Scapular pain and supra-scapular neuropathy in sports medicine.

Eight patients with shoulder pain are reported with a history of athletic a ctivities. On examination, performed with a delay of several months, all pa tients had painful paresis and atrophy of spinati fossa. Electroneuromyogra phy was carried out in all cases and showed a suprascapular nerve axonal lo ss from the spinati muscles or infraspinatus muscle, signs of denervation-r einnervation in spinati or infraspinatus muscles, normal examination of oth er scapular girdle muscles, and a coordinate spinati contraction with shoul der displacement excluding rotator cuff tears. All patients had conservativ e treatment and only two improved. Six patients underwent surgical decompre ssion of the suprascapular nerve; in three, motor function clearly improved , and in three others pain improved. The factors leading to entrapment incl ude stretch mechanisms associated with shoulder movements, leading to supra scapular nerve liability to mechanical lesions. In patients with shoulder p ain, the authors recommend an early electrophysiological work-up to recogni ze an isolated suprascapular neuropathy. The surgical decompression of the nerve should be based on persistent shoulder pain after conservative treatm ent. (C) 2000 Editions scientifiques et medicales Elsevier SAS.