After assessing my new client, I realized that her left shoulder is higher than the right one. She told me that she has had it all her life. She suffers no pain and the only limitation is when she raises her hands above her head. Then the left arm is at about a 35% limitation. This I am told is Springle Deformity. and that there is an extra little bone in her shoulder. Should I alter her shoulder and back exercises? Thank you Bea.
The short answer is: "Heck, yeah!" Actually, you don't have much of a choice.
Sprengel's Deformity is the most common congenital deformity of the shoulder. The scapula on the affected side is smaller, higher, and typically downwardly rotated. It's typically unilateral and affects three times as many women as men.
About 30 percent of people diagnosed with Sprengel's Deformity have the "extra" bone you mentioned. It's called an Omovertebral bone and connects the superior angle of the scapula to the lower cervical vertebrae.
Obviously, this severely hinders scapulothoracic motion. Glenohumeral motion, however, remains normal.
Since the asymmetry of the scapulae necessarily affects the length-tension relationships of all of the muscles in that region, be sure to check for muscle imbalances. Weakness and atrophy of the trapezius, deltoids and rhomboids are common.
Passive stretching used to be the recommended treatment, but studies have revealed it to be of little benefit.
Unfortunately, since Sprengel's deformity varies in severity, there are no specific exercises or modifications I can recommend.
As my wife, a rheumatologist, likes to tell me, you will never go wrong asking for the advice of your client's physician, physical therapist, etc.
It's the most effective and most professional way to take care of your client's best interest. As a bonus, it helps cover you legally and can be a source of referrals.