Suprascapular Nerve Injury

Aka: Suprascapular Nerve Injury, Volleyball Player's Shoulder, Suprascapular Nerve Entrapment, Suprascapular Nerve Lesion

1. See Also
   1. Peripheral Nerve Injury
   2. Brachial Plexus
2. Pathophysiology
   1. Suprascapular nerve impingement (typically by ligament at the Scapular notch)
3. Causes
   1. Clavicle Fracture
      1. Suprascapular Nerve runs posterior to clavicle and subject to injury
   2. Repetitive overhead activity
      1. Risk of Stretching injury at the suprascapular notch and the spinoglenoid notch
   3. Glenoid Labrum Tear with secondary cyst formation
      1. May entrap and compress the suprascapular nerve
4. Symptoms
   1. Infraspinatus weakness
      1. Weak external rotation at the Shoulder
   2. Supraspinatus weakness (variably involved)
      1. Weak arm elevation overhead
5. Differential Diagnosis
   1. Rotator Cuff Injury
   2. Brachial Plexus Injury
      1. Suprascapular nerve exits Brachial Plexus trunk
6. Diagnostics
   1. MRI Shoulder
      1. Evaluate for Rotator Cuff Tear, Labral Tear
      2. Obtain early in course (i.e. first month)
7. Management
   1. Referral to orthopedic surgery if Rotator Cuff Injury or space occupying lesion
   2. Peripheral Nerve block
   3. Physical Therapy
      1. Shoulder Range of Motion Exercises
      2. Strengthen compensatory Muscles
   4. Avoid reinjury
      1. Avoid heavy lifting
      2. Avoid repetitive overhead activity
8. Course
   1. Anticipate 6-12 month course with therapy
9. References
   1. Mallon and Shoenberger in Herbert (2019) EM:Rap 19(2): 13-5
   2. Neal (2010) Am Fam Physician 81(2): 147-55 [PubMed]
   3. Safran (2004) Am Sports Med 32(4): 1063-76 [PubMed]
   4. Silver (2021) Am Fam Physician 103(5): 275-85 [PubMed]