Winged Scapula

[c00lduke]

About 5 years ago I was running around and jumped and swung from a tree branch but half way through the swing the branch broke and I feel on my back pretty hard. I was on vacation and notice that it was hard to swing the next couple days do to a pain in my shoulder blade.

The pain went away and I didn't think anything of it until 1-2 years later I noticed that when I'm bench pressing my shoulder bladed seemed to push me up on the right side. I took a look in the mirror and I can make my shoulder blade come out about 3 inches. From what I've found on the net this is referred to as a wing scapula. What I'm looking for is some suggestions on exercises that I could do to target the muscle that holds the blade in. I know the problem my be beyond fixing it that way but I'd figure I'd give it a try before I had to have surgery.

[Sick Puppy]

Dunno if I've got this right, but would I be right in assuming that your scapula moves outwards much easier than the other? Is there a difference between the size and shape of your serratus anterior muscles on each side? (ones underneath pecs that run into lats)

If so, the physio I saw said it was a "sub-luxing scapula", and suggested that I lie face down, arm by my side and palm facing inwards, and I pull the shoulder backwards and downwards, so that it is brought towards the spine.

There was also this article I spotted in T-Nation a while back (can't remember who here in the forum first brought it to my attention, but thanks!):

http://www.t-nation.com/readTopic.do...26252&pageNo=0

Hope these help.

[Sockomalo]

i had and still kinda have the same problem. go see a physiotherapist and they will tell you a bunch of exercises that will help fix the problem by strengthening the muscles that control the scapula. the guy above me is dexcribing one of the exercises but not too well, theyre kinda hard to explain. but the problem casn be corrected without surgery.... go see a physio therapist


face pulls are a great exercise too, im still trying to find an alternative to do them at home without a cable pulley though

[oziem]

You may get best results with:
1 Thoracic spine adjustment. It is likely you subluxated the T5 disc.
2 Adjust or massage any adhesions out of the scapular attachments.
3 Then pursue the pushups and face pulls.

The article referred to in the previous post is recommended.

Dr. Oziem

[Horseradish]

You may get best results with:
1 Thoracic spine adjustment. It is likely you subluxated the T5 disc.
2 Adjust or massage any adhesions out of the scapular attachments.
3 Then pursue the pushups and face pulls.

The article referred to in the previous post is recommended.

Dr. Oziem

I absolutely agree.

I had a winged scapula as a kid, and it was extremely painful. Physical therapists had me do weight exercises with 3 pound weights, but they didn't help at all. After a few years it went away on its own, but it was horrible while I had it and I was unable to sleep many nights.

Then, 20 or so years later I wake up in the middle of the night with searing pain in between my shoulder blades. The winged scapula had returned! I went for a couple months with the pain and inability to raise my right arm above 90 degrees, thinking it would start getting better soon. It didn't. I went to a doctor, who sent me to a neurologist, who confirmed that I had compression of my long thoracic nerve (the nerve that controls the serratus anterior, which holds in the scapula). Hundreds of dollars were spent to confirm the obvious, and the only thing I got out of it was a referral to a physical therapist. I said **** that and decided to go to a chiropractor.

To make a long story short, the chiropractor saw how messed up my upper back was (I could barely move my neck and I was very hunched over) and gave me several adjustments. Within a few minutes the pain was gone. My scapula winging rapidly subsided from that point on, and after about a year I was back to 100% again. The chiropractor is IMHO the best solution for your problem.

So go to a chiropractor, and start working on the posture of your upper back. Do face pulls, "serratus punch", and other exercises that target the serratus anterior and muscles of the upper back to help you with your posture. Most importantly, be patient and try to maintain a positive attitude. It can take up to 2 years for the nerve damage to heal (if it is benign enough to heal).

[euphoria1]

I'm just going to expound on the proper treatment of the winged scapula or aka the hunchback figure

In order to rectify your situation, you need to work both the scapular depressors and retractors: This includes Horizontal pulling variations (seated rows, prone middle and lower trap raises)


The serratus anterior plays an important role in facilitating scapular posterior tilt. To develop this, supine and standing single-arm dumbbell protractions are good ; scap pushups, scap dips, and scap pullups in which the athlete is instructed to keep the scapulae tight to the rib cage are effective isometric challenges to the serratus anterior.

[Horseradish]

I'm just going to expound on the proper treatment of the winged scapula or aka the hunchback figure

In order to rectify your situation, you need to work both the scapular depressors and retractors: This includes Horizontal pulling variations (seated rows, prone middle and lower trap raises)


The serratus anterior plays an important role in facilitating scapular posterior tilt. To develop this, supine and standing single-arm dumbbell protractions are good ; scap pushups, scap dips, and scap pullups in which the athlete is instructed to keep the scapulae tight to the rib cage are effective isometric challenges to the serratus anterior.

Winged scapula is known as the hunchback figure? Sounds like you might be thinking of postural kyphosis, not winged scapula...

I respectfully question your proposed solution to the problem. Since his injury was caused by falling on his back, I'm positive that it is a nerve damage/compression issue, not a muscular weakness one. It's not possible for muscles to waste away and weaken instantaneously to the point where a winged scapula occurs. However, it is very possible, and likely, that one or more nerves will become compressed or damaged during such an impact and will be unable to operate the muscles that it is connected to.

I have had a winged scapula twice before (once as a kid, once a couple years ago) as a result of nerve compression. You can try like hell to strengthen the appropriate muscles such as the serratus anterior, but it doesn't do any good because the nerve impulses never reach the muscles. The muscles just don't move, regardless of how hard you try to make them move! It's like trying to tell a paralyzed person to get up and walk -- it's just not possible.

The chiropractic adjustment is important because it remediates the nerve compression (subluxation) to allow the nerves to properly send impulses to the muscles and to heal correctly.

[euphoria1]

yes i am thinking of kyphotic thoracic spine

[fried96]

You could try out going to a chiropractor. In the meantime I would suggest doing seated ows and focus on squeezing the shoulder blades together. 3 sets x12

[MontanaPT]

euphoria is right about protraction exercises that will help strengthen the serratus anterior

[Fresch]

Discussions on chiropractic aside....

As that article mentioned before notes, there are other causes of winged scapula than just secondary to a nerve dysfunction, related to poor posture.

I do have issue with the face pull exercises as a form of early rehab, but that is another issue.

If there is a neural dysfunction, and it is common, then it will need to be remedied. It can be due to joint or soft tissue pressure, or due to a viral infection in the nerve (which I believe is rare to non-existant actually).

Either way, posture correction and retraining of the serratus anterior, rhombs and middle/lower traps is called for. This means learning to get the muscle to activate first, and leaning to control it, before going for gross movement and heavily resisted exercises.

[Anabolic82]

About 5 years ago I was running around and jumped and swung from a tree branch but half way through the swing the branch broke and I feel on my back pretty hard. I was on vacation and notice that it was hard to swing the next couple days do to a pain in my shoulder blade.

The pain went away and I didn't think anything of it until 1-2 years later I noticed that when I'm bench pressing my shoulder bladed seemed to push me up on the right side. I took a look in the mirror and I can make my shoulder blade come out about 3 inches. From what I've found on the net this is referred to as a wing scapula. What I'm looking for is some suggestions on exercises that I could do to target the muscle that holds the blade in. I know the problem my be beyond fixing it that way but I'd figure I'd give it a try before I had to have surgery.

I have experienced winged scapula two different times as well. While chiropractors are great, there is a faster option as well. There are specialist chiropractors out there who run what are called ChiroMAT clinics. MAT stands for Muscle Activation Technique, or AMIT technique. I went to a regular chiropractor for about two years after my injury and while he helped ease the pain, recovery was slow. I discovered a ChiroMAT clinic near me and he restored full function to my shoulder in about 6-8 appointments, with noticeable improvement immediately after each appointment. I re-injured it recently, but going to the ChiroMAT doctor right away I am already about 70% recovered in just 4 weeks (about 1-2 appointments a week).

[Gymnast001]

I recently discovered a slightly winged scapula when i lift my arms straight out to the sides while holding weight. I believe i damaged my long thoracic nerve while doing heavy seated upward dumbell flies. The doctor gave me Prednisone "Cortisone" for 10 days and told me to return after that. I'm going to visit a chiro mat clinic, I'm just wondering if anybody knows what exercises I can do for my back if I have to stay away from chins, pull ups, and pull downs - because from what I understand, this can keep the nerve damaged.

And are there any other exercises that I should stay away from? Or should I be able to work through it untill it is corrected? Any help is appreciated.

[braindx]

I recently discovered a slightly winged scapula when i lift my arms straight out to the sides while holding weight. I believe i damaged my long thoracic nerve while doing heavy seated upward dumbell flies. The doctor gave me Prednisone "Cortisone" for 10 days and told me to return after that. I'm going to visit a chiro mat clinic, I'm just wondering if anybody knows what exercises I can do for my back if I have to stay away from chins, pull ups, and pull downs - because from what I understand, this can keep the nerve damaged.

And are there any other exercises that I should stay away from? Or should I be able to work through it untill it is corrected? Any help is appreciated.

Why would you suspect nerve damage?

Did you have a pinching sensation and then loss of motor control or a similar injury?

Resting allows stuff to heal so rest...

[tumtum]

i had damage to my long thoracic nerve and suffered from a winged scapula..in fact i couldn't life my arm up at all for a while.. do not do exercises.. if it's nerve damage then you can worsen it by causeing motion around it.. i completely had to give up all activity.. golf.. football... weights.. for 13 months .. at 9 months he said it didn't look like it would heal.. but obviously it did.. do not work out.. go see a neurologist asap

[rmanuelsanchez]

About 3 weeks ago i woke up to this. Couldn't raise my arm above my head. My scapula was winging. Ortho doc confirmed it and neurologist too. Awaiting EMG but its obvious a nerve is jacked. No pain when moving my arm at all. Only time I feel pain is occasionally when im in bed at night and a burning nerve feeling starting from my shoulder to forearm kills me. My questions is HOW many people do you know had this and recovered? Im a former college athlete and had never even heard about this. I don't recall exactly when I injured it but id have to say maybe in the gym doing overhead press. Im very active and this really sucks. Nobody to relate to that understands how debilitating this is. Im currently doing physical therapy. Not sure if he has much exp dealing with this bc its not common but im doing 4physical diff types of exercises to increase strength in my back bc muscles have begun to atrophy in my right shoulder. Any information from your exp is appreciated.

[tumtum]

rmanuelsanchez.. WHY DO THEY HAVE U DOING PHYS THERAPY????

do not do phys therapy, you cannot teach the nerve to fire again, you have to let it heal on it's own. you could potentially completely destroy the nerve.. if you read my post above i had to sit out for 13 months, sucked, lost everything, but now i'm bigger and stronger than ever.

it's very debilitating, and no one seems to understand when u explain the situation, please reconsider the phys therapy. my neurologist told me not to do a single thing, not even stretch, not even sleep on my side, hold nothing with my right arm, and i can't thank him enough for being so strict on me.

[rmanuelsanchez]

Tumtum...My neurologist referred me for physical therapy. I don't know any better about this condition. I've been all over the internet looking for references to relate to my situation. I'm a former college athelete and current FED Law Enforcement Agent. In my whole life I've never head of this. I don't even know exactly what caused it but I know I awoke OCT 21, 2011 and I couldn't move my arm up above my head. I play basketball and can't shoot the ball. I love working out and box and can't do that. This is a horrible feeling. My boxing trainer with all his experience has never heard of this. Back to answer your thread...my physical therapist says I must keep my muscle around the scapula strong and exercise strenght in the muscle that must be turned on. That's what he says. I don't know but that's what I'm doing. I figure as long as I don't have any pain which I don't anymore I'm not hurting myself. I'm schedule for an EMG NOV. 28th, 2011. Not really sure what that's going to do for me because WE already know what that problem is..."can't move my shoulder". My therapist says its not a neck or spine injury. Thinks it's a muscle spasm somewhere in my upper shoulder area. I've tried to explain to all doctors I have a very tender spot in my rear deltoid where it's quite painful if there is pinpoint pressure put on it but they don't listen much. My orthopedic thinks it stems from my C5, neurologist says its damage to my long thoracic nerve, and phys therapist thinks its the spasm pinching my nerve. My only concern is am I ever going to get back to how I felt prior and how long. I'm working my ass off doing my prescribed exercises trying to do so. You are right, nobody understands this. I've read some article about this since 1987....I would figure there be more information about this if it's been known about this long. Pretty scary when at my orthos office he needs to call somebody in to look at my like its a freek show...same for my phys therapist. Like they never seen this before or its so rare that it's exciting for them to see a case. So are you back to normal? man it will be hard for me to rest due to my occupation. Hey, thanks for the reply. I'll check in and post as time goes on and maybe my progress helps somebody else.


Ronnie

[tumtum]

Tumtum...My neurologist referred me for physical therapy. I don't know any better about this condition. I've been all over the internet looking for references to relate to my situation. I'm a former college athelete and current FED Law Enforcement Agent. In my whole life I've never head of this. I don't even know exactly what caused it but I know I awoke OCT 21, 2011 and I couldn't move my arm up above my head. I play basketball and can't shoot the ball. I love working out and box and can't do that. This is a horrible feeling. My boxing trainer with all his experience has never heard of this. Back to answer your thread...my physical therapist says I must keep my muscle around the scapula strong and exercise strenght in the muscle that must be turned on. That's what he says. I don't know but that's what I'm doing. I figure as long as I don't have any pain which I don't anymore I'm not hurting myself. I'm schedule for an EMG NOV. 28th, 2011. Not really sure what that's going to do for me because WE already know what that problem is..."can't move my shoulder". My therapist says its not a neck or spine injury. Thinks it's a muscle spasm somewhere in my upper shoulder area. I've tried to explain to all doctors I have a very tender spot in my rear deltoid where it's quite painful if there is pinpoint pressure put on it but they don't listen much. My orthopedic thinks it stems from my C5, neurologist says its damage to my long thoracic nerve, and phys therapist thinks its the spasm pinching my nerve. My only concern is am I ever going to get back to how I felt prior and how long. I'm working my ass off doing my prescribed exercises trying to do so. You are right, nobody understands this. I've read some article about this since 1987....I would figure there be more information about this if it's been known about this long. Pretty scary when at my orthos office he needs to call somebody in to look at my like its a freek show...same for my phys therapist. Like they never seen this before or its so rare that it's exciting for them to see a case. So are you back to normal? man it will be hard for me to rest due to my occupation. Hey, thanks for the reply. I'll check in and post as time goes on and maybe my progress helps somebody else.


Ronnie

march 17, 2007 i woke up with the same thing, couldn't raise my arm above my shoulder, went to multiple docs and none of them knew what was going on. i regained use of my arm after a cpl weeks but after 9 months it was still winged.. at 13 months it was a full recovery and i'm in the best shape of my life. i never take a single day for granted because (not to scare you) but at 9 months they said since they didn't see any improvement it prolly wouldn't improve. we never knew exactly what caused mine, i just suddenly woke up one day and had terrible pains in my arm, this happened about every morning for a cpl wks.. then i work up with the condition one morning and no pain, have you thought about talking to other neurologists and getting their opinion? mine didn't want me to do a single thing.

[rmanuelsanchez]

march 17, 2007 i woke up with the same thing, couldn't raise my arm above my shoulder, went to multiple docs and none of them knew what was going on. i regained use of my arm after a cpl weeks but after 9 months it was still winged.. at 13 months it was a full recovery and i'm in the best shape of my life. i never take a single day for granted because (not to scare you) but at 9 months they said since they didn't see any improvement it prolly wouldn't improve. we never knew exactly what caused mine, i just suddenly woke up one day and had terrible pains in my arm, this happened about every morning for a cpl wks.. then i work up with the condition one morning and no pain, have you thought about talking to other neurologists and getting their opinion? mine didn't want me to do a single thing.

TUMTUM...It's a relief to hear that you fully recovered. 13 months is a long time for anybody. I'm glad feel better than ever. I hope I can get to that point soon, very soon. More so, I actually had reconstruction of my scaphoid lunate ligament in my wrist but opposite arm (left). This occurred over a year ago and since January 2011 have been recovering from the surgery. I had gotten back in great shape and then this happened. I'm not a big guy but strong for my weight and size. I am 6'3 185lbs built like a lanky basketball player with the the conditioning of a boxer. My training is soley based on explosive movements and focus on maintaining muscle definition. I don't lift that heavy so this wasn't caused my heavy lifting however I did read somewhere repetative use or overuse can cause LTN and wing scapula. Who knows I might be compensating at some level with my right arm for the injury I had on my left wrist. ???????? maybe. I just want to get back to moving right. Had a basketball game last night with some of my co-workers but didn't go so well. I got the ball under that basket and tried a layup but my shoulder said "hold on buddy". I couldn't push the ball up over the rim. lol. Very frusterating. No pain whatsoever but no function. I haven't thought about going to another ortho or neurologist. These guys are on of the best in San Diego. I see my neurologist on the 28th for that EMG. I'll send you a message let you know what happens. Hey, thanks for sharing your experience. I definately helps that there is hope in recovery. Surgery is definately not an option for me. I don't think it ever is unless dealing with the injury is constant pain. Who knows mayb I wake up tomorrow and I'm better. Happy Thanksgiving. TTY.

Ronnie

[buckeye7]

march 17, 2007 i woke up with the same thing, couldn't raise my arm above my shoulder, went to multiple docs and none of them knew what was going on. i regained use of my arm after a cpl weeks but after 9 months it was still winged.. at 13 months it was a full recovery and i'm in the best shape of my life. i never take a single day for granted because (not to scare you) but at 9 months they said since they didn't see any improvement it prolly wouldn't improve. we never knew exactly what caused mine, i just suddenly woke up one day and had terrible pains in my arm, this happened about every morning for a cpl wks.. then i work up with the condition one morning and no pain, have you thought about talking to other neurologists and getting their opinion? mine didn't want me to do a single thing.

Saw this and wanted to say I have the exact same thing. Mine is not so bad that I cannot raise my arm but I am constantly feeling like my right shoulder blade is sticking out. My deltoid is now bothering me as well like I strained it or pulled a muscle. I too did physical therapy for a while and it was getting better but I did something that completely reversed any progression. I think i'm going to try the chiropractor. I've spent WAY TOO much money dealing with this and it's very frustrating. I am very active as well and know this is going to take a long time to heal and am pissed because all my hardwork is going to go to waste. I've also been dealing with this for around 3-4 months already. Agitated, pissed, and depressed I can't train besides cardio/abs. Any update from rmanuelsanchez? I also have terrible tendonitis in my left thumb which is awesome (sarcastic).

[andylondon]

Seen this thread and have to say that I have something very similar. I have seen doctors and they just dont want to know. My left shoulder blade wings, I think it was occured 5 years ago when I was in my early teens and I used to hold out a dumbell for an insanely long time. After a while I got severe pain in my left shoulder and this just went.

5 years later, I have noticed that it wings when i bend forwards, stick my arms out and tense my pecs. Strange things is that it doesnt wing with any other movement I physically have to lean forwards and tense my pec. I have tried the wall test, floot test and it doesnt wing. I dont seem to have shoulder weakness as I can sort of do upside down press ups, with the same stregth as on my right.it also seems to wing when I hold a weight out and raise it above my head.
Because of this doctors dont care as it doesnt affect me.
It may be unrelated but I have strecthmarks around thed viein in my elbow pit on the same size as the winging and that vein protudes alot. I will see another doctors soon and see what they say.
Any ideas for the time being?

[rmanuelsanchez]

Its 12/23/2011....condition is the same. Been doing physical therapy at the gym. Took exercises from phys therapist on my one and only visit. Cool guys he understood. Scapula still winging but through the use of recorded videos I see some muscle tone improvement. This has not improved my arms range of motion. Still cannot lift overhead or shoot a basketball. Continue experience stiffness in my right triceps. Overall no improvement to report. I have been going to Chiropractor for two weeks now . Ill post if that helps. This sucks.

[VitaminJT]

Turn off upper traps via trigger points/stretching, work on activating lower traps which will help bind the inferior angle of the scapula against the rib cage and work on serratus anterior which helps hold the medial border of the scapula down to stop it protruding.

[thejcon22]

I have had the same problem. My left shoulder blade sticks out way further than my right one. I haven't had problems lifting my arm over my head and don't really feel too much pain. I never really feel the pain in my back, but sometimes my left shoulder hurts when I do bench and i can feel my left shoulder blade pushing out. I hate this. I want to lift and continue to workout but I'm afraid by doing that, it will make my injury worse. I have no idea how i got this, its been like this for as long as i can remember. I've got a chiropractor appointment set up later this week so hopefully that will help. If anyone has any suggestions one what to do that be great. Thanks

[gekkoboy14]

Turn off upper traps via trigger points/stretching, work on activating lower traps which will help bind the inferior angle of the scapula against the rib cage and work on serratus anterior which helps hold the medial border of the scapula down to stop it protruding.

This. OP google scapula depression exercises, as well as Y's.

[rmanuelsanchez]

Today, January 25th, 2012.

LTN damage with Scapular winging persists. I continue doing exercises prescribed by a physical therapist. The onset of this condition was Octorber 21, 2011. I've put up some videos on youtube to update my progress if you chose to look and compare you disability to mine. All professionals I've seen don't seem to thing this is a big deal. They do understand it makes me incapable of doing what I enjoy which is basketball, softball, lifiting weights, and just playing around throwing the ball with my kids. Not sure about everyone else but my pain on existed for about 3-4 days. A couple of those days was prior to the scapular winging which I blame on softball. I think throwing the ball around maybe did this now but couldn't be sure. The since those first couple days of pain I have not experience any pain at whatsoever. I'm hoping thats that good things and maybe I'm in dormant recovery mode. Anyway, I'll keep posting my progress. If you would like to see the youtube videos look me up by rmanuelsanchez43@gmail.com. My latest video was a couple weeks ago. there should be three on there. If anybody finds a good story to keep me going on the road to progress please post.


Ronnie

[northcounty]

Hey Ronnie,

I woke up at 3am two weeks ago with a red rash all over my upper torso, and extreme pain in the right rear delt, teres minor area. The rash went away within a few hours but the shoulder pain has lasted for about the two weeks. It went into my forearm and wrist but now that has subsided. I had hard a time sleeping, difficult to find any position that felt good. I am athletic, former college basketball player. I couldn't shoot a shot if I had to. I lift weights a lot and had no problems until I woke up and had sudden onset 2 weeks ago. If I try a double bicep "pose" for fun in the mirror, my serratus anterior is not there. I had no injuries or anything that would cause it. I was told it could be a virus, or some immune response. I went to my primary care dr. and they said .."oh...nothing wrong". Then went to Chiro/PT and they saw that the serratus anterior is not working. They suggest a visit to the neurologist which I will do but everything I see online calls this "serratus anterior palsy"
and can be onset for no reason. It's quite stressful. Any advice from anyone else would be great.

thanks

EB north san diego county

Today, January 25th, 2012.

LTN damage with Scapular winging persists. I continue doing exercises prescribed by a physical therapist. The onset of this condition was Octorber 21, 2011. I've put up some videos on youtube to update my progress if you chose to look and compare you disability to mine. All professionals I've seen don't seem to thing this is a big deal. They do understand it makes me incapable of doing what I enjoy which is basketball, softball, lifiting weights, and just playing around throwing the ball with my kids. Not sure about everyone else but my pain on existed for about 3-4 days. A couple of those days was prior to the scapular winging which I blame on softball. I think throwing the ball around maybe did this now but couldn't be sure. The since those first couple days of pain I have not experience any pain at whatsoever. I'm hoping thats that good things and maybe I'm in dormant recovery mode. Anyway, I'll keep posting my progress. If you would like to see the youtube videos look me up by rmanuelsanchez43@gmail.com. My latest video was a couple weeks ago. there should be three on there. If anybody finds a good story to keep me going on the road to progress please post.


Ronnie

[VitaminJT]

Here is a small article that I wrote about winged scapula along with some basic muscle activation exercises you can do.

http://www.jtwellbeing.com/2012/01/w...ow-we-can.html

[Serratedfury]

i had damage to my long thoracic nerve and suffered from a winged scapula..in fact i couldn't life my arm up at all for a while.. do not do exercises.. if it's nerve damage then you can worsen it by causeing motion around it.. i completely had to give up all activity.. golf.. football... weights.. for 13 months .. at 9 months he said it didn't look like it would heal.. but obviously it did.. do not work out.. go see a neurologist asap

Hey tumtum, I love your post as I have struggled with winging of the scapula for some time. 2 important questions. How did you manage to not move your arm for thirteen months (which is admirable) because I am struggling with how much to use mine. Also, did your scap come back spontaneously? B/c how did you know when you should start training and using your arm again. Hopeful hear from you man cause mine just recently went out for the second time and i thought i was good for life. I guess not.