A winged scapula is a common, yet debilitating condition which can lead to the limited functionality of the upper extremities!
Scapular winging in itself is not classified as a medical injury, it is just a symptom of another condition (we will discuss these conditions down below). Though this condition is relatively common, it can still go undetected and unattended.
If left unattended, it can further limit your shoulder mobility and worsen your posture. This is why today we will be discussing most common causes, symptoms and ways you can treat and fix your winged scapula!
Most Common Causes Of Scapular Winging
The most common cause of a winged scapula is serratus anterior muscle dysfunction. Serratus anterior is a muscle located on the side of the chest – originating on the surface of the 1st to 8th ribs and inserting along the medial border of the scapula (inner border which is parallel to the spine).
Serratus anterior dysfunction is generally caused by long thoracic nerve injuries. Due to its location, this nerve is prone to injuries.
As you can see, serratus anterior holds your scapula against your rib cage and, if for some reason the muscle fails to do its job properly, your scapula will stick out.
Another back muscle group we need to pay attention to are rhomboid major and minor muscles. Rhomboid muscles arise from the spinous processes of the spine (spinous processes are bony projections on the vertebrae you can feel under your skin) and attach to the medial surface of the scapula.
The main function of these muscles is to stabilise the scapula and hold it against your rib cage.
The third most common cause of scapular winging is tight pectoralis muscle. This tightness can often be overlooked but is very common, especially among younger individuals, and its due to our poor posture. When sitting in a slouched position, we are effectively tightening and shortening tendons of the pectoralis minor muscle.
Since the main function of this muscle is to pull the scapula towards the thorax, tightening can lead to various problems with the scapula including winging.
The condition itself is often asymptomatic, meaning the patient will feel no pain and often not know he has winged scapula until someone else points it out to him.
In addition to changes in physical appearance, patients may also experience:
- Pain when scapula is pressed
- Limited shoulder mobility – especially when attempting to raise their arm above their head
- Difficulty when performing (more challenging) daily activities
Using visual inspection we can, of course, diagnose and confirm this condition but we won’t be sure about its underlying cause. This is where electromyographic testing comes into play – this is the only sure and accurate way to determine which muscle is responsible and to which degree.
X-ray cannot be used to confirm or diagnose this condition, but it can be helpful in ruling out structural abnormalities in the neck and upper back.
Best Exercises For Fixing Scapular Winging
Treatment will, of course, largely depend on its underlying cause.
If you experience pain and swelling, as the first line of defence you can apply cold pack along this area (along the medial surface of the scapula).
For those of you who don’t experience pain, but want to “get rid” of a winged scapula, we have few exercises you should do daily in order to strengthen your back muscles.
Scapular Protraction For A Winged Scapula
Scapular protraction the best exercise specifically targeting serratus muscle. Check out the video below for the full exercise routine:
Pectoralis Muscle Stretch
Stretching the pectoralis minor muscle will not only help with winged scapula, it will also open up your chest and stretch all the muscles of the anterior torso, open up your airways and allow deeper breathing, and increase your shoulder mobility.
So, how do you stretch it? Stretching your pectoralis muscle is really simple:
- Stand in a corner of your room
- Raise your arms sideways, above shoulders
- Leen your arms against the wall and feel that deep stretching sensation spreading across your entire torso
- Hold the stretch for around 40 seconds and repeat 5,6 times
Check out the video demonstration below:
Surgery is generally recommended as a last resort but it is highly effective in fixing scapular winging, improving function and making you look good!
For more rhomboid exercises, you can check out one of your previous articles – Simple Rhomboid Stretches