
19/08/2025
I regularly see people with a winged scapula. Here is some great info for you. đ
đĽ Winged Scapula â âThe Floating Shoulder Bladeâ
đĽ A striking sign where the shoulder blade juts out like a wing â often unnoticed until weakness or injury affects your movement!
đ Name Origin & History
The term âWinged Scapulaâ comes from the visual resemblance of the scapula (shoulder blade) sticking out from the back like a birdâs wing.
First described in medical literature in the 19th century, commonly linked to injury of the long thoracic nerve affecting the serratus anterior muscle.
â ď¸ Causes
đ§ Long thoracic nerve injury (most common)
đ§ Serratus anterior muscle weakness or paralysis
đ§ Brachial plexus injury
đ§ Direct trauma to shoulder/back
đ§ Neurological conditions (e.g., poliomyelitis, muscular dystrophy)
đ§ Post-surgical complication (e.g., mastectomy, lymph node removal)
đď¸ Signs & Symptoms
𩸠Visible protrusion of the scapula from the thoracic wall
𩸠Shoulder instability
𩸠Weakness when pushing against resistance
𩸠Limited shoulder flexion and abduction
𩸠Pain or discomfort in shoulder/back area
𩺠Physical Assessment & Examination⤾ď¸
1ď¸âŁ Wall Push-Up Test â Increased winging when pushing against a wall
2ď¸âŁ Scapular Observation â Compare both sides during shoulder movement
3ď¸âŁ Manual Muscle Testing â Assess serratus anterior strength
4ď¸âŁ Neurological Exam â To check nerve involvement
𩻠Radiologic Findings⤾ď¸
đ X-ray â Usually normal (used to rule out fractures or deformities)
đ MRI â May reveal muscle atrophy or nerve injury
đ EMG/Nerve Conduction Study â Confirms long thoracic nerve damage
â Conservative Treatment ⤾ď¸
â
Pain management (NSAIDs if needed)
â
Activity modification to avoid aggravating movements
â
Orthotic bracing (scapular stabilizing braces)
đ§ââď¸ Physiotherapy Management⤾ď¸
đ
Strengthening of serratus anterior (e.g., wall slides, dynamic hugs)
đ
Scapular stabilization drills
đ
Postural correction exercises
đ
Stretching of tight pectoralis minor & levator scapulae
đ
Neuromuscular re-education
đ
Taping for scapular positioning support
đ Home Advice⤾ď¸
â
Continue prescribed exercises daily
â
Avoid heavy lifting overhead until strength returns
â
Maintain good posture at desk/work
â
Use a mirror to monitor scapular movement
â
Apply warm compress for tightness relief
Doctor of physical therapy