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scraping scapula after slap lesion surgery
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scraping scapula after slap lesion surgery


  I hope someone can help me. My girlfriend was in an automobile accident in 1995 in which she incurred a sprained wrist and a slap lesion of the bicep tendon.  She attended P/T for 2 years in which she had constant pain because the slap lesion had not yet been diagnosed.  Upon switching doctors she was finally diagnosed and operated on.  Orthroscopy was performed and a degradable tack was put in to re-attach the tendon and two years of scar tissue was removed.  She seemed to recover from this rapidly within only a couple of months.  As time progressed she slowly was losing muscle tone in the injured arm starting with the bicep an then to the rest of the arm muscles.  At that point she was put on another P/T program to rebuild the muscle.  She started feeling her shoulder "pop" and visted the doctor who performed the surgery once again. He had told her that all of the muscles in her arm had atrophied yet she had never stopped using the arm at any point or even used it less so the atrophy was unexplainable, he also told her that the popping was not coming from her ball an socket where it originally was pre-surgery, but rather from her scapula that was grinding and crunching on her rib cage.  The doctor prescribed hydrocodone for the emense pain she has been in ( so bad even with the hydrocodone she comes close to passing out from the pain),  which she normally has a high tolerance for, then he again put her on a P/T session for six weeks in which she has only attended a few times due to her pain (as per her therapists request) and the scraping. most of the exersizes she is unable to due, and her arm frequently goes numb while doing some of them her sholder blade appears to "stick out" towards the top right side of the scapula and can be moved around quite easily, she cannot lift anything, has little motor control as far as pulling, pushing or lifting is in excrusiating pain at times. recently the muscle attached to the top of the scapula is starting to cause her pain and giving her terrible headaches.  she keeps the arm in a sling most of the time and when taken out the arm becomes numb or painful. teh doctor has suggested cutting the top of the scapula off but i do not see how this would resolve the problem. If any one has any ideas on how to correct the problem or at least eleviate the pain please help!  
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Dear Craig:
What you describe may be a winging of the scapula. This can occur from damage to one of the shoulder nerves supplying one of the shoulder stabilizing muscles (serratus anterior, trapezius). Neither of the nerves, to my knowledge, is vulnerable to injury from shoulder dislocation/SLAP lesion-biceps tendon tear or shoulder surgery/arthroscopy. Either of these neuropathies, however, can occur spontaneously for unclear reasons (this occurence is termed "neuralgic amyotrophy" or "Parsonage-Turner syndrome" in appropriate circumstances).
A consultation with a neurologist with special expertise in focal neuropathies and neuromuscular disorders is appropriate, preferably at a major academic institution near you. A carefully conducted EMG test would be invaluable in diagnosing your friend's problem, and in guiding appropriate treatment.





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