Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Injuries to the Suprascapular Nerve

The suprascapular nerve supplies the supraspinatus and infraspinatus muscles. It runs in a groove on the upper edge of the scapula, and is held in the groove by a ligament. The suprascapular nerve can be damaged at the time of forward or backward dislocation of the shoulder joint, with the dislocation stretching the nerve over the edge of the scapula. In addition, the nerve can be damaged by a direct blow to the scapula, by external pressure (e.g. from a backpack) or by repetitive, one-sided overhead motions of the shoulder which cause tension in the nerve. Damage can also be caused by a local cyst.

Symptoms and diagnosis

– Pain radiates out toward the upper posterior part of the shoulder.
– Weakness in the supraspinatus and infraspinatus muscles is manifested by impaired abduction of the shoulder joint to an angle of 80–120°.
– Decreased volume (hypotrophy) of the supraspinatus and (especially) infraspinatus muscles can be pronounced and readily noticeable.
– Electromyographic examination will confirm the diagnosis.
– If only the infraspinatus is involved, compression of the nerve passing the spina scapulae should be suspected.

Treatment

Treatment includes:
– avoiding abuse if there is pain;
– flexibility training and, if there is no pain, strength training;
– local steroid injection;
– if the complaints persist, surgery to free the nerve by cutting the overlying ligament;
– neurolysis (release of the nerve), which should be performed distal to the spine.

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