Baseball pitchers, tennis players and others whose activities entail repeatedly reaching above their heads are vulnerable to a relatively rare condition called suprascapular neuropathy. It causes shoulder pain and dysfunction.

As Dr. Dana P. Piasecki and associates noted in a review article for the journal of the American Academy of Orthopaedic Surgeons, the Suprascapular Neuropathy results from the stress that arm stretching and rotating movements place on the shoulder. The suprascapular nerve is injured by excessive stretching, kinking and friction.

The nerve extends from the neck to the back of the shoulder, in a narrow passageway through bones and ligaments. The nerve can become compressed, or entrapped, at several points. Ganglion cysts and masses of soft tissues are sometimes responsible, though much of the time the compression is an overuse injury resulting in Suprascapular Neuropathy.

Retracted rotator cuff tears can cause Suprascapular Neuropathy in older patients. Nearly one-third of the time, suprascapular nerve injury is associated with shoulder dislocations or humerus fractures, according to the article.

More than 80 percent of those with suprascapular neuropathy report pain and spinal weakness. Patients have described the discomfort as a dull, ocassionally burning, ache in the shoulder that sometimes extends to the neck and arm. Reaching across the torso, or rotating the shoulder, may be particularly painful.suprascapular-neuropathy

Most patients who undergo nonsurgical treatment for Suprascapular Neuropathy enjoy reduced pain. They regain shoulder function by modifying their physical activities, taking anti-inflammatory medication and receiving physical therapy.

For others, “muscle bulk and motor strength may be irreversibly lost” due to atrophy, Piasecki et al noted. Surgery might be necessary to allow for shoulder function to return. The procedure typically involves widening the spinoglenoid or suprascapular notch, points at which the nerve tends to sustain injuries. This can be done as open surgery or arthroscopically.

A study by Kim et al, involving 31 patients, found that the procedure produced long-term pain relief and restored strength in more than 90 percent of the  Suprascapular Neuropathy cases. In another study, arthroscopic suprascapular notch decompression significantly helped all 10 patients. Surgeons sometimes perform open spinoglenoid decompression while arthroscopically repairing related labral tears.

In research featuring patients with spinoglenoid notch entrapment resulting from ganglion cysts, all six participants reported that they no longer felt any pain after undergoing decompression surgery. Another study showed that the procedure resulted in significant nerve recovery, pain relief and restored function for patients diagnosed with suprascapular neuropathy and large rotator cuff tears.



It’s always exciting to work at the forefront of a field defined by so much innovation. I have written before about the many ways technology is changing orthopedic medicine. Now doctors and entrepreneurs are finding new paths to intuitive medical designs via 3D printing.

No two bodies are the same. This fact has long bedeviled designers and specialists looking to create braces that cover a variety of shapes and ranges of movement. Scoliosis in particular has been infamous in this regard, which is why it is encouraging that some people are finally creating ways to design utterly customized, one-of-a-kind braces:

The 3D printing and design company on Monday released its plans for a scoliosis brace that is devised to be sleek and comfortable. Dubbed “Bespoke,” the 3D-printed brace can be personalized to the backs of children and young adults who have the condition.

It is yet another sign that medical devices are finally catching up to other wearable technologies in terms of versatility and comfort. To learn more about how to relieve and treat back pain, please contact a San Diego orthopedic surgeon today.


It is a question that has bedeviled physicians, nutritionists and trainers for generations: Why do some people hit the gym every day without fail, while others can barely find the motivation to hit the restroom in the morning?

Now scientists may have found a clue. A new study in the Journal of Physiology suggests genetic loading may influence the level of activity in which most of us engage on a daily basis. A rat study suggested that identical twins have a tendency to exercise a similar amount no matter what environment with which they are faced. Researchers then bred rats that were inclined to be highly active, and a separate group inclined to be more sedentary. Once again, the rats did as their genes predicted:

Even so, Dr. Booth said, his group’s data would seem to suggest “that humans may have genes for motivation to exercise and other genes for motivation to sit on the couch,” and over generations, one set of these genes could begin to predominate within a family. But predispositions are never dictatorial.

The silver lining in this particular study, however, is that rats who spent more time sedentary soon began to mimic their active counterparts; studies indicated that their brains actually began to look more like their motivated cousins across the lab. It seems possible that you, too, can raise your energy level just by, well, raising your energy level.  Just say to yourself “I will do it!”  Get out there and move!

We have plenty of hard data that tells us exercise can prevent knee pain and back pain, and prevent costly orthopedic knee surgeries. This study should be a strong reminder that exercise is a choice we can all make when necessary.

© 2023 Dr. Robert Afra – San Diego Orthopedic Surgery Shoulder – Knee – Elbow