Clicking of the scapula: symptoms, causes, diagnosis and treatment

You have probably heard of scapulatory pathology, the most common name for the “clicking” that occurs in the area of the scapula when some movement is made with the arm and the shoulder is involved. Depending on the symptoms of this pathology, intervention by experts in shoulder traumatology may be required. Keep reading this post, where we talk about the causes, symptoms and treatment of clicking of the scapula.

What is scapula clicking?

Scapular clicking syndrome, known by other names such as crepitation or scapulatory bursitis It was first described by the French surgeon Boinet in 1867. The scapula is a large, flat, triangular bone located between the second and seventh ribs, which helps move the arm.

When talking about clicking of the scapula or scapulothoracic syndrome refers to entrapment of the scapula to the muscles around it, which become inflamed and atrophy instead of sliding smoothly through the chest wall.

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When this inflammation lasts over time, it will cause muscle weakness, altering the position of the scapula, leading to certain trauma injuries.

Symptoms of scapular clicking syndrome

The symptoms of clicking of the scapula are related to inflammation of the bursa, finding patients who have pain to touch or movement related to activity.

Additionally, as the name of this pathology indicates, there is crepitation that includes a “cracking” sound or sensation when the arm moves.

These symptoms may be insidious in onset, appearing after a change in activity pattern, or associated with trauma.

Causes of scapular clicking

Experts in the pathology of scapular clicking syndrome determine that The most common causes of this are trauma to the shoulder. and the presence of fractures in any of the vertebrae of the spine or scapula.

Likewise, performing certain movements, such as hitting a tennis ball or baseball, can cause inflammation of the tissues located between the scapula and the shoulder blade.

On some occasions, this pathology is observed when, due to the patient's inactivity, the scapular muscles shrink and atrophy, reducing the distance between the rib cage and the scapular bone, being in direct contact with the vertebrae.

Poor postural habits, excessive use of the shoulder, and performing overly demanding workouts could cause changes in the alignment of the scapulothoracic joint.

Difference between scapular clicking and other shoulder injuries

Scapular clicking can be confused with other shoulder pathologies such as supraspinatus tendinitis or subacromial syndrome, since in these cases the pain is mainly located in the anterior or superior part of the shoulder, while in scapular clicking, discomfort occurs in the posterior region, between the scapula and the rib cage.

To correctly identify it, a specialist performs specific maneuvers to pinpoint the origin of the sound. In scapulothoracic syndrome, the clicking sound occurs when moving the arm or rotating the shoulder.

In some patients, such as athletes or people with overuse of the shoulder, both conditions can coexist. In these cases, an accurate diagnosis is essential to establish appropriate treatment and avoid unnecessary interventions or, worse, incomplete recovery. The most effective way to make an accurate diagnosis is through imaging analysis.

How to prevent scapulothoracic syndrome

To prevent scapulothoracic syndrome, it's essential to maintain proper posture, both in daily life and during sports activities. Spending long periods in front of a computer or performing repetitive movements without breaks can cause muscle tension in the back and shoulders. That's why it's so important to incorporate active breaks and stretching exercises to protect joint health.

Strengthening the back muscles and scapular stabilizers helps maintain proper shoulder alignment. It is also advisable to warm up properly before activities that require significant arm movement, such as swimming, padel, or tennis.

Finally, those who have already suffered episodes of scapulothoracic bursitis should have regular check-ups with a specialist to detect muscle imbalances or postural alterations in time and correct them before a new injury occurs.

Diagnosis and treatment of scapulatory bursitis

For the diagnosis and treatment of scapulororacic pathology, It is important to go to traumatology experts so that they can carry out a complete study of the symptoms. present and with this, determine the most appropriate treatment for each patient.

Diagnosis of scapula clicking

In most cases, pathologies of the scapula can be detected by looking at the patient from behind, so that the edge of the affected shoulder blade is higher. This is what is commonly known as the winged scapula.

The specialist will thoroughly examine the spine to detect if there is any excessive curvature that could affect scapular movement. Through imaging studies such as x-ray, magnetic resonance imaging, ultrasound and computed tomography, skeletal irregularities will be sought to be identified.

Treatments for scapulothoracic pathology

Generally, most patients with scapulothoracic bursitis can end your pain through conservative treatment, without requiring any type of surgical treatment.

When to see an orthopedist for a scapular clicking sound

It's important to consult an orthopedist if the sound is accompanied by persistent pain or swelling in the upper part of the shoulder. You should also check for loss of strength, difficulty moving the arm, or a feeling of joint locking.

To determine whether the origin is muscular, skeletal, or inflammatory, the specialist will review the medical history and perform physical and imaging tests. Early diagnosis is key to starting the appropriate treatment and preventing the injury from becoming chronic.

Recommended exercises for scapular rehabilitation

For optimal rehabilitation, physical therapy is an essential part of the treatment for scapulothoracic syndrome. Its aim is to restore the scapula's fluid movement and strengthen the stabilizing muscles. To achieve this, specific scapular mobility exercises and stretches of the pectoralis minor are performed; a shortened muscle can alter the natural position of the shoulder blade.

Among the most effective exercises are scapular retraction and movements with elastic bands, which help activate the middle and lower trapezius and the serratus anterior, muscles responsible for keeping the scapula stable.

Gentle, progressive exercises, combined with good posture, help relieve inflammation, regain strength, and prevent future relapses.

Conservative treatment options range from resting the patient, applying ice to the affected area and using anti-inflammatories, always prescribed by a specialist doctor, to performing exercises with physiotherapy. If all these conservative treatments fail, surgical intervention will be necessary. Arthroscopic shoulder surgery is one of the techniques that offers the greatest advantages over traditional open shoulder surgery.. With it, the patient's hospitalization and rehabilitation period is shortened and, as it is a minimally invasive shoulder surgery, minimal aggression is carried out on the patient's skin.

It is important that to carry out this type of procedures, you have specialists with years of experience in minimally invasive shoulder arthroscopy, such as those that can be found at Clínica Elgeadi.

Do you have any shoulder trauma injuries? Do not hesitate to make an appointment with our team. experts in shoulder traumatology in Madrid, they will be eager to help you recover from your injury so you can start living pain-free. At Clínica Elgeadi we have the most advanced techniques that offer multiple advantages to patients who trust our team. The fusion between the experience and professionalism of our traumatologists specializing in minimally invasive surgery in Madrid will make the difference in the evolution of your injury.