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“I think my shoulder problem is because I have a winging scapula. My friend called it an “angel wing” on my back.”
Just the other day, a patient came into Life Strength for a shoulder issue and that was the first thing they said. After talking with the patient for a little bit, it turns out they were swimming with a friend who pointed out that the border of their shoulder blade was really prominent on their painful shoulder. To clarify, the scapula is commonly known as the shoulder blade.
Naturally, this patient went on the internet that evening to consult with Dr. Google to see if there was a link between how their shoulder blade looked and the pain they were having. What the internet search results said was that this patient had “scapular dyskinesis” and that having such a condition could lead to shoulder problems if not corrected.
Has anyone told you that you have a “winging scapula?” What did that mean to you?…and how can you “fix it?”
Weakness in the muscles around the scapula, particularly the serratus anterior, can affect how your shoulder blade moves.
-Alex Ewart
Scapular Dyskinesis, commonly called “winging scapula,” is when the border of the shoulder blade is prominent from the back of the ribcage and resembles a wing. It is thought scapular winging is a result of weakness in the muscles around the scapula, particularly one muscle called the serratus anterior.The serratus anterior plays a critical role in helping your scapula upwardly rotate, which is necessary for being able to reach all the way overhead. The serratus anterior is also uniquely positioned to keep the border of the shoulder blade held closely to the ribcage.
Weakness in the muscles around the scapula, particularly that serratus anterior I just mentioned, can affect how your shoulder blade moves. Altered scapular movement can limit the strength in your shoulder, your ability to reach overhead, and lead to certain muscles overworking to compensate.
While it used to be thought that there was a direct correlation between scapular winging and shoulder pain, this may not be true. A recent study was done that looked at people who had scapular winging versus people who did not have scapular winging. The participants were followed for a time to see how many/which people in each category would go on to develop shoulder pain. It turned out that both groups had an equal prevalence of shoulder pain during the course of the study. What does that mean? There was no direct correlation between a winging scapula and shoulder pain!
Another study looked to see if there was a change in scapular position over the course of a physical therapy plan of care. While the majority of patients’ pain decreased, function improved, and strength increased significantly, the position of their scapula did not change at all. This suggested that scapular winging may be a normal variant of posture. Again, scapular winging did not correlate with strength deficits or risk of shoulder injury.
After sharing this information with this patient, they realized that their scapular winging may not be the root cause of their shoulder pain. They felt relieved that they did not have something structurally wrong with their shoulder blade. While they did have weakness in the muscles around the shoulder blade, the position of their shoulder blade was not a result of this weakness.
Are you having shoulder pain and are unsure what to do? Give us a call.
In the meantime, here are some of our favorite exercises to activate and strengthen the muscles around your shoulder blade.
Philip W McClure, Jason Bialker, Nancy Neff, Gerald Williams, Andrew Karduna, Shoulder Function and 3-Dimensional Kinematics in People With Shoulder Impingement Syndrome Before and After a 6-Week Exercise Program, Physical Therapy, Volume 84, Issue 9, 1 September 2004, Pages 832–848, https://doi.org/10.1093/ptj/84.9.832
