Despite what it sounds like, Winging Scapula is not a type of bird found in the Cayman Islands – it’s a condition affecting a person’s shoulder area that can leave sufferers with a wing-like protuberance on the upper back.
The shoulder ‘blade’ is technically known as the scapula. It is the largest bone in the shoulder and has a large number of muscles attached to it.
The muscles that attach to the scapula control the movement of the shoulder and stabilise the shoulder. This ability to both create movement and stability is possible through a complex balance of the shoulder muscles. Sometimes these muscles oppose each other, sometimes they act together, but they always act as a well balanced team.
A loss of balance due to one of these muscles not working correctly leads to shoulder dysfunction. One possible noticeable effect of this dysfunction is ‘winging’ of the scapula. Additionally, the muscles surrounding the rotator cuff and scapula will tighten in attempt to stabilise the rotator cuff and scapula. The result will be pain and stiffness in the area in addition to ongoing damage to the joints.
Winging of the scapula describes what occurs with this condition; the scapula protrudes from the back like a stumpy little wing. Often there is no pain associated with a winging scapula. However, it should not be ignored as it can be a clue to underlying problems with the shoulder.
The winging associated with Winging Scapula is most apparent when attempting to push with the arms completely outstretched.
There are many possible causes of a Winging Scapula. It can occur due to shoulder muscle damage, muscle weakness, nerve damage, shoulder instability, or as a reaction to pain.
A true Winging Scapula is due to problems with one specific shoulder muscle; the Serratus Anterior. The Serratus Anterior muscle attaches from the scapula to the side of the upper rib cage through a series of notches that resemble the teeth of saw; just like a serrated knife refers to its finely notched edge.
Problems due to dysfunction of the Serratus Anterior muscle are not common. When there are problems, it is usually due to injury to the nerve that controls the muscle; the Long Thoracic Nerve. The Long Thoracic Nerve forms from a combination of three nerves in the lower neck. It travels along the side of the chest wall to each of the notches of the Serratus Anterior.
Due to the long unprotected distance the Long Thoracic Nerve travels, it is open to injury either through a direct blow or from an over-stretch. Injury to this nerve has been caused in almost all sports, usually from a blow to the ribs underneath an outstretched arm. Surgery in the area under the arm can also risk damage to the nerve. Even carrying a heavy bag over the shoulder for a prolonged time can damage this nerve. Early symptoms of damage to the nerve may be a complaint of a ‘burning’ along the scapula.
Treatment for a Winging Scapula is always initially nonsurgical. Sufferers will be shown a series of exercises to strengthen the shoulder, and in particular the Serratus Anterior muscle. Dysfunctional motion segments in the neck and upper back/ribs will need to be address as well. Other therapies that directly affect muscles may be of benefit as well. Those who fail to respond to conservative care and have pain due to shoulder dysfunction may require surgery.
It is important to note that this is not a problem one should attempt to correct through exercise without guidance. The thoracic nerve may be affected either through injury or infection. Therefore it is important to be diagnosed by a specialist before starting treatment.
Related Videos
