
“ North Aurora office is terrific! Was referred in 2019 for an ankle issue that Joe fixed in a few sessions. When I started having rotator cuff issues and didn't immediately want surgery, I didn't hesitate to return to them. Very caring group that gives you a full hour of attention as well as a bunch of educational videos and exercises. I couldn't be more thrilled with my results! ”
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I have been at Physical Therapy Advantage for over 2 years and Julie Crane was my PT and she was fantastic. I came in with a lot of muscle weakness/pain on my left shoulder which caused some headaches... ”
“ I have been at Physical Therapy Advantage for over 2 years and Julie Crane was my PT and she was fantastic. I came in with a lot of muscle weakness/pain on my left shoulder which caused some headaches and she drastically improved my quality of life over the period of time I was seeing her. She listens and knows her anatomy very well and is willing to try multiple things to see what works best for you. She is kind, patient and genuinely cares and just an overall amazing person. I thank Julie for her service and I will continue to recommend this business to anyone that is willing to go. ”
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I am a Batavia resident, so glad I discovered Physical Therapy Advantage just 5 minutes away on Randall in North Aurora. I went there after shoulder surgeries and they did a great job. Then had to go... ”
“ I am a Batavia resident, so glad I discovered Physical Therapy Advantage just 5 minutes away on Randall in North Aurora. I went there after shoulder surgeries and they did a great job. Then had to go just last week for vestibular therapy after my first vertigo experience. Julie is great and I only needed one treatment. If you want your physical therapy in a small, warm, family-type atmosphere instead of an impersonal corporate chain, I really recommend the highly skilled, nice people at Physical Therapy Advantage! ”
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Joe, Christine, Julie and staff were awesome. Great help for rehabbing if my shoulder, professional, knowledgeable and just great people. Thank you all! ”
“ Joe, Christine, Julie and staff were awesome. Great help for rehabbing if my shoulder, professional, knowledgeable and just great people. Thank you all! ”
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Quality. Caring. Professional. Community driven. Physical Therapy Advantage stands as a shining star in the North Aurora area. I previously worked there as an aide and was blown away by the amount of... ”
“ Quality. Caring. Professional. Community driven. Physical Therapy Advantage stands as a shining star in the North Aurora area. I previously worked there as an aide and was blown away by the amount of care and professionalism Joe, Julie, and the Team carried themselves with. Years later I am now returning as a client for my shoulder and low back pain (I wouldn't think of going anywhere else). Julie has been able to relieve me of back pain that I had previously deemed as "something I will have to live with" as well as helped me with the numbness in my fingers. So yes, I would and have recommended Physical Therapy Advantage to anyone and everyone who needs it. ”
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I saw both Dana and Julie at Physical Therapy Advantage for shoulder pain and numbness. The whole staff is so wonderful and friendly as well as accommodating. Their knowledge and experience is... ”
“ I saw both Dana and Julie at Physical Therapy Advantage for shoulder pain and numbness. The whole staff is so wonderful and friendly as well as accommodating. Their knowledge and experience is phenomenal. I couldn’t sleep for weeks because of the pain and discomfort. Upon seeing Julie for Dry needling I was 40% better after my first session. I finally slept through the night. After four dry needling sessions I was 100% pain and discomfort free. I cannot give them enough credit for helping me out. Thank you, Julie, Dana, and staff stir everything! ”
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You can’t go wrong with the people and treatment at PTA. Joe, Julie, and Shae are the best...I couldn’t recommend one over the other. The staff that assists them are personable and professional... ”
“ You can’t go wrong with the people and treatment at PTA. Joe, Julie, and Shae are the best...I couldn’t recommend one over the other. The staff that assists them are personable and professional and a pleasure to “work” with during the exercise phase. I have been to PTA numerous times for hip, neck, and shoulder issues and have complete confidence in their ability to treat me. I have found Joe King to be a master at evaluating your condition and recommending treatment. Happy 13th Anniversary and many, many more! ”
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I came to Physical Therapy Advantage with shoulder impingement. The staff was great. They really worked on my shoulder tightness and challenged me to complete my homework exercises. After several... ”
“ I came to Physical Therapy Advantage with shoulder impingement. The staff was great. They really worked on my shoulder tightness and challenged me to complete my homework exercises. After several weeks of therapy, my shoulder pain was all but gone and I had a greater range of motion with my shoulder. I can't recommend PTA enough! ”
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I had both shoulders operated on within 60 days. The 2nd one was a total replacement. I had no use of my bad arm for over a year due to pain. I am now 4 months from surgery and have full use of my... ”
“ I had both shoulders operated on within 60 days. The 2nd one was a total replacement. I had no use of my bad arm for over a year due to pain. I am now 4 months from surgery and have full use of my arm thanks to the staff at Physical Therapy Advantage. From top to bottom, they all care about one thing, making you their customers better. Thanks to all of you. ”
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I really appreciated the care and attention from Joe, Julie and the rest of the team. My doctor has been very pleased with my progress, and since unfortunately, I have had another rotator cuff surgery... ”
“ I really appreciated the care and attention from Joe, Julie and the rest of the team. My doctor has been very pleased with my progress, and since unfortunately, I have had another rotator cuff surgery 2 days ago (other shoulder), will be going back to the friendly confines of PTA. I would highly recommend them. ”
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After just one visit to PTA, my shoulder pain was vastly reduced and range of motion increased. After two treatments per week for 3-4 weeks, I have full range of motion restored and no pain. With... ”
“ After just one visit to PTA, my shoulder pain was vastly reduced and range of motion increased. After two treatments per week for 3-4 weeks, I have full range of motion restored and no pain. With their friendly, cheerful and knowledgeable therapists and staff, I highly recommend PTA. ”
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I had the pleasure of working with the staff at PTA after bilateral knee replacement in 2015, and again after rotator cuff surgery in 2016. Absolutely amazing. Everyone is so positive, fun and upbeat,... ”
“ I had the pleasure of working with the staff at PTA after bilateral knee replacement in 2015, and again after rotator cuff surgery in 2016. Absolutely amazing. Everyone is so positive, fun and upbeat, while encouraging you to work hard and make progress. Julie especially was extraordinary. Even when I wasn't sure I was able to do certain things, she calmly and confidently showed me that I could. I'm hoping to take a break from surgeries, but they would be my go-to place if need be! ”
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Greeted me with professional kindness and helped with their thorough review of my needs. They carried out the required therapy and that special touch that only a true professional can deliver. Very... ”
“ Greeted me with professional kindness and helped with their thorough review of my needs. They carried out the required therapy and that special touch that only a true professional can deliver. Very successful in my rehabilitation from rota-tor repair. ”
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 Physical Therapy Advantage, our Physical Therapist 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 Physical Therapist 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 Physical Therapist 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 Physical Therapists at Physical Therapy Advantage have treatment options that will help speed your recovery, so that you can more quickly return to your active lifestyle.
Physical Therapy Advantage provides services for Physical Therapists in North Aurora, Batavia and Aurora.
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 Physical Therapist at Physical Therapy Advantage 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 Physical Therapist 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 Physical Therapist 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 Physical Therapy Advantage, 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.
Physical Therapy Advantage provides services for Physical Therapy in North Aurora, Batavia and Aurora.
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.
