Houston Methodist. Leading Medicine

Shoulder FAQ

Question:

I'm looking for information on snapping scapula syndrome. If I have the surgery, what kind of recovery can I expect? How long will it take?

Answer:

Snapping scapula syndrome is as the name suggests: when the arm moves, some portion of the scapula drags against the rib cage causing a snapping sound and sensation. Pain is often (though not always) a main feature associated with this problem. Patients present with a range of severity from mildly irritating to extreme debilitation. The people affected most often are usually young athletes involved in activities requiring repetitive overhead motion. As you have probably experienced yourself, without a properly working scapula (shoulder blade), smooth and coordinated motion and function of the arm is compromised. Disorders of the scapula are rare and a thorough understanding of the anatomic features of this structure is needed to treat them successfully. An understanding of the knowledge we have about this problem is important because surgery doesn't always "fix" the problem. That's why conservative care is recommended first. This approach may include medications and change in activity type/level to reduce inflammation. If these measures don't help, then one to three steroid injections may be tried. Physical therapy to address posture and weakness or imbalance in muscle function is a key feature of the nonoperative approach to snapping scapula syndrome. Patients are advised to be patient as the rehabilitation process can take up to six months to be effective. Only when there are tumors or "masses" should surgery be considered sooner. When six months (or more) of conservative care fails to change the clinical picture, then surgery to remove a portion of the bone and/or inflamed bursae may be advised. The exact rehab protocol will depend on the type of surgery done (open versus arthroscopic, what procedure was used, what tissues were removed). Open surgery requires a longer period of immobilization in a sling afterwards (e.g., four weeks for open surgery instead of one week after arthroscopic surgery). The reason for this is because more muscle tissue is disrupted with open surgery. A longer time of rest and protection is needed to allow for muscular healing. Only passive shoulder motion is allowed in the first eight weeks after open surgery. Passive motion is quickly progressed to active motion and then strengthening exercises for patients who have arthroscopic surgery. These patients are advanced according to their own tolerance level for pain and discomfort. After open surgery, active motion begins at eight weeks post-op and strengthening begins at 12 weeks post-op. Depending on your occupation and/or activity level, you may continue on with physical therapy to prepare you for return to specific work, sports, or recreational activities. Keep in mind that results of surgical treatment for this condition are not always as expected or hoped for. Studies published with patient outcomes report incomplete relief from painful symptoms and lower than expected function are possible. Trevor Gaskill, MD, and Peter J. Millett, MD, MSc. Snapping Scapula Syndrome: Diagnosis and Management. In Journal of the American Academy of Orthopaedic Surgeons. April 2013. Vol. 21. No. 4. Pp. 214-224.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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