If you have wings, you can fly high in the sky. However, if you have winged scapulars, the result is drastically different.
Nobody wants their scapulars to be winged as it can lead to many unwanted symptoms such as discomfort or pain in the shoulders or back. It can also significantly reduce the range of motion in your shoulders.
For this reason, it’s important to address this condition if you happen to have it.
This article will help you determine whether you have a winged scapula, and if so, what you can do about it and exercises to try.
Though you should consult with a chiropractor or other trained professional regarding treatment, you can get started with some exercises at home that help correct scapular winging.
What Is a Winged Scapula?
The scapula is the plate-like part of your shoulder on your upper back, known as your shoulder blade, or sometimes called a “wing bone.”
A winged scapula is a shoulder blade that is protruding outward from your back rather than lying flat.
Because the scapula plays such a critical role in your posture and the mobility of your arms and shoulders, scapular winging causes deformity that leads to pain in your back and shoulders.
How Can You Tell If You Have Winged Scapula?
As discussed, when someone has a winged scapula you’ll notice that their shoulder blade seems to stick out more than it should. In some cases, you may even see the shoulder blade stick out of a person’s shirt.
A normal shoulder blade should be pushed up right against the back of the ribcage, however, with a winged scapula, it has become loosened from the rib cage.
You can typically tell if you have scapular winging because of the physical protruding of the scapula from your back while in your natural resting posture.
Other symptoms include pain in the shoulder blade and surrounding area, weakness, reduced range of motion and difficulty raising your arm above your shoulder.
Symptoms vary from person to person depending on the cause and which muscles and nerves are affected.
However, there are some signs you can test for.
- The first thing to check is whether your shoulders are rounded forward. Even if you have good posture in your back, your shoulders can hunch forward, resulting in scapular winging.
- You can take a picture of your back while you’re standing in your natural posture and see if your shoulder blade is protruding. Ideally, it should be lying flat.
- You can also take a video of your back while you’re doing a push-up against a wall. If you can see your shoulder blades protruding, you have scapular winging.
- If you lay flat on your back and push dumbbells toward the ceiling with your arms in a push-up-like motion, you’ll feel your shoulder blades digging painfully into the floor if they are winged.
What Causes Scapular Winging?
Scapular winging can happen because of injuries that cause nerve damage, as well as muscle imbalances or tightness that affect your skeletal structure and posture.
When it’s the result of some sort of injury, it’s typically caused by damage done to the long thoracic nerve (e.g. holding a bag over one shoulder for too long), dorsal scapular nerve or spinal accessory nerve.
Repetitive movements and tasks like washing windows, digging in the ground or trimming bushes can result in injury to these nerves, especially if the muscles around your scapula are weak .
Athletes repetitively using their arms in overhead motions to throw balls, swim or swing racquets are susceptible.
The Serratus Anterior Muscle
The serratus anterior muscle is frequently the main culprit behind winged scapula. Specifically, it has become inactive or very weak.
The serratus anterior starts at the side of the rib cage below the chest and goes round the back below the scapula. If the muscle is working well, it attaches onto the scapula and pulls it tight to the ribs.
If the muscle is weak, the scapula will float off the rib cage leaving little control over the scapula and shoulder, and most noticeably a protruding shoulder blade.
If there’s weakness or loss of function in your serratus anterior muscle, trapezius muscle or brachial plexus, it raises your risk of injuries that cause scapular winging.
People who have an anterior pelvic tilt may also be susceptible to developing a winged scapula because the serratus anterior muscle can become too relaxed in this type of posture.
Muscle Imbalances: The Pecs and the Serratus Anterior Muscle
Muscle imbalances can also cause scapular winging. When your pectoral muscles are excessively tight, they pull the shoulders forward, resulting in scapular winging.
As discussed, the serratus anterior is the muscle group on your back that holds your shoulder blades in place on the back.
When this muscle is underused as a result of a slouching posture or excessive sitting in chairs, it becomes loose and deactivated rather than contracted to bring your shoulder blades down your back.
This also happens when your pecs are continually contracted, as they’re the opposing muscles to the serratus anterior–meaning, when they’re contracted, the serratus anterior is released.
In turn, this releases your shoulder blades upwards and results in scapular winging.
While scapular winging is often caused by injuries, sometimes it isn’t the result of force.
It can also be caused by viral illnesses, allergic reactions to medication, drug overdoses, muscular dystrophy and excess exposure to toxins.
Why It’s Important to Fix Scapular Winging
You want to avoid or treat scapular winging to prevent chronic pain and poor posture.
When your shoulders are rounding forward due to scapular winging, it’s only natural for your upper back to follow suit and give you a slouching posture.
This requires your neck and lower back to arch unnaturally so that you can compensate for a rounding upper back.
People with scapular winging often also have upper cross syndrome, in which tightness in your pecs, upper trapezius and levator scapula cause you to hunch forward.
In addition to poor posture and the tightness and pain that results from it, scapular winging also reduces your range of motion in your arms and shoulders.
If you’re an athlete, this affects your performance. However, it can even cause pain when performing daily tasks.
Treatment Options for Scapular Winging
Scapula winging can be corrected, though the treatment that works will depend on the nerve and muscle causing it.
In most cases, scapular winging can be fixed through physical therapy, massage, stretching and strength exercises. In more serious cases, surgery may be required.
Massage therapy can release the tightness in your pectoral muscles and around your shoulder blades that prevent your serratus anterior from activating and holding your shoulder blades in place.
Muscle relaxants, painkillers, anti-inflammatory drugs can assist in the treatment of painful scapular winging in which muscle tissue has become terribly inflamed and knotted.
If these treatments don’t work, a professional might recommend surgery. This is more common in cases of injuries involving brute force and nerve damage.
For example, scapular winging caused by damage to your spinal accessory nerve typically necessitates surgery.
Surgical treatment may involve nerve and muscle transfers, in which a surgeon removes nerve or muscle tissue and relocates it to another part of your body.
Another surgery that treats scapular winging is static stabilization, where a sling is placed between your scapula connecting it to either your ribs or vertebrae so that it lays flat on your back.
A more risky surgery called scapulothoracic fusion involves attaching your scapula onto your ribs, but it can actually reduce your mobility instead of improving it and is only recommended when all other options have been exhausted.
Physical Therapy and Home Exercises
Physical therapy and strength training that strengthen your serratus anterior and release tension in your pectoralis minor help correct scapular winging. It’s always best to have a physical therapist guide you, but you can do exercises and stretches at home to correct scapular winging.
This is what the next section will focus on.
Corrective Exercises to Fix Scapular Winging
Many (but not all) cases of scapular winging can be fixed with exercises you can do at home. With regular practice of these, you can expect to correct it over time.
The main muscle imbalance that needs to be corrected is an overactive pectoralis minor and underactive serratus anterior.
If you have this muscle imbalance but haven’t experienced a serious injury, this method of correcting scapular winging should work for you. A chiropractor or physical therapist can help you determine this.
Below are some exercises that can help fix with scapular winging. The exercises are taken from videos about scapula winging.
It would be advisable to watch these informative videos in full to learn more about form and boost your overall knowledge on how to correct winged scapula.
1. Scapular Pushup
It seems logical for us to think that the serratus anterior muscle is responsible for pulling our shoulder blade back in place, however, the opposite is true. It is responsible for protracting our shoulder blade.
A great exercise is to do a scapular pushup as shown in the video above. Note that this exercise can also be done against a wall.
2. Banded Shoulder Protraction
This exercise involves a similar motion to the scapula pushup except a band is used. This option is great if you do not want to put pressure onto your hands like the scapula pushup.
To do this exercise:
- Wrap a band around you so it goes around your back
- Using both arms, slowly retract and protract your shoulder blades, pushing the band away from you.
- Keep doing this back and forth.
Watch the video below to see this exercise in motion, as well as learning more about fixing a winged scapula.
3. Wall Slides
This exercise is great for anyone who does not want to get onto the floor but would prefer to use a wall instead.
- Stand in a position with your arms against the wall, and push your shoulder blades back outwards (shoulder blades protracted)
- Slide your arms up the wall and keep your back pushed backwards
- Once at the top, slide back holding the position of your shoulders and back
- It is important to not let your back sink in during this exercise
Watch the video below to learn how to do a wall slide, as well as get some further exercise ideas.
4. Lying Dumbbell Shoulder Protraction
To do this exercise you will need a dumbbell or small weight.
- Lie down on your back
- With a small weight in one hand, raise it out in front of you
- Next push it toward the ceiling only using the shoulder joint
- Slowly lift and lower
The video below shows this exercise in motion and also some others that you can try.
5. Dumbell Pull-Over
You may have come across this exercise already as it’s the well-known dumbbell pullover.
- Lie on your back holding a dumbbell with both hands.
- Raise the dumbbell above your chest
- Slowly lower the dumbbell so that it sits above your head
- Be very careful not to smash your own face with this one!
To see how to do this exercise watch the video below.
6. Pec Stretch & Release
Your pectoral muscle group stretches between your two armpits across the centre of your chest. The pectoralis minor is the armpit region on either side of your chest where your shoulder meets your chest.
When these muscles are chronically tight and knotted, they need to release in order for the opposing muscle group, your serratus anterior, to “wake up” and contract.
Stretching and massaging the pectoralis minor is not very straightforward, but there are some exercises you can do.
One way to release your pec minor is to use a massage ball.
Lay on a mat or rest against a wall with your stomach facing downward. Place the massage ball directly beneath your pec minor and use your body weight to apply pressure to release its tension.
To stretch your pec minor on both sides, you can stand at a door frame and place your palms and forearms on either side of the door frame.
Then, you can lunge one leg forward and push your chest forward until you feel a stretch in your pec minor region.
For a more comprehensive guide on how to stretch the Pec Minor see this page.
Be Persistent & Fix it For Good
If you have scapular winging to any degree, be sure to make correct posture and muscle balance a priority to prevent or improve your shoulder blade alignment.
Recovery can take anywhere from a few weeks to a few years, depending on the cause, the nerves and muscles involved in the injury or misalignment, and the treatment method used.
However, it’s always ideal to check with a professional who can diagnose scapular winging and get you on track with the best treatment for you. This can help speed up your recovery and ensure you’re not at risk of worsening your injury.
Once you’ve corrected scapular winging, you want to continue using the same home exercises that helped you fix it, in order to prevent it from recurring in the future.
Regularly stretching, strengthening and massaging the muscles in your shoulders, back, arms and neck will help you maintain correct posture and prevent injuries that could cause scapular winging.
You can also switch to an ergonomic chair, ergonomic pillow, ergonomic backpack and so on, to prevent misalignment.