PT eDigest

SICKWhen Your Shoulder Blade Is “SICK”

Do you have a “SICK” scapula? No, not sick with a fever or a cold, but SICK—an abnormal condition of the shoulder blade. This condition is characterized by

  • Scapular malposition: The scapula has moved to an abnormal position on the rib cage.
  • Inferior medial border prominence: The scapula protrudes abnormally along the back.
  • Coracoid pain and malposition: Pain at the top of the shoulder is caused by movement of the coracoid process (a bony projection from the neck of the scapula) to an abnormal position.
  • dysKinesis abnormalities: The scapula moves abnormally as the arm moves (also called scapular dyskinesis).

The scapula (shoulder blade) is attached to the rest of your skeleton only at the clavicle (collarbone). It is held in place by multiple muscles that must be strong enough to keep it stable but flexible enough to allow arm movement in multiple planes. SICK scapula develops most often in athletes, such as pitchers, volleyball players and tennis players, who make repetitive, forceful overhead movements.

Repeated overhead motion creates abnormal stresses on the muscles that hold the scapula in place. As a result, some muscles weaken while others tighten, and the scapula is pulled out of position. Eventually the affected shoulder will appear lower than the normal shoulder, and the scapula may visibly push out or protrude from the back. Other symptoms include severe pain at the top, front or back of the scapulaheaviness in the arm when performing overhead activities; or a noticeable hitch or jump in scapular motion when the arm moves.

A SICK scapula is corrected by strengthening the muscles that hold the bone in place. If you have received a diagnosis of SICK scapula or scapular dyskinesis, we can design an exercise program to strengthen the muscles that hold the scapula in place in a balanced, corrective way. If left untreated, SICK scapula can progress to conditions that need surgical correction or end an athletic career. We can provide an exercise program to help alleviate your shoulder pain.

Download the PTedigest for April 2014