Summary in English by Simone Rechter
Snapping scapula is a painful condition with multifactorial etiology. It is often overlooked as a cause to shoulder pain. It is caused by an incongruent movement of the scapula on the thorax. It can be a result of muscular inbalance due to overuse, bony reasons as exostosis or structural problems as in kyphosis. The incongruence results in a bursitis mainly at the superomedial corner of the scapula.
In our specialized Scapula clinic patients with painful snapping scapula start with relevant physiotherapy. Until now the optimal physiotherapy program is unknown. To evaluate scapular muscle recruitment and strength in patients with chronic snapping scapula all patients will be involved in a study where they will be examined with surface EMG measurements. By this the knowledge with respect to muscle performance will increase and hopefully lead to an improved physiotherapy program.
If patients underwent 3-6 months of relevant physiotherapy and still complain about pain underneath the scapula as well as they get pain relief by an injection with local anesthesia underneath the superomedial corner of the scapula, surgery will be considered.
Scapular muscle recruitment in patients with scapula crepitans: An exploratory electromyographic study
Ann Cools, PT, PhD
Background: Snapping scapula is a painful condition with multifactorial etiology. Up to date, knowledge of scapular muscle performance related to the clinical condition of snapping scapula is unknown.
Purpose: To evaluate scapular muscle recruitment and strength in patients with chronic snapping scapula during a variety of commonly used rehabilitation exercises.
Methods: 40 patients with snapping scapula will be examined in this cross-sectional study. Surface EMG measurements will be performed on 4 scapular muscles (serratus anterior and 3 trapezius parts) during 14 commonly used rehabilitation exercises, consisting of elevation exercises, exercises for the trapezius, protraction exercises, and external rotation exercises. Isometric strength will be evaluated with a Hand Held Dynamometer.
Results: Primary outcome measures are the mean EMG activity, expressed as a % of a maximal voluntary contraction. Secondary outcomes are isometric strength for scapular and glenohumeral muscles.
Conclusion: This study will increase the knowledge with respect to muscle performance in snapping scapula patients, and will help the clinician in exercise prescription in this patient population.