Winged scapula treatment

winged scapula treatment

Winged scapula or scapular winging is a protrusion of the medial or lateral borders of the shoulder blade away from the ribcage. Winged scapula happens as a result of weakened muscles that are in charge of stabilising the scapula. This winging can be more or less prominent in different people.

 

 

This presentation may be acquired or congenital. It can be triggered by an injury to the muscle or nerve around the shoulder blade.

 

 

Winged scapula or scapular winging is a protrusion of the medial or lateral borders of the shoulder blade away from the ribcage. Winged scapula happens as a result of weakened muscles that are in charge of stabilising the scapula. This winging can be more or less prominent in different people.


This presentation may be acquired or congenital. It can be triggered by an injury to the muscle or nerve around the shoulder blade.

winged scapula treatment

What muscles are involved in winged scapula

In case the musculoskeletal system, with its physiology and biomechanics, wasn’t already complicated enough, throw into the mix 18 muscles that attache to the scapula. Not always an easy task to figure out where the problem is!

 

In case of scapular winging we know that happens as a result of weakness and poor connection between the Serratus muscle group, Serratus anterior and posterior.

What muscles are involved in winged scapula

In case the musculoskeletal system, with its physiology and biomechanics, wasn’t already complicated enough, throw into the mix 18 muscles that attache to the scapula. Not always an easy task to figure out where the problem is!

 

In case of scapular winging we know that happens as a result of weakness and poor connection between the Serratus muscle group, Serratus anterior and posterior.

What problems does winged scapula cause

The abnormal position of the scapula can cause musculoskeletal pain in and around the shoulder blade as well as decreased strength and range of motion. All muscles attached to the scapula will be affected.

 

Our body works as a tensegrity structure, where all parts are interrelated and the functioning of one will affect the whole. When there is malfunction the body will adapt everything else to compensate for it. This creates a domino effect, the body becomes less functional and can cause other problems down the line.

 

In case of winged scapula, the scapula-thoracic and scapulo-clavicular joints are already directly affected but the closest joints to it, both above and below (shoulder joint and thoracic spine) tend to be the first ones to fall under the domino effect and problems like pain or frozen shoulder are frequently related to scapular winging.

What problems does winged scapula cause

The abnormal position of the scapula can cause musculoskeletal pain in and around the shoulder blade as well as decreased strength and range of motion. All muscles attached to the scapula will be affected.

 

Our body works as a tensegrity structure, where all parts are interrelated and the functioning of one will affect the whole. When there is malfunction the body will adapt everything else to compensate for it. This creates a domino effect, the body becomes less functional and can cause other problems down the line.

 

In case of winged scapula, the scapula-thoracic and scapulo-clavicular joints are already directly affected but the closest joints to it, both above and below (shoulder joint and thoracic spine) tend to be the first ones to fall under the domino effect and problems like pain or frozen shoulder are frequently related to scapular winging.

What’s the best treatment for winged scapula

Assessment

First of all a thorough assessment will help identify the problem and the consequences as well as the severity of the presentation.

 

Assessing range of motion and pain levels as well as movement of the joint involved and the ones straight above and below it.

Hands-on treatment

In case of winged scapula, hands on treatment, preferably myofascial release, will deal with restrictions that are contributing to the problem or are caused by it, reducing pain and resetting the body to a place where it can start healing. It is a necessary step to increase the chances of a good rehabilitation.

Exercise rehabilitation

This is the last step and a key one for winged scapula since it’s a presentation caused by muscular weakness.

 

A lot of people stop after the previous step because there is no more pain after the treatment or this is minimal. The fact that there’s no pain doesn’t mean, in case of scapular winging, that the problem root cause is fixed. This means that the same or similar symptoms will reoccur in the future.

 

Incorporating exercise rehabilitation into the treatment for this condition is a must.

 

The whole body should be considered when creating an exercise rehab plan but due to the nature of the presentation there will be a common theme, targeting the Serratus group and learning how to integrate these smaller muscles with larger muscles like Trapezius and Lattisimus dorsae.