Pterygoid scapula can appear in both adults and children. This condition occurs when the shoulder blades no longer fit snugly against the surface of the chest. In the absence of this violation, muscles provide diligence. Outwardly, the shoulder blades, when deviating from the norm, resemble wings in their shape, from where the name came from.
Causes of occurrence
In the correct position, the scapula is held by the serratus muscle. Near it is a superficial nerve, which is quite easy to damage. If it is injured, then the scapula begins to protrude forward, namely its lower edge.
Also, the cause of the pterygoid scapulae can be a rupture of the deltoid and serratus anterior. It is very easy to see the development of the violation, just lean your back against a flat wall, and the protruding shoulder blade will be immediately visible.
Moreone factor influencing the development of this disorder is the transfer of poliomyelitis or progressive muscular dystrophy. The consequence of the displacement of the shoulder blades in relation to the chest is the development of the pterygoid scapula syndrome.
This pathology may be congenital. In this case, the violation develops during the development of the fetus and is detected immediately after birth.
A photo of the pterygoid scapula is presented in the article.
Features of development in children
The first signs of the development of pterygoid scapula in children often appear before school. At this time, parents pay attention to the unnatural arrangement of the shoulder blades in the child and consult a doctor.
In children attending school, the cause of the displacement of the shoulder blades can be not only trauma, but also improper wearing of a heavy satchel. In this case, symptoms begin to appear that are absolutely no different from the signs of the disease with pterygoid scapula syndrome in adults.
Main symptoms
Man at a young age often suffers from pterygoid scapula disease.
This disease manifests itself suddenly: early in the morning or at night. First of all, a person begins to feel severe pain, which can radiate to the limb. Because of these sensations, there is a significant limitation of active movements. Over time, the pain disappears, but after a month, the mass of the muscles of the shoulder girdle is significantly reduced and there is an increase in weakness in the arm (or arms, if both are affected).shoulder blades).
Although rare, during the pathological process all the muscles of the shoulder, forearm, and also the hand can be involved.
Most often, only one side is affected, but over time, the displacement of the second scapula also begins.
Diagnosis
Syndrome of pterygoid shoulder blades is accompanied by constant pain in the shoulder blades or behind the chest, which are aching in nature. In addition, discomfort may be felt in the shoulders or upper limbs. Outwardly, the syndrome manifests itself in the unnatural position of the shoulder blades, which protrude from the back.
To determine the presence or absence of muscle and nerve damage, doctors use electroneuromyography. It is also mandatory to conduct an X-ray examination of the shoulder blades in order to exclude congenital pathology of the bones. As additional diagnostic measures, a blood test is taken and antinuclear antibodies are determined. To confirm the diagnosis, the use of magnetic resonance imaging of the spine in the cervical region, brachial plexus and spinal cord is sometimes required. However, this is only used when neurological problems are suspected.
The most obvious sign of the development of the pterygoid scapula syndrome is their position in relation to the inner edge of the chest. In the process of raising the arm, the shoulder blades only move away from it more strongly. In addition, it is quite difficult to raise the shoulder to a horizontal position, and insome cases is not possible. It is this symptomatology that makes it possible to accurately diagnose pterygoid scapulae.
Treatment methods
For effective therapy, it is necessary to know exactly what caused the displacement of the shoulder blades and why the serratus muscle stopped functioning normally. Often the cause of the syndrome is damage to the superficial nerve, which can be caused by various factors (for example, compression by a tumor formation or nearby tissue).
Treatment of pterygoid scapulae can take a very long time, but never lead to a full recovery. First of all, the efforts of doctors are aimed at eliminating the causes of this pathology. In cases where there are signs of a formation that presses on a nerve, surgery is performed to remove it. After the operation, you should stop wearing weights or backpacks.
In order for the scapula to assume its natural position, special orthopedic devices can be used. They help stabilize the scapula and influence its movement.
In cases of patient complaints of pain in the shoulder blades, the doctor prescribes medications in the form of tablets, which belong to non-steroidal anti-inflammatory drugs, as well as undergoing physiotherapy procedures. These include:
- use of cold and heat applications;
- massage sessions;
- physiotherapy exercises.
In case of damage to the muscle or nerve, surgicalsurgery to restore them.
Treatment in children
Displacement of the shoulder blades in preschool children is treated with long courses of massage, therapeutic exercises, and the creation of an even posture. If these measures fail, then a surgical operation may be prescribed, which involves muscle plasticity, or fixing the scapula to the ribs using special sutures.
Treatment of pterygoid scapulae in children attending school also includes a course of special massage and physical therapy exercises. In the process of treatment, the child must be protected from carrying a heavy satchel or bags. If necessary, parents should carry their own weights to school. Swimming, cycling, skating or skiing are also recommended as therapy, as strengthening the spinal muscles accelerates the healing of the pterygoid scapulae.
Surgery
In cases where conservative treatment fails, the patient is referred for surgery. There are two ways to do it:
- The first method is based on replacing a paralyzed serratus muscle with a he althy one, by transplanting it from an unaffected area. This method is called functional.
- The second method involves attaching the shoulder blade to the ribs. This method is called stabilizing. After such an operation, the scapula no longer takes part in the movement of the shoulder girdle.
Therapeutic exercises
In treatmentpterygoid shoulder blade exercises and therapeutic exercises are equally effective for both children and adults. Such activities are used not only as a treatment, but also to prevent the development of this pathology.
It is best to start the treatment of pterygoid scapulae with exercises that affect the serratus muscle. First of all, you should stand against the wall, leaning on it with one hand. When pressing the palm of your hand against the wall, you should feel the tension in the muscles of the chest and back.
In addition, pulling up with the “front grip” will help to correct the defect. When performing this exercise, the arms should be wide apart with the palms in front. Instead of pulling up, girls are advised to do push-ups from the gymnastic bench. Their hands should also be wide apart with the fingers outside.
It is considered very useful to exercise on the crossbar. Its essence lies in the fact that it is necessary to raise both hands to grab it. Initially, the torso should be tilted to the left, and then to the right. Properly performed, the exercise stretches and contracts the serratus muscle, as well as the mass between the shoulder blades.
After the above exercises are completed, you need to take a pose, leaning on your knees and elbows. The purpose of the exercise is to bend the torso to reach the upper part of the sternum to the floor. During execution, you should spread your elbows to the sides.
After you need to start exercises that affect the anterior serratus, rhomboid muscle and abdomen. To perform, you should be in the knee-carpal position, shifting body weight to the shoulder girdle. With inhalation, the elbows need to be closed, tensing the abdominal and chest muscles as much as possible.
To strengthen the retainers of the shoulder blades, lie on your back. Hands should be spread apart. With maximum relaxation of the upper muscle group, you should raise your arms, chest, neck and head.
Possible complications and prognosis
All complications of pterygoid scapula can be divided into two groups:
- The first one, which includes damage to the shoulder due to its limited functionality.
- The second one is related to an error in the diagnosis, as a result of which the syndrome is not treated for a long time.
Timeliness of treatment and a correct diagnosis is the key to recovery in 90% of cases. An important condition is the absence of paresis in a person that cannot be restored.
Often, pain in the arm or shoulder persists for quite a long time. In 5% of cases, a relapse of the disease occurs, which can occur both in the same place and on the other side. In the vast majority of cases, relapses are less painful than the original disease.
