Treating a SICK Scapula

When a scapula, or shoulder blade, is described as SICK, it doesn’t mean ill; it is actually an acronym invented by researchers/physicians who observed a syndrome involving the shoulder areas of professional baseball players. It stands for Scapula Internal rotation, Coracoid pain and Dyskinesia, the conditions that make up this syndrome. Because the scapula is attached to one bone—the clavicle (or collarbone), which provides the only solid bony attachment of your hand, forearm and shoulder to the rest of your body—its role is an important one.

Shoulder blade problems used to be the territory of professional athletes—especially basketball and baseball players and swimmers. However, because so many people spend time hunched over computers and steering wheels nowadays, we are becoming a “SICK” nation.

An internally rotated scapula (usually from repetitive strain and improper posture) is referred to as “winging,” an innocuous-sounding term for something that can have debilitating consequences. Winging occurs when a combination of tight and weak muscles disrupts the position of the shoulder blades on the rib cage. This in turn affects the movement pattern of the mass of muscles (including the four rotator cuff units) controlling your arm and shoulder movements. Misuse of these muscles can cause a subsequent reaction of pain in the kinetic chain, creating discomfort in your neck, elbows, wrists and fingers.

The best way to combat a SICK scapula is to restore the muscles in the shoulder area to their properly functioning state. A physical therapy program can focus on strengthening the muscles behind the shoulder (the “posterior restraints”) and the group of muscles holding the scapula in place. Stretching the tight, strained muscles that have caused the problem in the first place will also help to correct any imbalances.

But that is not all: You must also retrain your body to move correctly. All the strengthening in the world will not help if you are still moving in ways that may contribute to winging. We can design an individualized exercise program to teach you how to sit, stand and move properly; improve function; reduce pain; and prevent your scapula from turning into a SICK one.