Scapular Dyskenesis or Winging of the Scapula
“A winged scapula (scapula alata) is a skeletal medical condition in which the shoulder blade, or shoulder bone, protrudes from a person’s back in an abnormal position. In rare conditions it has the potential to lead to limited functional activity in the upper extremity to which it is adjacent. 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 clothes and washing one’s hair may be hindered. The name of this condition comes from its appearance, a wing-like resemblance, due to the medial border of the scapula sticking straight out from the back.” In Wikipedia.
What is a Winging Scapula?
Scapular winging or dyskenesis occurs from either a muscle imbalance in the shoulder blade area or from a nerve injury which controls those muscles.
The rotator cuff muscles all attach onto the scapula and then send the tendons to the humeral head or the top of the arm bone. These tendons help to rotate the arm. If the scapula is winging, it will cause the rotator cuff muscles to work in a different way than they should and cause them to get irritated. This can then lead to rotator cuff tendon problems. See the rotator cuff section.
What can one do for a dyskenetic scapula?
If the scapula is winging from muscle weakness, then the only way to treat the problem is with therapy. I must stress that rotator cuff strengthening exercises will not make your scapular muscles better. The therapy has to be directed for the specific muscle(s) which are dysfunctional.
Is there any surgery that can fix this problem?
Unless your scapular problem is from a nerve injury, there is no surgical procedure that can be done to correct the winging. Therapy is the only option, but as mentioned above, one has to have the right type of physical therapy and not just rotator cuff strengthening exercises (this is very important).
Can I wear a brace to make this better?
There is a brace that may be prescribed for you, but the best thing is to go to therapy and do your exercises as instructed by your therapist. A brace can help you get your muscles back in shape, but it will not correct the problem by itself.
Do you ever see any other shoulder problems associated with scapular winging?
Yes, many of the patients with rotator cuff tears and with shoulder instability have some scapular dyskenesis. It is important in these cases not only to treat the tear or the instability, but also the scapula. In patients with lax ligaments who have shoulder instability, scapular dyskenesis can exacerbate the shoulder looseness. Scapular dyskenesis can also make rotator cuff problems worse.