By: 4 October 2013

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.


Without the scapula, smooth and coordinated motion and function of the arm is compromised. Problems affecting the scapula that can disrupt the motion and rhythm of arm movement include bursitis, snapping scapula, and tumours of the bone or nearby soft tissues.

This paper reviews the anatomy and physiology of the scapula motion and stability. They go on to discuss the conservative and surgical management of a specific problem known as snapping scapula syndrome. Details of what they have learned performing arthroscopic surgery on the scapula are provided. They say that complete familiarity with the scapula and surrounding soft tissues is essential to avoid unnecessary problems.

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. The people affected most often are usually young athletes involved in activities requiring repetitive overhead motion.

Conservative care is recommended first, which 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. Patients are advised to be patient as the rehabilitation process can take up to six months to be effective. Only when there are tumours or “masses” should surgery be considered sooner.

When six months (or more) of conservative care fails, then surgery to remove a portion of the bone and/or inflamed bursae may be advised. The authors take the reader through both open and arthroscopic surgical techniques for snapping scapula syndrome.

Drawings, photos of patient positioning, arthroscopic images, and CT scans are used to illustrate the step-by-step approach described. Special tips are provided to aid the surgeon in avoiding injury to the nerves and blood vessels. Newer portal placements developed for this surgery are described.