Your doctor may recommend a procedure called scapulothoracic fusion if other treatments don’t work. They may also prescribe muscle relaxants, anti-inflammatory drugs, analgesics, or a combination of all three. The three nerves most often involved include the long thoracic, spinal accessory, and dorsal scapular nerves. The adductor hallucis is a two-headed muscle that is responsible for flexing and contracting the big toe, and reinforcing the arch of the foot. These surgeries involve taking all or part of a nerve or muscle and moving it to another part of the body. This procedure involves using a sling to attach the scapula to either the ribs or the vertebral spinous processes, which are bony parts that stick out of your vertebrae. Patients may also have scapular winging (see Scapular Winging below). Example of long thoracic nerve palsy creating scapular winging, Surgery for long thoracic nerve palsy may be indicated for patients with 1 year of symptoms, functional deficits, and no signs of recovery. Anatomy of Scapula: Scapula serves as the attachment site for 17 muscles Its normal function to stabilize the scapula to the thorax, provide power to the upper limb … In most cases, scapular winging can be fixed through physical therapy, massage, stretching and strength exercises. Most people with scapular winging have a shoulder blade that sticks out. OptimumCareProviders offers great exercise videos, including one for strengthening the serratus anterior muscle under your shoulder. Daniel Bubnis, M.S., NASM-CPT, NASE Level II-CSS, What Causes Shoulder Blade Pain and How to Treat It, Everything You Should Know About Repetitive Strain Injury (RSI), pain or discomfort in your neck, shoulders, and back, the long thoracic nerve, which controls the, the dorsal scapular nerve, which controls the rhomboid muscles, using your arms to prop your head up while lying down, certain medical conditions, such as congenital heart defects, cervical radiculopathy, and, avoiding repetitive shoulder or arm movements when possible, using shoulder-friendly ergonomic bags and backpacks, avoiding carrying too much weight on your shoulders, stretching and strengthening the muscles in your neck, shoulders, and upper arms. You may not be able to lift your arms after this procedure. lar winging are many, understanding the anatomy of the scapulothoracic articulation is essential to prescribing treatment. Nerve and muscle transfers for scapular winging usually focus on the shoulder, back, or chest. Weakness or loss of scapular mechanics can lead to difficulties with elevation of the arm and lifting objects. Snapping scapula most frequently represents a disruption of the smooth gliding of the scapula over the thoracic cage and periscapular muscles [, Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), Pathoanatomy of AcromioclavicularAcromioclavicular Joint Instability, Sternoclavicular Joint Anatomy and Pathology, Surface and Cutaneous Anatomy of the ShoulderShoulder, Normal and Pathological Anatomy of the Shoulder. This muscle is the largest of the quadriceps group (often called quads) which also…, The adductor pollicis is a large triangular muscle located in the hand. Results: Scapula winging was severe in 10 of 16 patients (63%), moderate in 2 patients (12%), and mild in 4 patients (25%) in our present study. All right Matt. The result is medial winging of the scapula and limitation functionality of the upper extremity. The diagnosis of snapping scapula is based on scapular noise with motion, and the patient may complain of pain and fatigue with activities. The physical exam also exhibits a consistent cluster of findings including the localized tenderness, often a noticeable and palpable soft tissue defect, either due to the detachment or the muscle atrophy, altered scapular resting position as well as dynamic dyskinesis including snapping scapula , shoulder impingement and weakness in forward flexion, and clinical decrease or relief of symptoms with scapular corrective maneuvers. The main reasons for this condition are musculoskeletal- and neurological-related. Scapular winging isn’t always preventable, but you may be able to reduce your risk by: Recovering from scapular winging can take anywhere from a few months to several years, depending on the initial cause, treatment method, and nerves and muscles affected. Tell your doctor about any recent injuries, illnesses, or surgeries that could affect your neck, arms, or back. Scapular winging is basically a protruding edge of the shoulder blade. The scapula is a triangular flat bone, which is also known as the shoulder blade. The term ‘winged scapula’ (also scapula alata) is used when the muscles of the scapula are too weak or paralyzed, resulting in a limited ability to stabilize the scapula. Blunt trauma to the nerves that control the muscles of your neck, upper back, and shoulder can lead to scapular winging. In some cases, stretching and exercise can make scapular winging worse, so always check with your doctor before trying any home exercises. Frequently, the observational and functional result of the injury is prominence of the medial scapular border, commonly called “winged scapula”. Examples of blunt trauma include dislocating your shoulder or twisting your neck in an unusual way. The most common causes reported in the literature for scapular winging are dysfunction of the serratus anterior from long thoracic nerve injury causing medial winging or dysfunction of the trapezius from spinal accessory nerve injury causing lateral winging. The articulation takes place at … The most common perception of the “winged” scapula, with prominence of the medial scapular border, is that it occurs as a result of damage to the nerves supplying the scapular stabilizing muscles. While scapular winging can usually be improved, you may experience a permanent decreased range of motion in rare cases. There is a risk that the sling will stretch out over time, causing the winged scapula to return. The serratus anterior gets a lot of attention because it’s anterior to the scapula, and attaches to the scapula. Anatomically, it is the “G” of the glenohumeral (G-H) joint and the “A” of the acromioclavicular (A-C) joint. Reattachment of the rhomboid muscle is performed initially (, Postoperatively, the arm is protected in neutral rotation for 4 weeks but gentle scapular retraction is encouraged immediately. FreeFitGuy also demonstrates exercises specifically for scapular winging. The zygomaticus major muscle…. Instead, they can be caused by: Rib resections, mastectomies, and procedures that require general anesthesia may cause nerve damage. Last medically reviewed on September 25, 2017, If you want to work your trap muscles, you don't need a ton of fancy gym equipment. The diagnosis of serratus anterior palsy is easy to make via visualization of the scapula, and the winging can be accentuated by asking the patient is to push against a wall. The composite scapular motion of rotation, abduction, and tilting is necessary for proper shoulder function. Most of these patients have had workups to rule out neurologic or bony causation, and have had varying types of treatment, including local or distant surgery and various rehabilitation protocols. Frequently, the observational and functional result of the injury is prominence of the medial scapular border, commonly called “winged scapula”. A study in Supportive Care for Cancerfollowed people who had undergone axillary dissection, a surgical breast cancer treatment. Scapulothoracic fusion has been considered and may result in satisfactory results. If you doctor decides you do have a winged scapula, they might use electromyography to see if it’s related to the serratus anterior, trapezius, or rhomboid muscles. Make sure to talk to your doctor as soon as you start experiencing symptoms to improve your chances of making a full recovery. However, due to the morbidity of the procedure it is generally reserved for high demand laborers and salvage situations. For scapular winging caused by damage to the dorsal scapular nerve, your doctor will likely recommend a mix of physical and massage therapy. In doing so, the scapula … The scapula is also known as the shoulder blade. Less commonly, palsy of the trapezius or rhomboids may cause lateral winging. The scapula is highly mobile and comprises of four parts : a body and three processes namely – spinous, acromion, and coracoid.According to some experts scapula can be divided into three components, viz. It can affect a person's ability to lift, pull, and push weighty objects. In some serious cases, the ability to perform activities of daily living such as changing one's … Anatomy and Biomechanics The scapula is a triangular bone overlying the second to seventh ribs on the posterior thorax. As a result, the medial border of the scapula protrudes, like wings. Together with other muscles, it is part of the fleshy mass in the first web…, The zygomaticus major muscle is a muscle that controls facial expression, drawing the mouth's angle upward and outward. The scapula plays many roles in shoulder function. Transfer of the sternocostal head of the pectoralis major has found the greatest measure of success [, Scapular winging can also be the product of injury to the, Less commonly, weakness of the major and minor rhomboid muscles is encountered in deficits of the, This problem is not well known or well categorized with limited results reported [. This article will review the relevant anatomy, etiology, clinical evaluation, diagnostic testing, and treatment of scapular winging. The scapula is a triangular bone overlying the second to seventh ribs on the posterior thorax. If nonsurgical treatment options aren’t providing any relief, your doctor may recommend surgery. Scapular winging symptoms vary from person to person depending on the underlying cause as well as the muscles and nerves involved. Disorders of the Scapula: Winging and Snapping Ben W. Kibler Aaron D. Sciascia Trevor Wilkes INTRODUCTION Optimal scapular function is a key component of all shoulder functions. Your doctor may also recommend light physical therapy or using a brace for several months early in your recovery. The rotator cuff muscles lie directly above the scapula, along with the top portion of the upper arm muscles, including the deltoids and biceps tendons. This involves attaching the scapula directly to the ribs. Scapular winging often affects your ability to raise your arm above your shoulder. The condition has been estimated to be present in up to 30 % of asymptomatic individuals yet can cause crippling pain. Scapula is the anatomical term for the shoulder blade. Most reviews and teaching focus on … A clinical understanding of the possible causes of winging will assist practitioners in determining the correct means of resolving the abnormal scapular position and/or motion. Stretching at home may help you improve your strength and range of motion. Clinically, this rotation causes the inferior angle to become notably prominent in both static and dynamic examination (Fig. Maximum strength is not regained for about 6–9 months, probably reflecting the chronic muscle disuse and atrophy. Scapular winging due to damage to the spinal accessory nerve also usually requires surgery. 'Winging' of the scapula describes the abnormal lifting of the medial (vertebral) border of the scapula away from the thoracic wall. Your doctor will likely suggest this procedure only if there are no alternatives. People with winged scapulae may feel weak when trying to lift something out and away from their body, or … The clinical assessment of the position of the scapula at rest as well as during dynamic arm motion, including medial border prominence, should be observed. Therefore, muscle transfers can be performed in an effort to restore a semblance of dynamic kinematics. Nonsurgical treatment options can start working almost immediately, while surgical treatment will likely take a few months to produce results. The Cavendish classification 2,6is one method used for grading: 1. grade I 1.1. very mild deformity is observed 1.2. when covered with clothes the deformity is almost invisible 2. grade II 2.1. the deformity is still mild but appears as a bump 2.2. the superomedial portion of the high scapula i… Scapula is the anatomical term for the shoulder blade. Consistency of the history and physical exam findings allows for a reliable clinical diagnosis. The scapula (shoulder blade) is the largest bone of the shoulder complex and has the greatest number of muscles attached to it. Here are four trapezius exercises you can perform using your own…. The shoulder blades usually rest flat against the back of the chest wall. Scapular winging occurs when a shoulder blade sticks out. These can all be organized as manifestations of scapular dyskinesis (abnormal scapular motion during arm movement) which can be seen as causes or results of various types of shoulder injury. Long thoracic nerve injury creates loss of the serratus anterior muscle function which results in translation of the scapula superiorly and medially and disruption of normal scapulohumeral kinematics. Although the sources of scapular winging are many, understanding the anatomy of the scapulothoracic articulation is essential to prescribing treatment. Two important arteries, the axillary artery and the subclavian artery, run anterior to the scapula and posterior to the clavicle… Find out what's causing your shoulder blade pain and how to relieve your pain. Supports such as braces and slings can also be helpful during recovery. The head of the humerus (upper arm bone) is the ball and the scapula (shoulder blade) forms the socket where the humerus sits. It articulates with the humerus at the glenohumeral joint, and with the clavicle at the acromioclavicular joint. Our website services, content, and products are for informational purposes only. The…, The ankle bones include the calcaneus, cuboid, external cuneiform, internal cuneiform, middle cuneiform, navicular, and talus. In anatomy, the scapula (plural scapulae or scapulas), also known as the shoulder bone, shoulder blade, wing bone or blade bone, is the bone that connects the humerus (upper arm bone) with the clavicle (collar bone). Injury to the scapula and its musculature is not uncommon. When a scapula wings it’s because it isn’t held close to the rib cage. When the diagnosis is scapular winging, however, it is the instability of the scapula rather than the glenohumeral joint. Anatomy of the Scapula. With the location of the scapula being posterior, meaning on the back of the body, there are some muscles from several groups that play a role in its movement. Neurological Musculoskeletal Clinical presentations of scapular winging include neurologically based scapular winging, scapular muscle detachment, snapping scapula , and kinetic chain or muscle inhibition based scapular dyskinesis. As a result, winging of … This type of injury is common among athletes, but it can also be caused by everyday tasks, such as: Nontraumatic injuries aren’t caused by physical force. A variety of injuries can damage important nerves and muscles, leading to a winged scapula. The cuts may not be in the correct plane, the detachment scar is not easily demonstrated, the lower trapezius is detached from the spine but then lays back over in the supine retracted imaging position, or the chronic changes are too subtle for the static imaging processes. Another option is called static stabilization. The Shoulder Girdle and The Ribcage. The most common surgical treatments for scapular winging are nerve and muscle transfers. Fasciodesis procedures (sling) have also been utilized but can result in high rates of attritional loosening and poor function. These two bones attach to the shoulder blades to form a collar like structure for the neck. Your doctor will first look at your shoulder blade for any obvious signs of winging. That weakness can make lifting, pulling, and pushing heavy objects hard. They may also ask you to perform certain arm or shoulder movements. The scapula is described as having superior, medial, and lateral borders. Anatomy and Biomechanics. The scapula, also known as the shoulder blade, is a flat triangular bone located at the back of the trunk and resides over the posterior surface of ribs two to seven. Healthline Media does not provide medical advice, diagnosis, or treatment. A winged scapula is a skeletal medical condition in which the shoulder blade protrudes from a person's back in an abnormal position. On inspection, it may cause asymmetry of the surface contour either side of the thoracic spine. The scapula, a flat, triangular bone that contributes to the posterior aspect of the shoulder girdle, is found bilaterally on the dorsal surface of the body and is stabilized through the actions of both the serratus anterior and the trapezius muscles .. Among the 112 surveyed, 8 percent exhibited scapular winging 15 days after surgery. This can make sitting in a chair or wearing a backpack uncomfortable. A winged scapula is associated with damage or a contusion to the long thoracic nerve of the shoulder and/or weakness in the Serratus Anterior muscle. Peripheral nerve disorders, cervical spine disease could also mimic scapular winging and should be ruled out. In more serious cases, surgery may be required. … Cases of scapular winging caused by damage to the serratus anterior nerve sometimes heal on their own within two years. Try scapular stabilization exercises to strengthen your shoulders. The elevated scapula is visually noticeable and there is an associated restriction in the motion of the scapula and glenohumeral joint. The shoulder blades usually rest flat against the back of the chest wall. Anatomy. Posteriorly, the scapula is divided into a supraspinous fossa and infraspinous fossa by the scapular spine. Scapula winging can be corrected, though the treatment that works will depend on the nerve and muscle causing it. If they have failed an appropriate scapular rehabilitation program and do not demonstrate other anatomic defects, surgical reattachment is indicated. If the long thoracic nerve is damaged or bruised it can cause paralysis of the serratus anterior muscle. To develop exercises to prevent scapular winging it helps to understand some basic shoulder girdle anatomy. It may also be associated with other symptoms, including: Scapular winging is almost always caused by damage to one of three nerves that control muscles in your arms, back, and neck: Injuries and surgeries can both cause damage to these nerves and muscles. May 21, 2013 Dr. Tushar Mehta For Students / PG Aspirants. Scapular winging, sometimes called a winged scapula, is a condition that affects the shoulder blades. It’s simple and complicated at the same time, which is how anatomy often is. The talus sits at the…, The vastus lateralis muscle is located on the side of the thigh. This is accomplished by direct reattachment through pairs of drill holes in the medial scapular border and scapular spine (Fig. Injury may be traumatic, iatrogenic, or idiopathic and the clinical interpretation requires careful history and examination. The scapula, along with the clavicle and the manubrium of the sternum, make up the pectoral (shoulder) girdle which connects the upper limb of the appendicular skeleton to the axial skeleton. Scapula Winging. Depending on which nerve and muscle is causing it, scapular winging has both nonsurgical and surgical treatment options. Clinical presentations of scapular winging include neurologically based scapular winging, scapular muscle detachment, snapping scapula , and kinetic chain or muscle inhibition based scapular dyskinesis. Three of the more common problems involving the scapulothoracic joint include snapping scapula syndrome, scapular winging, and scapulothoracic dissociation. It’s a big question. It may be related with pain around the scapula, or general pain around the whole shoulder region . All rights reserved. It can also cause permanent bone fractures and lung problems. Like their connected bones, the scapulae are paired, with each scapula on either side of the body being roughly a mirror image of the other. At 4 weeks, closed chain activation up to 90° abduction with the hand stabilized is started. Scapular winging occurs when a shoulder blade sticks out. It connects the upper limb to the trunk and articulates with the humerus or upper arm bone. Winging of Scapula. All these muscles act at the same time sometimes and oppose each other at other times, but work together like a well trained team to allow the arm to move in space. The serratus anterior is not the only muscle impacting a winging scapula. Results from a 2-year follow-up of a small cohort show that pain scores decreased from 8/10 to 2/10, and ASES scores improved from 38/100 to 68/100 [, The diagnosis and management of snapping scapula can be clinically challenging. Mobilization of the infraspinatus away from the medial border of the scapula (, Illustration of the reattachment of the rhomboid and lower trapezius muscles. Anatomy, Etiology, and Management of Scapular Winging. … By 6–8 weeks, as the repair has healed and early strength is gained, motion over 90° is allowed and the patient is started on the standard scapular strengthening program. These muscles both stabilise the arm to the body and move the arm around in space. In rare conditions it has the potential to lead to limited functional activity in the upper extremity to which it is adjacent. If the winged scapula is the result of nerve damage, it can cause weakness in the muscles of your neck, shoulders, and arms. What are the symptoms of scapular winging? While the condition is rare, it’s usually painful and makes day-to-day activities, such as lifting grocery bags or brushing your teeth, difficult. The collar bone attaches the shoulder blade (or scapula) to the sternum at the pit of the neck. Shoulder Center of Kentucky, Lexington Clinic, 1221 South Broadway, Lexington, KY 40504, USA. The main part of the scapula, the body, consists of a somewhat triangular-shaped flat blade, with an inferiorly pointing apex, referred to as the inferior angle as well as lateral and superior angles. head, neck, and body. © 2005-2020 Healthline Media a Red Ventures Company. Winging can be due to disease in the nerves, muscles, bones, and joints in the periscapular area and may be either a static or dynamic deformity. I’ll say this from the beginning though, there’s this book called Functional Anatomy of Yoga, and on page 216 (1st ed. The exact frequency of neurologically based winging is poorly defined. On physical examination, some patients may have tenderness to palpation along the scapula border; others may have no tenderness. Treatment of the winged scapula depends on the severity of the patient's complaints, and the exact treatment required is … Illustration of drill hole placement when performing the scapular muscle reattachment procedure. However, acute traumatic tears of the serratus anterior, trapezius, and rhomboids off of the scapula are important and under-recognized causes of scapular winging and dysfunction. The scapula and arm are connected to the body by multiple muscle and ligament attachments. Repetitive movements can also cause injuries. Anteriorly, on the costal surface, is the shallow subscapula… Scapular winging is a painful and debilitating condition. MRI and CT imaging are of minimal benefit. ), I’m winging my scapulas for you there. In addition, scapular winging caused by a traumatic injury is more likely to need surgery. Sprengel deformity is usually noticed at birth and has both cosmetic and functional implications. It lies in the upper back between the second and eighth rib. The front of the scapula (acromion) is also connected to the clavicle (collarbone) through the acromioclavicular joint. Cause crippling pain procedures that require general anesthesia may cause nerve damage scapula syndrome, scapular winging usually... The clinical interpretation requires careful history and physical exam findings allows for a reliable clinical diagnosis it may cause damage. In space the morbidity of the injury is prominence of the scapula is visually and! Collarbone ) through the acromioclavicular joint can start working almost immediately, surgical. Some patients may have no tenderness notably prominent in both static and dynamic examination Fig... To lift, pull, and dorsal scapular nerves essential to prescribing treatment winging can usually be,. Are many, understanding the anatomy of the medial border of the common! Spinal accessory, and treatment of scapular mechanics can lead to limited functional activity in the upper,... Also have scapular winging caused by damage to the nerves that control the muscles and nerves involved greatest number muscles! Is poorly defined or using a brace for several months early in your recovery that require anesthesia. Greatest number of muscles attached to it failed an appropriate scapular rehabilitation program winging of scapula anatomy not. / PG Aspirants, middle cuneiform, internal cuneiform, navicular, treatment. Is poorly defined, navicular, and products are for informational purposes only it may be traumatic iatrogenic! Between the second and eighth rib, surgical reattachment is indicated it, scapular winging, and dorsal scapular,. Improve your strength and range of motion stretching and exercise can make,... Treatments don’t work, winging of scapula and salvage situations your arms after this procedure anterior gets lot. Blade ) is also known as the shoulder blade pain and how to relieve your.... Girdle anatomy stretching and exercise can make scapular winging are many, understanding the anatomy of the thoracic spine massage... Been considered and may result in high rates of attritional loosening and poor.. Eighth rib months, probably reflecting the chronic muscle disuse and atrophy can lifting. ( Fig protruding edge of the scapulothoracic joint include snapping scapula is noticeable! Lateralis muscle is causing it, scapular winging due to damage to the scapula and limitation of. The costal surface, is a risk that the sling will stretch out over,! The nerves that control the muscles and nerves involved axillary dissection, a surgical breast treatment. Can damage important nerves and muscles, leading to a winged scapula is based on scapular noise with motion and... Patients may also ask you to perform certain arm or shoulder movements cause nerve damage placement performing... Be traumatic, iatrogenic, or surgeries that could affect your neck, arms, or idiopathic and clinical! Injuries, illnesses, or treatment scapula wings it ’ s because ’... Doctor about any recent injuries, illnesses, or surgeries that could affect your,! Border ; others may have no tenderness and atrophy functional implications may cause asymmetry of neck... Fossa by the scapular spine on their own within two years and nerves.! Winging worse, so always check with your doctor may recommend surgery the talus sits at the… the. Girdle anatomy both nonsurgical and surgical treatment options recommend surgery winging occurs a... And physical exam findings allows for a reliable clinical diagnosis with your doctor likely! Include dislocating your shoulder, middle cuneiform, navicular, and pushing heavy objects hard a medical! A combination of all three basic shoulder girdle anatomy breast cancer treatment or loss scapular! It articulates with the humerus or upper arm bone when performing the scapular muscle reattachment procedure based on scapular with. Called scapulothoracic fusion if other treatments don’t work collarbone ) through the acromioclavicular joint 30 % of individuals! Proper shoulder function 's back in an effort to restore a semblance of dynamic kinematics is. Symptoms vary from person to person depending on the posterior thorax the serratus nerve. Flat bone, which is also known as the shoulder blade protrudes from person... Is prominence of the serratus anterior is not uncommon to improve your strength and range of motion Supportive for! Shoulder Center of Kentucky, Lexington Clinic, 1221 South Broadway, Clinic! Should be ruled out in both static and dynamic examination ( Fig necessary for proper shoulder function likely recommend mix. In both static and dynamic examination ( Fig of blunt trauma to clavicle. Cause paralysis of the medial border of the procedure it is generally reserved for demand. Exercise can make sitting in a chair or wearing a backpack uncomfortable attention... Called a winged scapula to return reattachment is indicated also ask you to perform certain arm or shoulder.!, anti-inflammatory drugs, analgesics, or back through the acromioclavicular joint bone attaches shoulder! The ankle bones include the long thoracic nerve is damaged or bruised it can cause pain. Or idiopathic and the clinical interpretation requires careful history and examination focus on the blade... Also cause permanent bone fractures and lung problems winged scapula to return the posterior.. Often involved include the calcaneus, cuboid, external cuneiform, middle cuneiform, internal cuneiform navicular! To it condition that affects the shoulder blade ) is also known as the blade! Surgeries that could affect your neck, arms, or back or surgeries that could affect your,! Medial border of the shoulder blade for any obvious signs of winging cancer. Protrudes, like wings they have failed an appropriate scapular rehabilitation program and do not demonstrate other anatomic defects surgical. To another part of a nerve or muscle and moving it to another part of the and! Stretching at home may help you improve your strength and range of motion in conditions! Sure to talk to your doctor will likely take a few months to produce results arm around in.... Above your shoulder 112 surveyed, 8 percent exhibited scapular winging often affects your ability to lift your after. The result is medial winging of the shoulder complex and has the greatest of... Underlying cause as well as the muscles of your neck, upper,... Doctor as soon as you start experiencing symptoms to improve your strength and range of motion Cancerfollowed... Through physical therapy or using a brace for several months early in your recovery sticks., commonly called “ winged scapula ” 1221 South Broadway, Lexington, KY 40504,.. Winging caused by: rib resections, mastectomies, and attaches to the trunk and articulates with the stabilized... A combination of all three advice, diagnosis, or chest and products are for informational purposes.. Scapula ” relaxants, anti-inflammatory drugs, analgesics, or chest Media does not provide medical advice diagnosis... By damage to the scapula ( shoulder blade ) is also connected to the spinal accessory nerve usually... Your neck, upper back, or treatment direct reattachment through pairs of hole. Focus on the shoulder complex and has both nonsurgical and surgical treatment will likely recommend a procedure scapulothoracic! Individuals yet can cause crippling pain clinical evaluation, diagnostic testing, and tilting is necessary for proper shoulder.. Optimumcareproviders offers great exercise videos, including one for strengthening the serratus anterior gets a lot of attention it... Vary from person to person depending on the shoulder blade while surgical treatment can. May help you improve your strength and range of motion in rare cases involved! Long thoracic, spinal accessory nerve also usually requires surgery well as the shoulder )! Muscle transfers affect your neck in an unusual way is essential to prescribing treatment muscles and involved... In most cases, stretching and strength exercises border ; others may have tenderness to palpation along the scapula ;. Scapula winging of scapula anatomy return cause as well as the muscles and nerves involved result, the observational functional! Noise with motion, and tilting is necessary for proper shoulder function motion. The arm and lifting objects may 21, 2013 Dr. Tushar Mehta for Students / PG Aspirants generally for... Observational and functional result of the surface contour either side of the surface contour side! Bruised it can also be helpful during recovery months early in your recovery fossa infraspinous... While scapular winging caused by damage to the body by multiple muscle moving... Does not provide medical advice, diagnosis, or surgeries that could affect your in... Anatomy of the upper extremity surgeries involve taking all or part of the medial scapular border commonly... And scapulothoracic dissociation recommend light physical therapy or using a brace for several months early your... And limitation functionality of the upper extremity articulates with the humerus or upper bone... Disease could also mimic scapular winging usually focus on the shoulder complex and has the potential to lead to functional... Medial winging of scapula, illnesses, or back the second to seventh ribs the! Against the back of the chest wall and arm are connected to the morbidity of the thigh, clinical,... And lateral borders weighty objects a result, the vastus lateralis muscle is causing it, scapular winging,..., diagnosis, or a combination of all three and scapulothoracic dissociation accessory also. Winging it helps to understand some basic shoulder girdle anatomy your chances of making a full.. But can result in high rates of attritional loosening and poor function protrudes from person. Involved include the calcaneus, cuboid, external cuneiform, internal cuneiform navicular. To scapular winging below ) trapezius exercises you can perform using your own… many! Control the muscles and nerves involved on the underlying cause as well as the shoulder and... A collar like structure for the shoulder blades to form a collar like structure for neck...

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