A winged scapula is when the shoulder bone protrudes abnormally from the back, caused by damage to the long thoracic nerve. It can be caused by injury, weightlifting, or other factors. Treatment depends on the severity and cause, with physical therapy or surgery as options.
A winged scapula is a scapula, or shoulder bone, that protrudes abnormally from a person’s back. Because the scapula protrudes outward, it resembles a wing, hence the name of this condition. A winged scapula is typically caused by damage to a nerve known as the long thoracic nerve. This nerve supplies a muscle called the serratus anterior, which is found on the side of the chest and normally acts to pull the scapula forward. While this is the true condition of scapula winging, a number of other problems affecting the muscles around the shoulder can also cause scapula winging to some extent.
Damage to the long thoracic nerve can be caused by a blow to the neck or shoulder, or by activities such as weight lifting or sports that involve a lot of throwing. Sometimes other body structures put pressure on the nerve or it can become inflamed during a viral illness. Pushing against a wall with both palms is one way to check if a winged scapula is due to damage to the long thoracic nerve; this action should protrude the scapula. In addition to looking strange, a winged shoulder blade can cause pain and catch on the backs of chairs, and it can be difficult to raise your arm or lift heavy loads.
Many different muscles are attached to the scapula and work together to move it normally. If any one of the muscles is not working as it should, this can lead to the entire system being thrown out of balance, resulting in a scapula wing. For example, an important muscle known as the trapezius muscle, which helps lift the scapula to its normal position, can be damaged during surgery. Injuries and fractures of the ligaments and bones surrounding the scapula can also cause wings. A winged scapula can occur in muscular dystrophy, a condition that causes muscle weakness, and the wing can also be the result of pain, where shoulder movement becomes abnormally restricted.
Treatment for a winged scapula depends on the cause and severity of the problem, with some cases resolving on their own. Sometimes, if the long thoracic nerve has been injured but the damage is not too severe, a course of physical therapy over several months will cure the condition. Where the long thoracic nerve is severely compressed by other structures, surgery may be needed to remove whatever is causing the pressure. In extreme cases, parts of another nerve can be used to restore function.
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