Scapular Pain Treatments and Exercises
Scapular pain can be a devastating and debilitating illness, especially for people who are always on the go and busy with their daily activities. There are numerous factors that can lead to pain in the shoulder blades, most of which should be assessed and monitored by a health provider.
What Are The Functions Of A Scapula?
Before tackling the subject of any scapular abnormalities that may lead to the manifestation of pain, it is important that we understand the anatomical and physiological purpose of this part of the body. Our shoulders are composed of three bones namely the clavicle, otherwise known as the collarbone, the scapula, otherwise known as the shoulder blade and the humerus, otherwise known as the arm bone. These bones are typically attached together with ligaments, muscles, tendons and joint capsules in order to allow the arm to work properly. The shoulder is also made up with three specific joints namely the acromioclavicular joint, the glenohumeral joint and the sternoclavicular joint, which allows freedom of movement.
The scapula has three roles in the body. Its primary role is to keep the humeral head and its axis during the humerus’ movement. The scapula also allows movement along the thoracic wall by becoming a stabilizing or a movable platform and assists in raising the acromion process during throwing and cocking movements. Lastly, the scapula is also considered to be a link between the arrangement of force, velocity and energy on a proximal to distal basis. Since the arm alone is not enough to propel a ball, the scapula assists by moving energy into the arm. The scapula is also responsible for the excess energy created by an elevated arm.
Causes of Scapular Pain
Overexertion of the scapula and bad posture is one of the most common causes of pain in the shoulder blades. Shoulder trauma is another reason. Cases of trauma include fractures, shoulder dislocations and shoulder separation. Each of these injuries also has numerous causes of their own.
Fractures are commonly brought about by a straight blow to the area injured through motor vehicle accidents, collision and even fall. A fractured scapula is uncommon, mainly because the scapula is protected by the chest and the surrounding muscles. Oftentimes, people with chest injuries are also diagnosed with scapular trauma too.
On the other hand, shoulder dislocation has two common types, which are the anterior dislocation and the posterior dislocation. The posterior dislocation occurs from electric shocks or seizures wherein the muscles of the shoulders in the front contract. This type of dislocation is less common. The anterior dislocation, which is more common, is caused when the arm is vehemently twisted in the outer direction above the shoulder level. Meanwhile, shoulder separations are primarily brought about by lifting heavy objects or falling with the shoulder first. Scapular pain can also occur if there is a presence of facet lesions, discogenic lesions and cervical nerve root blocks in the spinal nerve.
When visiting your health provider, it is important that you are open to the questions and circumstances that may be related to the pain in your shoulder blades. Your health history and your family’s history will be taken to rule out any existing or genetic illnesses. A physical test accompanied with an X-ray will also be done to determine the extent of the injury, if you have one. Computer Tomography (CT) scans can also be done for further imaging scans, if the radiograph is not enough.
Treatment for Scapular Pain
For people whose pain in the shoulder pains are only brought about by poor posture or overexertion, the physician usually recommends a rehabilitation session that will flex and strengthen the muscles in the area. Clinical trials have shown that rehabilitation decreases the scapular pain, allowing the patient to resume to his daily activities. Rehabilitation often lasts for roughly four weeks or more and usually involves exercise routines. These exercises include:
Scapular Pain Exercises
1. Stretching the trapezius and the rhomboideus muscles by straining your left hand towards the right direction, like reaching out.
2. Another stretch for the trapezius and rhomboideus muscles wherein you mimic the basic position of a volleyball player. The arms should be stretched in front of you with the hands clasped together.
3. Rotating your upper torso while sitting.
4. With your arms position like you’re lifting weights, press your arms towards the wall with your shoulder blades retracted.
In case of fractured scapulas, surgery may be withheld as only 10% up to 20% of the cases pertaining to fractured shoulder blades actually need one. Oftentimes, those that need surgery often have fracture fragments wherein the shoulder joint or the clavicle was involved. The fracture fragments will be fixated with plates and screws to ensure immobilization. On the other hand, when the fracture does not need surgery, the doctor will only recommend a sling or a shoulder immobilizer, medications and icing the area to bring down the inflammation.
For shoulder separations, the intervention done usually depends on the degree of the injury and the direction where the separation began. Not so serious shoulder separations can easily be treated without surgery while severe separations and people who are athletes and manual laborers are recommended to undergo surgery. Meanwhile, in cases of shoulder dislocations, the treatment usually involves reducing the dislocation. The patient will be under pain medicine and a mild sedative while the doctor pulls on the shoulder to realign the joints. Afterwards, the patient will undergo an X-ray to ensure that the shoulder is back in its proper place before putting it on a special brace or an immobilizing sling. However, people who are 25 years old and below and those who are constantly having problems with shoulder dislocations in order to repair the soft tissues surrounding the area.
With these interventions, discipline and taking good care of your body, scapular pain won’t haunt you anymore.
1. American Academy of Orthopaedic Surgeons (2007) [online]
2. Kibler, W., et. al. (2003) “Scapular Dyskinesia and its Relation To Shoulder Pain”, Journal of the American Academy of Orthopaedic Surgeons
3. Fruth, S. (2006) “Differential Diagnosis and Treatment in a Patient with Posterior Upper Thoracic Pain”, Journal of the American Physical Therapy Association
4. Mizutamari, M. (2010), “Corresponding Scapular Pain with the Nerve Root Involved In Cervical Radiculopathy”, Journal of Orthopaedic SurgeryScapular Pain Treatments and Exercises ,
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