Shoulder bone pain

Many male friends do a lot of physical work in their daily lives, which can easily cause a protruding bone on their shoulders, and the protruding part will be more painful. Therefore, we should pay attention to how to relieve the pain of a protruding bone on the shoulder. Appropriate shoulder massage and shoulder joint movements can all relieve shoulder pain, and we should pay attention to resting our shoulders in our daily lives.

main reason

Weak upper back muscles, bad posture such as hunching, and spinal injuries.

Inspection scope

Generally, the wing-like protrusion of the scapula can be divided into unilateral and bilateral. According to the common direction of the protrusion, it can be divided into medial protrusion (protrusion towards the dorsal spine) or lateral protrusion.

The scapula is fixed to the thorax by seven muscles: the trapezius, levator scapulae, rhomboids major, rhomboids minor, pectoralis major, scapula clavicle, and serratus anterior. These muscles are responsible for stabilizing the shoulder blade and are also known as the scapula stabilizers. Since a large part of the stability of arm movement comes from the scapula, lesions in the stabilizing muscles will significantly affect shoulder joint movement and arm movement.

Bilateral winging of the scapula is usually associated with kyphosis, while asymmetric bilateral winging is often associated with scoliosis.

The medial protrusion is often caused by weakness of the serratus anterior muscle (innervated by the long thoracic nerve). When the patient raises his arms horizontally to push against the wall or tries to raise his arms, he will find a protrusion on the lower edge of the scapula. He will also experience scapular pain, limited shoulder joint mobility (especially during abduction and internal rotation), and subsequent inflammatory reaction of the shoulder rotator muscles and tendons. Symptoms similar to this may sometimes occur in cases of radiculopathy of the fifth and sixth cervical vertebrae, brachial plexus injury, superior scapular nerve compression, scoliosis, rotator cuff injury, trapezius muscle paralysis, or poor healing of humeral fractures, as well as enchondroma.

The lateral protrusion is caused by the trapezius muscle (innervated by the eleventh cranial nerve) protruding to the outside on one side when the shoulder is adducted, as well as unilateral weakness or asymmetric shoulder height when shrugging the shoulders. Scapular protrusion caused by muscular reasons is usually accompanied by chronic traction of nearby muscles, causing pain. Therefore, pain near the protrusion is often mistakenly considered to be difficult to treat.

The diagnosis of this disease requires a detailed physical examination and medical history by a specialist. Electromyography and nerve conduction in electrical diagnosis can also be used to find the exact lesion. In terms of treatment, in addition to using electrical muscle stimulation to strengthen the muscles, you can also do appropriate strengthening exercises for the scapula stabilizing muscles to avoid future injuries to the shoulder joint. It is worth noting that some myoneural genetic diseases can also manifest as winged scapula.

Differential Diagnosis

Scapular hypoplasia and abnormal shape: Sprengel deformity refers to the shoulder blade being higher than the normal position relative to the thorax, usually accompanied by hypoplasia and abnormal shape. Other congenital malformations may also be present, such as cervical ribs, rib hypoplasia, and cervical vertebrae deformities (Klippel-Feil syndrome), and occasionally one or more shoulder girdle muscles are partially or completely absent.

Unless the deformity is very severe, serious functional impairment generally does not occur. When the deformity is mild, there is only a slight elevation of the scapula, the scapula is slightly smaller than normal, and the movement is slightly restricted. But in cases where the deformity is severe, the scapula is not only very small but also positioned high, even touching the occipital bone. The patient's head is often tilted to the affected side, and about 1/3 of the patients have an extra small bone, the scapular vertebra, which is a diamond-shaped piece of bone or cartilage located in a solid fascial sheath and extends from the upper angle of the scapula to the spinous processes, lamina and transverse processes of one or more low cervical vertebrae. Sometimes the scapula and vertebrae form a well-developed joint; sometimes there is only fibrous tissue connecting the scapula; it is extremely rare for a bone bridge to form between the scapula and vertebrae. Cho used 3D-CT to conduct a morphometric study on 15 patients and found that the morphological characteristics of the high scapula were mainly manifested by a reduced height-to-width ratio of the scapula, but it was larger than the contralateral scapula; the rotation function of the scapula was inversely proportional to the position of the scapula elevation, but there was no significant difference with the morphology of the glenoid cavity.

Mitigation methods

Friends who have no training foundation can try the seated rowing exercise: sit in front of the equipment, put your feet on the pedals, straighten your back, slightly lean your upper body back, and hold the handles with both hands; contract your back to pull your elbows behind your body, and feel your shoulder blades moving closer to the spine from both sides; then slowly return to the posture in Figure 1, and do this 12 times in a row. Practice every other day, 2-3 sets each time, 12-15 times each set. Most gyms have this kind of equipment, and the simple fitness equipment in the community can also do similar exercises.

The seated rowing exercise is also suitable for women. It can help you shape a flat and beautiful back and add more grace. If you train at home, you can try the one-arm rowing movement: bend your knees slightly, lean your upper body forward, and keep your lower back straight. Support your right hand forward on the edge of the bed, and hold a small 6-8 pound dumbbell in your left hand, letting it hang naturally. Contract your back muscles, bring the left shoulder blade closer to the spine, and pull the left elbow back and up. Then control the dumbbell and slowly lower it to the initial position. If you don't have dumbbells, you can use any heavy object that is easy to hold, such as a book, a drink bottle, etc.

If you are a regular at the gym, you should ask a trainer to help you develop a back training plan. It generally includes a variety of movements such as pulling backwards, pulling downwards, and making the upper body lean forward and then straighten up. It should also be supplemented by training with different equipment such as pullers, barbells, dumbbells, etc. Pay attention to mastering the correct movement standards first, and then gradually increase the weight.