MRI of normal shoulder intratendinous signal MRI of rotator cuff full-thickness tear Tears of the rotator cuff tendon are described as partial or full thickness, and full thickness with complete detachment of the tendons from bone.
This condition is called suprascapular neuropathy. The result can be shoulder pain and loss of function. For athletes who depend on the muscles supplied by that nerve, such a problem can be very disabling.
Overhead athletes with traumatic shoulder injuries, especially severe rotator cuff tears seem to be affected most often.
In this review article, orthopedic surgeons from Rush University in Chicago report on their experience with this fairly uncommon shoulder problem. First, they review the anatomy of where the nerve is located, the two rotator cuff muscles it supplies motor function to infraspinatus and supraspinatusand what happens to cause suprascapular neuropathy.
Diagnosis depends on the patient history, physical exam, and imaging studies. Treatment can be conservative nonoperative with change in activity and Physical Therapy.
Or surgery may be needed to remove bone, ligaments, or cysts putting pressure on the nerve. Repair of an insufficient rotator cuff is essential when weakness of this shoulder stabilizer alters shoulder biomechanics. For example, if the rotator cuff can't stabilize the shoulder in the socket, then the altered position of the scapula and altered movement patterns of the scapula can pull on the nerve or compress impinge it.
Deciding what type of treatment is best requires an accurate diagnosis of the problem. Chronic pressure, traction, or kinking of the nerve can lead to denervation destruction of the nerve -- and that means permanent loss of muscle strength and function supplied by the nerve.
In cases like that, surgery is needed to remove whatever is putting pressure on the nerve, a procedure called decompression. Sometimes the surgeon must also go in and open up a notch opening in the scapula shoulder blade where the nerve passes through.
This notch or opening is called the spinoglenoid notch.
Everyone has one and the natural size, shape, and location in the bone can vary. The nerve can also get stuck to the bone by fibrous tissue so that it can't move as the arm is raised.
This condition is called nerve entrapment. Other things that can cause suprascapular nerve entrapment include bone fracture, cysts, and enlarged veins. Cysts form most often when damage to the labrum rim of fibrous cartilage around the shoulder joint allows fluid from the joint to escape and pool inside the cyst.
Drawings of the natural pathway for the nerve through this notch and down the back of the scapula are included in this article. Six different types and shapes of scapular notches are also drawn and depicted for the reader. Photographs of patients and cadavers help show what this condition looks like inside and out.
Besides hearing of a history of overhead work either as a throwing athlete or as a manual laborerthe examiner will see muscle atrophy wasting along the back of the shoulder.(OBQ) Internal impingement commonly occurs in overhead athletes and is very common amongst elite baseball pitchers.
In which phase of throwing does . Nov 01, · Repetitive overhead athletes have been reported to experience neuropathy secondary to traction and microtrauma [8–10].
The mechanism is tightening of the spinoglenoid ligament when the shoulder is in a position of overhead throwing [ 11 ].
(OBQ) A year-old male bodybuilder presents to the office with vague, deep shoulder pain and weakness with his bench press. His examination is somewhat difficult due to his large size, but no significant abnormal findings are noted. The following materials are provided as a service to our profession.
There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress. Suprascapular Neuropathy in Athletes Page 2 of 4 o Dislocation of glenohumeral and acromioclavicular joint o Penetrating injuries to region Diagnostics 1.
History o Overhead activities or direct trauma to shoulder girdle o Usually dominant arm o May have isolated infraspinatus atrophy w/o pain or decr in performance 2.
Physical exam o Weakened external rotation and abduction.
This is why the most common patients exhibiting symptoms of suprascapular neuropathy are athletes. Especially athletes who play baseball, volleyball, swimming, weightlifting and tennis (sports that require a lot of overhead activity).