What Is Scapular Winging?

Scapular Winging And Scapulohumeral Rhythm

Scapular winging, also referred to as a winged scapula, is a condition affecting the shoulder blades (a bone of the shoulder anatomically referred to as the scapula). The name of this condition comes from its appearance, in which the scapula have a wing-like resemblance. Where an individual presenting with scapular winging, will rather than their shoulder blades lying flat against the back of their chest wall, their shoulder blades “stick out” protruding abnormally with the inside border of the shoulder blade sticking out from the chest wall with the appearance looking like that of the individual having wings.
Over and above the simple appearance of visually having winged scapulae, this condition may have functional consequences. Once such consequences is that a winged scapula may affect the individuals ability to raise their arms above shoulder height, since scapular winging can disrupt the normal scapulohumeral rhythm (being the movement of the shoulder blade around the chest wall associated with upper limb movement and load bearing). The scapula itself has many important muscles attached to it, muscles responsible for stabilizing the shoulder complex and helping facilitate movement of the upper limb. If one or more of these muscles are weak, paralyzed, or no longer work in unison with the other scapula muscles it impacts overall scapula movement. Such dysfunction of a shoulder blade stabiliser for example the serratus anterior muscle, which is a muscle commonly associated with winging scapula can lead to scapular dyskinesis (abnormal shoulder blade movement). It may be surprising to read that this type of condition in some form is actually relatively common and a shoulder having  abnormal scapulohumeral rhythm can occur as a result of pain, tightness and/or weakness of specific shoulder muscles or the thoracic spine and ribs among other things. A common contributor to abnormal scapulohumeral rhythm we see in physio practices are patients with winged scapula.

Symptoms Associated With A Winged Scapula

The presence of some amount of scapula winging is often considered normal in young children and is frequently not a cause for concern. In children this will usually rectify itself given time, as they build and develop trunk and shoulder strength over their formative years. However winged scapula are not considered normal shoulder blade postures in older children and adults. With scapular winging, symptoms may vary from person to person depending on the “cause” of the winging in the first place. Pain is not always a symptom in shoulder blade winging, however fatigue is a relatively common characteristic, as well are limitations in activities of daily living. Restrictions and fatigue associated with daily tasks can come about due to the potential for a loss of active range of movement when using arms above shoulder/head height as well as weakness in these and other shoulder postures.

Some of the possible symptoms associated with winged scapula may include:

• A winged scapula may affect both sides, or be just a unilateral issue.
• Pain or discomfort experienced in your neck, shoulders, and upper back.
• Weakness, fatigue or difficulty with pushing, pulling or lifting activities.
• A reduced capacity to raise and/or sustain holding your arm above shoulder height.
• Cosmetic appearance of a drooping shoulder

Disclaimer: Sydney Physio Clinic does not endorse any treatments, procedures, products mentioned. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance on What Is Scapular Winging? should consult his or her general practitioner, sports medicine specialist, physiotherapist or otherwise appropriately skilled practitioner.