Management of Humeroscapular Roughness.

Last updated Thursday, January 27, 2005

Figure 2 - Coracoacromial arch

Figure 3 - Subacromial abrasion

Management

Nonoperative management

Because shoulder roughness is usually of insidious onset, there is usually a good opportunity to try nonoperative management. Unless the diagnostic evaluation dictates otherwise, the patient is reassured that crepitus and occasional catching do not mandate surgical intervention.

Crepitus on moving the humerus with respect to the deltoid and coracoacromial arch is very common and often of little functional significance; some form of subacromial roughness can be found in most adult shoulders. Occasionally, patients demonstrate compromised smoothness of various aspects of the humeroscapular motion interface after injury or surgery, for example, roughness at the site of surgical reattachment of the subscapularis as it passes beneath the coracoid muscles on rotation.

In patients with functionally significant roughness of the nonarticular humeroscapular motion interface, the aim of nonoperative management is to restore normal kinematics. The first goal is flexibility, eliminating adhesions or posterior capsular tightness that may cause obligate anterosuperior humeral translation and subacromial abrasion. As flexibility is improved, attention is also directed at optimizing the normal stabilizing effect of the rotator cuff musculature by strengthening exercises, emphasizing internal and external rotation strength and endurance.

Operative management

Disclaimer

This resource has been provided by the University of Washington Department of Orthopaedics and Sports Medicine as general information only. This information may not apply to a specific patient. Additional information may be found at http://www.orthop.washington.edu or by contacting the UW Department of Orthopaedics and Sports Medicine.

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