eMedicine Specialties > Sports Medicine > Neurological

Suprascapular Neuropathy: Follow-up

Author: Jonathan C Reeser, MD, PhD, Department of Physical Medicine and Rehabilitation, Marshfield Clinic
Contributor Information and Disclosures

Updated: Apr 16, 2008

Follow-up

Return to Play

Most individuals with suprascapular neuropathy are asymptomatic and compete with little to no discernible performance deficit. This observation complicates the issue of how to handle the return-to-play decision in an athlete who is asymptomatic and whose physical examination incidentally reveals suprascapular neuropathy.

In practical terms, elite athletes (in whom the prevalence is highest) can probably continue to compete while they are concurrently participating in a rehabilitation program. However, to minimize the progression of the condition, the extent to which the athlete performs overhead skills during practice should be limited.

In symptomatic athletes, a more restrictive course seems reasonable. Once the athlete can perform sport-specific skills (eg, spiking and blocking in volleyball) in a pain-free manner, he or she can return to play. Athletes who undergo surgical decompression should participate in an appropriate postoperative rehabilitation program to restore their strength, flexibility, and endurance before returning to play.

Related Medscape topic:
Resource Center Exercise and Sports Medicine

Prevention

Ferretti proposed that suprascapular neuropathy in volleyball players is related to performance of the floater serve. If so, the incidence of volleyball shoulder is expected to decrease because, with the advent of the jump serve or spike serve, the floater serve has become less popular.

To the author's knowledge, no definitive study findings implicate specific spiking styles in suprascapular neuropathy; thus, providing technical advice about biomechanics to volleyball athletes with suprascapular neuropathy is difficult. Additional considerations remain unanswered; for example, the duration and magnitude of the load that is sufficient to precipitate volleyball shoulder through chronic overuse is unknown. Furthermore, the extent to which a SICK scapula is associated with the incidence of suprascapular neuropathy deserves further investigation.

Prognosis

As discussed earlier, the prognosis for a favorable clinical outcome is good. At the time of diagnosis, affected athletes report surprisingly little functional limitation. According to the literature, most cases respond favorably to either conservative treatment programs or, when indicated, surgical intervention. Furthermore, most athletes were able to return to their previous level of sports participation following therapeutic intervention.

Miscellaneous

Medicolegal Pitfalls

  • A thorough examination and a reasonably high degree of clinical suspicion are required to diagnose suprascapular neuropathy.
  • Sports medicine practitioners should include suprascapular neuropathy in their differential diagnosis of shoulder pain (see Differentials and Other Problems to Be Considered), particularly in volleyball players or in athletes with rotator cuff tendinopathy in whom the pain fails to respond to initial attempts at treatment.

Related Medscape topic:
Resource Center Medical Malpractice and Legal Issues

 


More on Suprascapular Neuropathy

Overview: Suprascapular Neuropathy
Differential Diagnoses & Workup: Suprascapular Neuropathy
Treatment & Medication: Suprascapular Neuropathy
Follow-up: Suprascapular Neuropathy
Multimedia: Suprascapular Neuropathy
References
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Further Reading

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Keywords

volleyball shoulder, suprascapular neuropathy, shoulder pain, infraspinatus muscle, rotator cuff tendinopathy, suprascapular nerve, infraspinatus syndrome

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Contributor Information and Disclosures

Author

Jonathan C Reeser, MD, PhD, Department of Physical Medicine and Rehabilitation, Marshfield Clinic
Jonathan C Reeser, MD, PhD is a member of the following medical societies: Alpha Omega Alpha, American Association of Neuromuscular and Electrodiagnostic Medicine, American College of Sports Medicine, American Medical Association, Association of Academic Physiatrists, Phi Beta Kappa, Physiatric Association of Spine, Sports and Occupational Rehabilitation, and State Medical Society of Wisconsin
Disclosure: Nothing to disclose.

Medical Editor

Leslie Milne, MD, Assistant Clinical Instructor, Department of Emergency Medicine, Harvard University School of Medicine
Leslie Milne, MD is a member of the following medical societies: American College of Sports Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

CME Editor

Jon B Whitehurst, MD, Clinical Instructor of Surgery, University of Illinois College of Medicine; Partner and Executive Board Member, Rockford Orthopedic Associates; Orthopedic Chairman, Rockford Memorial Hospital
Jon B Whitehurst, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

Chief Editor

Sherwin SW Ho, MD, Associate Professor, Department of Surgery, Section of Orthopedic Surgery and Rehabilitation Medicine, University of Chicago
Sherwin SW Ho, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

 
 
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