How to Fix Winged Scapula?

How to Fix Winged Scapula?

The scapula, otherwise known as the shoulder blade, connects the upper arm with the collar bone. It’s surrounded by muscles and helps provide stability and movement to the arm. A winging scapula has several different causes. 

Fixing a winged scapula is a matter of determining what is causing it. Sometimes a winging scapula is caused by trauma or injury, other times it’s caused by poor posture, nerve damage, or overuse of the shoulder blade. There are both surgical and non-surgical options to fix this condition. 

How To Identify Winged Scapula

It’s fairly easy to identify a winged scapula. It’s not easily confused with common issues, such as a knot in the shoulder. Since the shoulder blades sit just under the skin on the upper back, it’s easy to visually identify an abnormal protrusion. A winged scapula will stick out at an angle from the back. Some cases cause a more apparent protrusion, but nearly all cases result in protrusion of one or both shoulder blades. 

Unfortunately, the underlying causes of scapular winging are a little harder to pin down. There are several different causes, each bringing different symptoms and requiring different methods of treatment. First, let’s take a look at the symptoms. 

Symptoms of Scapular Winging

Symptoms of a winged scapula vary depending on the cause of the issue and how the person’s body reacts. Some common symptoms include:

  • Protrusion of the shoulder blade.
  • Pain in the shoulder. 
  • Pain in the neck, arm, and upper back. 
  • Discomfort around the shoulder blade. 
  • Discomfort while sitting or wearing a backpack due to the protruding shoulder blade. 
  • Muscle weakness and/or fatigue for the shoulder.
  • Limited function of the affected arm and shoulder. 

Types of Scapular Winging

There are a few different types of scapular winging. The type usually dictates the specific treatment options available. It is almost always caused by damage to one or more nerves: the long thoracic nerve, spinal accessory nerve, or the dorsal scapular nerve.  

1) Repetitive Motion Injuries

  • Repeated, shoulder-heavy motions can contribute to scapular winging. Activities such as digging, trimming bushes, washing the car, or lifting items over your head repeatedly can all cause this issue. 

2) Traumatic Injuries

  • Injuries such as dislocating your shoulder, blunt force trauma to the area, twisting the neck, or falling on your shoulder blade can potentially cause scapular winging. 

3) Non-Traumatic Injuries

  • Flu, polio, certain surgical procedures, allergic reactions, and some specific medications can also cause it. 
  • Muscular dystrophy, exposure to toxins, and drug overdose may also contribute. 
  • Maintaining poor posture for years at a time may also contribute to winging scapular. 

Winged Scapula Test

There are many different kinds of tests that medical professionals perform to diagnose a winged scapula. A range of tests is often performed to determine how the movement of the shoulder blade is affected. Since the scapula has attachments to 17 different muscles, it’s important to know how movement is affected in order to get proper treatment. 

Most of these tests involve different types of shoulder movements while the physician evaluates the movement of the shoulder blade. These tests are designed to determine the specifics of scapular winging. There are a few different definitions for scapular winging:

  • Medial
  • Lateral
  • Neurogenic
  • Bone
  • Muscular

Electromyographic testing is also essential in diagnosing scapular winging. This tests the muscles by recording their electrical activity. It’s a good way to determine nerve function since damaged nerves are a common cause of winged scapula. 

Of course, any anterior/posterior shoulder pain you feel will also indicate the extent of the scapular winging and your treatment options. 

Winged Scapula Treatment

The specific treatment of winged scapula depends on the underlying cause. There are surgical options and nonsurgical options. In most cases, nonsurgical options should be exhausted before surgical options are seriously considered. Chiropractic care, physical therapy, and bracing are common non-invasive options. 

Can A Chiropractor Fix Winged Scapula?

Can A Chiropractor Fix Winged Scapula?

Chiropractors can help shoulder pain in general, but a common question regards their ability to treat winged scapula. Although chiropractic care usually isn’t right for winged scapula caused by traumatic injuries, it is a good option for winged scapula caused by injuries or issues with the muscles and tendons.

In fact, when you see a chiropractor for shoulder impingement or other shoulder issues, you could head off winged scapula before it gets too serious. This is because chiropractic adjustments can help correct posture imbalances and strengthen the muscles that support the shoulder and scapula. 

If you’re having shoulder issues or suspect you may be developing a winged scapula or other shoulder issues, don’t hesitate to seek chiropractic help. You can’t just wait for rotator cuff injuries to heal themselves— or any other shoulder injuries.   

Other Treatment Options

If chiropractic care, physical therapy, and/or bracing haven’t had a positive effect after an amount of time determined by your physician or doctor of chiropractic, you may need to try other treatment options. 

Nerve and muscle transfers are the least risky option of the three main surgical procedures. This is when a surgeon transfers healthy muscle and nerve tissue to the affected area, promoting healthy healing and normalized use. Static stabilization is a surgical procedure that attaches the scapula to another part of the skeleton, such as the ribs or the vertebrae with a sling. 

The more risky option involves fusing the scapula to the ribs. This usually has more unwanted side effects and is usually a last resort. 

How Long To Fix a Winged Scapula?

The road to recovery depends on how severe the winged scapula is. Some diagnoses only require some adjustments and physical therapy to heal within a few months. For these cases, it’s about the equivalent of getting rid of a pinched nerve in the shoulder

Other times it can take up to 2 years for the scapular winging to fully heal. It all depends on the cause, the treatment options available, and the individual patient’s factors. 

Winged Scapula Stretches and Exercises

There are a number of exercises that can benefit those with scapular winging. However, it’s always best to talk to your health care provider before doing and specific stretches like the ones outlined below. 

1) Scapular Stretch

  • Assume a standing position and grab onto something at waist level with the hand of the affected shoulder. 
  • Lean slightly away from that side so you can level your shoulder blade to keep it down and in place. 
  • Tilt your head away from that side, using your free hand to add a little stretch in the neck by gently pulling your head down and away from that shoulder. 
  • Hold for 30 seconds.
  • Repeat 3 to 5 times. 

2) Scapular Push-Ups

  • Get into a regular push-up position. 
  • With your arms straight and core engaged, use only your shoulder blades to perform push-ups. 
  • Your chest won’t move more than a couple of inches, which is fine. The idea is to engage all the muscles around the shoulder blades. 
  • Perform 15 to 20 reps. 
  • Repeat 3 times. 

3) Standing Angels

  • Begin in a standing position, palms together over your head, elbows bent and facing outward. 
  • Engage the muscles of your upper back and scapula as you bring your arms down. 
  • In the down position, your palms should be facing up at shoulder level, your elbows pointing down.
  • Bring your hands back together above your head. This is one rep. 
  • Make sure your scapula muscles are engaged the entire time. 
  • Repeat 10 to 12 reps. 
  • Repeat 3 times. 

4) Scapular Retraction

  • Assume a standing position with elbows bent and palms facing forward just above your head. 
  • Squeeze your shoulder blades together as you bring your elbows toward each other behind your back, as if you’re trying to get them to touch. 
  • Keep your palms facing forward as you do this. 
  • Return your hands to the starting position. This is one rep. 
  • Perform 12 to 15 reps. 
  • Repeat 3 times. 

5) Seated Row

  • Affix two resistance bands to a secure structure in front of you. 
  • Sitting down or standing on your knees, take hold of the bands, one in each hand. 
  • Keeping your back straight and your hands in-line, pull your elbows straight back behind you, focusing your efforts on the upper back. 
  • Return your hands to the starting position. 
  • Perform 12 to 15 reps, 
  • Repeat 5 to 8 times.  

Resources:
https://www.sciencedirect.com/science/article/abs/pii/S0363502318304088
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684151/#:~:text=Scapular%20winging%20is%20diagnosed%20easily,in%20a%20push%2Dup%20motion.
https://link.springer.com/article/10.1007/s11999-007-0086-2
https://www.medicalnewstoday.com/articles/scapular-winging#recovery

Dr. Brent Wells - Anchorage Chiropractor
About the Author

Dr. Brent Wells, D.C.

Dr. Brent Wells has been a trusted chiropractor since moving his family from Oregon to Alaska back in 1998 and founded Better Health Chiropractic & Physical Rehab – B.S. from Univ. of Nevada, Doctorate from Western States Chiropractic College, volunteer for Reflex Sympathetic Dystrophy Foundation, and member of the American Chiropractic Association. As a chiropractor his focus is on family, including his 3 children and wife of 20+ years, his clinics, and ongoing education.