The FitRehab Podcast, Episode 3: An Often Overlooked Cause of Shoulder Pain and Weakness: Suprascapular Neuropathy
Discover an often overlooked cause of long-term shoulder pain and weakness. Learn exercises to alleviate symptoms and restore strength.
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Have you been treating your shoulder for rotator cuff tendonitis and/or shoulder bursitis for quite some time now but the pain is still there? That could be because a nerve that passes through this same area may have become irritated. But this is often an overlooked cause for long-term shoulder pain, and thus ends up going on unaddressed. In this episode we’ll discuss this condition further and, more importantly, I’ll share some recommendations on things you can start doing now to improve your symptoms.
The fancy medical term for this condition that I’m referring to is Suprascapular Neuropathy. You see the Suprascapular nerve passes through the same small space in the shoulder as the rotator cuff and bursa. When either the rotator cuff or bursa become inflamed, this inherently narrow space becomes even more narrow. This then sets off a cascade of events, with one of those events commonly being compression (or impingement) of the suprascapular nerve. This can then cause symptoms of pain or decreased sensation near the BACK of the shoulder and down the shoulder blade and can make you feel weak with lifting your arm out and away from your body as this nerve is no longer able to effectively communicate with the muscles that control those movements.
Now, this injury does not always present immediately as it can take some time for the symptoms to manifest and/or those symptoms could be masked by the pain from injury to the other structures in the shoulder (such as the rotator cuff or bursa). Thus, this is a fairly overlooked cause for shoulder pain, and a plausible culprit for long-term shoulder impairments, such as pain, weakness, and (in severe cases) muscle wasting.
Overhead athletes (such as baseball players, especially pitchers, and quarterbacks) and workers that repeatedly lift or work with their arms overhead for extended periods of time are at increased risk for developing this injury.
So, again , the 2 primary indicators for Suprascapular neuropathy are:
pain and/or lack of sensation along the BACK of the shoulder that can travel down the shoulder blade and
Weakness with rotating your arm out and away from your body, such as if you’re trying to reach behind your head or even just brush your teeth
So, if you think this describes what you're experiencing, let's go over some exercises that might help alleviate your pain and difficulty by restoring strength, mobility, and stability to your shoulder.
I listed all of these exercises with instructions (sets, reps, additional pointers, etc.) and video demonstrations of each exercise in a post on my blog. I'll put the link to that post in the description for this episode. So, I encourage you to hop over to that post once we’re done here so you can save it and refer back to it whenever you need a refresher or further explanation.
Exercise 1: Row with scapular retractions
When doing this exercise, make sure you activate the rhomboids by squeezing your shoulder blade backward as if you’re trying to squeeze a small ball between your shoulder blades.
Exercise 2: Scapular Protraction
This exercise works the exact opposite muscles as the first exercise. This exercise strengthens the serratus anterior which is important for a strong and mobile shoulder. It is a muscle that is necessary to keep your shoulder blade along your rib cage as you raise your arm. If you’ve heard about “winging” of the shoulder blades, this is the muscle that is lacking and thus leading to that quote winging.
Exercise 3: External Rotation
This exercise activates the muscles necessary to turn your arm away from your body. The suprascapular nerve supplies two out of the four rotator cuff muscles and one of those two muscles (called the infraspinatus) externally rotates the humerus which of course is required in order to turn your arm away from your body.
Exercise 4: Shoulder Abduction
This exercise works the deltoid and rotator cuff muscles that stabilize your shoulder and lift the arm out to the side away from your body. Start by trying to raise only until about shoulder height and then- once you can complete in this range without any pain- try going further overhead little by little. It’s common to require a few sessions before being able to comfortably get this far.)
Exercise number 5: Planks
Planks are a great exercise to put the 4 prior exercises together as it really challenges the stability, endurance, and tolerance to bear weight through the shoulders.
During each session, try completing 1-3 sets of 8-12 reps for the first four exercises and then 1-3 sets of the plank holding each plank for 10-30 seconds, as tolerated. Complete 2-3 sessions per week, allowing at least 48 hours of rest between each session.
So there you go; there's 5 exercises you can start doing now to address suprascapular neuropathy. Head on over and save the blog post by clicking the link in the description so you can see demonstrations to ensure that you’re doing each exercise correctly, and then refer back to it in the future if you ever need a refresher. The blog post also includes the reps and sets that I spoke about earlier.
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Thank you for reading this blog post. This blog is a service of Optimal Living Solutions under the alias "FitRehab". The information in this blog is not to be substituted for physician consultation, evaluation, and/or treatment. You are advised to consult a physician before you undertake any physical exercise program. If you experience any chest discomfort and/or abnormalities in your heart rate or breathing, stop exercising and consult a physician immediately. Optimal Living Solutions makes no guarantees with regard to outcomes you will experience from information provided within this blog, including but not limited to, resolution of pain and/or symptoms, the amount of weight you may gain or lose, or the rate at which such weight loss or weight gain will occur.