Term
| Suprascapular Nerve-motor and sensory |
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Definition
Motor to the supraspinatus and infraspinatus
Sensory to GH jt. capsule, AC joint, subacromial bursa, coracohumeral and coracobrachial ligaments.
Arises from the superior trunk of the brachial plexus, nerve courses through the posterior triangle of the neck, then laterally deep to trapezius muscle toward the suprascapular notch.
At the level of the notch, the artery and vein pass over the superior transverse scapular ligament and the nerve passes under the ligament. |
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Term
| Suprascapular Nerve-Origins of mechanical irritation |
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Definition
Suprascapular notch (anatomic variation of shape)
Transverse scapular ligament (hypertrophy, calcification, etc.)
Chronic RC repairs, dislocations, scapular fractures, clavicle fractures (proximity to the middle/distal 1/3 of clavicle)
Repetitive traction/friction: overhead athletes, forced horizontal Adduction, scapular protraction |
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Term
| Suprascapular Nerve-Examination: |
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Definition
Often diffuse pain, poorly localized in the shoulder region, typically includes the posterior shoulder and can be deep
Muscle weakness/wasting/atrophy supraspinatous and infraspinatous
PFT at suprascapular notch, spinoglenoid notch (connects supraspinous and infraspinous fossas)
Reproduction of pain with PROM Classical/AROM with flexion, abduction and horizontal adduction with without stabilization of the scapula (cross adduction test). This pain should decrease if the same movements are performed with scapular stabilization.
Reproduce pain with PROM accessory to scapula for protraction and downward rotation |
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Term
| Suprascapular Nerve-Treatment: |
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Definition
Strengthening exercise of the rotator cuff and parascapular muscles
Consider including Russian E-stim to infraspinatus
Consider causative impairments, ie. tight pecs, glenohumeral mobility impairment, thoracic and cervical mobility, motor control etc.
Analgesic nerve injection
Surgical decompression |
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Term
| Dorsal Scapular Nerve-motor and sensory |
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Definition
Motor to the rhomboid muscles and levator scapula
From the 5th cervical nerve root just above the upper trunk
Passes through the body of the middle scalene, then passes under the levator scapula to the rhomboids
Origins of mechanical irritation:
ntrapment at middle scalene
C-spine hypermobility or respiratory impairments leading to overactivity and hypertrophy of the scalenes
Cervical rib
Examination:
Pain pattern at the medial border of the scapula
No sensory changes
Scapular dyskinesia with motor control impairment, accentuated when lowering from forward elevation
Cervical AROM side-bending and rotation towards the side of symptoms reproduces pain
Cervical PROM side-bending and rotation away reproduces symptoms.
Treatment:
Address |
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Term
| Dorsal Scapular Nerve-Origins of mechanical irritation |
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Definition
ntrapment at middle scalene
C-spine hypermobility or respiratory impairments leading to overactivity and hypertrophy of the scalenes
Cervical rib |
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Term
| Dorsal Scapular Nerve-Examination: |
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Definition
Pain pattern at the medial border of the scapula
No sensory changes
Scapular dyskinesia with motor control impairment, accentuated when lowering from forward elevation
Cervical AROM side-bending and rotation towards the side of symptoms reproduces pain
Cervical PROM side-bending and rotation away reproduces symptoms. |
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Term
| Dorsal Scapular Nerve-Treatment: |
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Definition
Address cervical and thoracic spine impairments, mobility, motor control of deep neck flexors etc.
Consider diaphragm control
Mobility of scalenes
Scapular mobility and motor control |
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