Couple of winged scapula related questions - serratus and rhomboids!

[tehmac]

Question 1:

I have a winging scapula on my right side and have had this for a few years and have just lived with it (bad I know). On the plus side, I have never had any pain associated with it and have full motion of my arm with just a popping noise/feeling in the shoulder which causes no discomfort. What does this mean if I have no pain and full motion? Am I one of the lucky ones? Is it less severe?

Question 2:

I have read a lot of literature on how to prevent it or help recover from this, including all searched threads on this topic in this forum. I have been doing scapula push ups to strengthen my serratus anterior muscles and also bent over rows and various exercises to strengthen my rhomboids as I heard this can also be an issue (after one workout on the rhomboids I found the rhomboids on my right hand side the next day having really been worked, far more than the left, which makes me believe the right side really is weak there). My question is, with the serratus anterior, when I look in the mirror, the serratus finger-like muscles appear to not be as close to my rib-cage on the right hand side as they are on my left side and they appear further spaced apart from each other. However I am unsure if this is a function of my right hand side being more developed in general with bigger lats on this side as I am right handed in general. Any thoughts? Will strengthening the serratus muscles pull this back in around my body rather than to the front and keep them closer to my rib-cage?

Thanks guys, any help is appreciated!

[King Viscera]

Question 1:

I have a winging scapula on my right side and have had this for a few years and have just lived with it (bad I know). On the plus side, I have never had any pain associated with it and have full motion of my arm with just a popping noise/feeling in the shoulder which causes no discomfort. What does this mean if I have no pain and full motion? Am I one of the lucky ones? Is it less severe?

Question 2:

I have read a lot of literature on how to prevent it or help recover from this, including all searched threads on this topic in this forum. I have been doing scapula push ups to strengthen my serratus anterior muscles and also bent over rows and various exercises to strengthen my rhomboids as I heard this can also be an issue (after one workout on the rhomboids I found the rhomboids on my right hand side the next day having really been worked, far more than the left, which makes me believe the right side really is weak there). My question is, with the serratus anterior, when I look in the mirror, the serratus finger-like muscles appear to not be as close to my rib-cage on the right hand side as they are on my left side and they appear further spaced apart from each other. However I am unsure if this is a function of my right hand side being more developed in general with bigger lats on this side as I am right handed in general. Any thoughts? Will strengthening the serratus muscles pull this back in around my body rather than to the front and keep them closer to my rib-cage?

Thanks guys, any help is appreciated!

To sum things up, if you dont have a long thoracic nerve palsy (LTN) causing the winging scapula that is a good thing and means that you can strengthen your serratus so the scapula protracts tightly against the rib cage.

If it is a long thoracic nerve palsy than that means the nerve to the serratus is damaged and the serratus is not engaging so your scapula hangs to the side like a wing and protrudes when arms are put out infront of you.

Youre very prone to shoulder injury with a winging scapula so be careful. I was also living pain free for years with a winging scapula until a couple years ago when I really overused the shoulder and strained some rotator cuff tendons. Now it is next to impossible to rehab the shoulder because there is no scapular protraction and the RC tendons are having a difficult time strengthening because of this. I get alot of anterior deltoid pain and bicep tendon impingement from this problem.

So try to strengthen it up and see what happens, try a physio therapist even. If all else fails talk to a sports med ortho and get a nerve conduction study and EMG performed.

[tehmac]

To sum things up, if you dont have a long thoracic nerve palsy (LTN) causing the winging scapula that is a good thing and means that you can strengthen your serratus so the scapula protracts tightly against the rib cage.

If it is a long thoracic nerve palsy than that means the nerve to the serratus is damaged and the serratus is not engaging so your scapula hangs to the side like a wing and protrudes when arms are put out infront of you.

Youre very prone to shoulder injury with a winging scapula so be careful. I was also living pain free for years with a winging scapula until a couple years ago when I really overused the shoulder and strained some rotator cuff tendons. Now it is next to impossible to rehab the shoulder because there is no scapular protraction and the RC tendons are having a difficult time strengthening because of this. I get alot of anterior deltoid pain and bicep tendon impingement from this problem.

So try to strengthen it up and see what happens, try a physio therapist even. If all else fails talk to a sports med ortho and get a nerve conduction study and EMG performed.

Is there any way to tell if you have LTN palsy? Sometimes, maybe once every month or so depending on the way I'm lying in bed on my right hand side then I feel this blinding nerve pain like I've trapped a nerve under my right shoulder blade and I have to force through the pain and move (difficult) so the pain goes away (which it does instantly). Not sure if that is indicative of the palsy or not, as it only happens very occasionally and could mean that it's not permanently under pressure?

[King Viscera]

Is there any way to tell if you have LTN palsy? Sometimes, maybe once every month or so depending on the way I'm lying in bed on my right hand side then I feel this blinding nerve pain like I've trapped a nerve under my right shoulder blade and I have to force through the pain and move (difficult) so the pain goes away (which it does instantly). Not sure if that is indicative of the palsy or not, as it only happens very occasionally and could mean that it's not permanently under pressure?

The only way to 100% determine if you have an LTN palsy is if the doctor sends you for a nerve conduction study (NCS) and an EMG. They will test several muscles by inserting 3 inch long acupuncture needles into different muscles. The acupuncture needles are attached to a computer which gives a read out of what is exactly happening with the your nerves.

Also, in regards to the pain your expereincing underneath the scapula, Im not sure if its nerve or muscle pain. I have the same problem though.

I have a chronic mild soreness underneath the scapula and I think it might be the serratus being pinched between the scapula and the thoracic wall. It seems to get more sore after flexing my back or doing scapular retractions and such. There were a few cases were I get the severe pain like you describe in that area but its more often just a mild soreness 90% of the time.

Anyway, if I were you Id try to get a good sports med physio therapist right now and try a conservative approach to remediating your winging scapula and see how that works out for you.

Also, here is a good website and the top specialist for winged scapula and LTN's in north america: http://www.drnathwingingscapula.com/#

Check it out and let me know what you think.

[xam1]

The only way to 100% determine if you have an LTN palsy is if the doctor sends you for a nerve conduction study (NCS) and an EMG. They will test several muscles by inserting 3 inch long acupuncture needles into different muscles. The acupuncture needles are attached to a computer which gives a read out of what is exactly happening with the your nerves.

Also, in regards to the pain your expereincing underneath the scapula, Im not sure if its nerve or muscle pain. I have the same problem though.

I have a chronic mild soreness underneath the scapula and I think it might be the serratus being pinched between the scapula and the thoracic wall. It seems to get more sore after flexing my back or doing scapular retractions and such. There were a few cases were I get the severe pain like you describe in that area but its more often just a mild soreness 90% of the time.

Anyway, if I were you Id try to get a good sports med physio therapist right now and try a conservative approach to remediating your winging scapula and see how that works out for you.

Also, here is a good website and the top specialist for winged scapula and LTN's in north america:

Check it out and let me know what you think.

So I have been living with it my entire life’s however it isn’t painful other than one instance for my entire life I’ve had extreme difficulty with doing push-ups as my shoulder blade kindof locks up and sometimes hurts if I try to go down is it related or am I just being a weak ass