Scapula winging is a musculoskeletal condition in which the scapular (shoulder blade) lifts from the chest wall. This occurs when the muscles of the scapular are too weak (or in some cases paralysed) resulting in a reduced ability to stabilise. As a result the medial border of the scapula protrudes – like wings.
Symptoms of Scapular Winging
Symptoms will vary between individuals depending on the underlying cause as well as the muscles or nerves involved. However common presenting factors include:
- One (or both) shoulder blades lift off from the thoracic cage
- Pain or discomfort in neck, shoulders and back – especially with use of the arm (upper limb) for push, pull and lifting movements
- Visual asymmetries between left and right shoulder blades and/or arms
- Strength and endurance differences between arms
- Stability issues
Causes of Scapular Winging
There are two primary reasons for scapular winging – neurological & musculoskeletal:
Trauma, viral infection or other medical conditions can lead to damage to the nerves innervating the muscles of the scapula. This leads to weakness or paralysis meaning the muscles cannot act sufficiently to stabilise the scapula. This is due to injury of one or more of these nerves:
- the long thoracic nerve, which controls the serratus anterior muscle
- the dorsal scapular nerve, which controls the rhomboid muscles
- the spinal accessory nerve, which controls the trapezius muscle
In the absence of a specific underlying cause, it is possible to develop muscular weaknesses or imbalances that prevent proper scapular stabilisation.
Repetitive motion activities can also lead to injury or contribute to muscle imbalances. This is seen in athletes but also activities involving overhead and rotational components such as cleaning, painting and digging.
Scapular Winging Exercises
At our Trained Physio East Perth clinic we more commonly see musculoskeletal based scapular winging due to muscular weakness. This required a combination of manual therapy, proprioceptive re-training, stability and strengthening exercises to resolve. In some chronic cases, where shoulder pain is also involved it can take several months to0 retrain. Scapular Winging Exercises requires diligent and personalised rehabilitation to resolve your scapular winging and ensure good shoulder health.
Scapular Winging Treatment
Did you know at Trained Physio we have a fully equipped rehabilitation facility? Check out the details here. Physiotherapy has several goals including promote healing, reduce pain, avoiding aggravation, optimising physical function and global strengthening to restore normal movement patterns. To see how I can help you BOOK ONLINE TODAY
Written by: Olivia Strelein
- BSc. Physiotherapy (Honours)
- BSc. Exercise and Sport Science
- Personal Trainer