Why does my scapula hurt?

Your scapula likely hurts because your scapular biomechanics are off, which is causing abnormal movements, which can cause pain.  As an orthopedic surgeon in Colorado Springs, Colorado, I frequently treat people who have pain in and around their scapula or shoulder blade. Pain from an abnormally moving scapula can often be missed, and can present as middle back pain, when it is actually coming from the scapula. I frequently see patients who have been seen somewhere else and who have undiagnosed scapular issues. You can actually break your scapula, but this usually doesn’t happen unless there is a high energy injury such as a car crash.

What causes scapula pain?

The scapula (or shoulder blade), is a complex bone that 17 different muscles attach to! It works and moves together with your shoulder to make sure that your shoulder can move as freely as it does. It is an often forgotten component of shoulder motion, as most people tend to focus on the shoulder alone. The scapula is supposed to glide frictionlessly along the ribs. When scapular biomechanics get disrupted, it stops moving fluidly and can cause pain in and around the scapula. A lot of time scapular biomechanics get disrupted due to a shoulder injury. The scapula wants to compensate for the injured shoulder and starts moving funny. This funny movement in turn produces pain. I see a lot of scapular issues that are caused by shoulder impingement or bursitis. This diagnosis is called scapular dyskinesis.

What does scapula pain feel like?

Scapular pain is normally felt as pain in the middle of the back, right around the scapula. Sometimes you can actually press on it to find the sore spot. You will also experience this pain when raising your arm, or lowering it slowly. Underneath the scapula there is a bursa (fluid filled sac to decrease friction). In bad cases of scapular dyskinesis, the bursa can become inflamed, leading to clicking, and a much more painful condition called subscapular bursitis. 

How do you relieve scapular pain?

The best way to relieve scapular pain is to do a course of physical therapy which will retrain the scapula to move properly. This is often accomplished by specific exercises that make both of the scapulae move together. If there is also shoulder pain, that needs to be treated too, because that is usually the cause of the scapular dyskinesis in the first place. In some cases, if someone has developed subscapular bursitis, I will give them a steroid injection beneath the scapula. In my experience as an orthopedic surgeon in Colorado Springs, subscapular steroid injections tend to work pretty well. Scapular dyskinesis hardly ever needs surgery. A good course of physical therapy with the occasional steroid injection is usually enough.

I hope I was able to answer some of your questions about why your scapula hurts. If you would like me to treat your It band pain, contact us below to make an appointment if you are in the Colorado Springs area. I also am available for virtual consults.

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