Scapular Winging

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Scapular Winging: Commonly called winged scapula. A type of scapular dysfunction or dyskinesis in which part or all of medial border of the scapula is prominent and lifts away from the posterior wall of the thorax in both static and dynamic conditions. This could indicate the presence of a SLAP (Superior Labrum Anterior and Posterior) lesion, weakness of the serratus anterior, rhomboids, the lower, middle, and upper trapezius, tight shoulder rotators; as well as a long thoracic nerve problem.

Winging due to injury to the long thoracic never is called neurogenic winging and this results in paralysis, rather than simple weakness, of the serratus anterior muscle and is the most common cause of scapular winging. This winging, in severe cases, can be seen at rest, but forward flexion of the arms can make the winging more prominent. The serratus anterior is the primary upward rotator of the scapula during abduction of the arm and stabilizes the shoulder during scapular protraction.

Injury to the spinal accessory nerve can also lead to scapular winging due to trapezius nerve palsy. This results in a scapular winging that has subtle differences to that produced by long thoracic nerve injury. As well, damage to the dorsal scapular nerve can cause winging due to rhomboideus palsy.

Some degree of scapular winging is normal in children.

scapular winging (winged scapula) due to injury of the long thoracic nerve and serratus anterior muscle paralysis

Scapular Winging due to Long
Thoracic Nerve Injury/Serratus Anterior Paralysis
image via wikipedia

See the scapular dyskinesis category and Examination of the Shoulder: The Complete Guide.

This page created 01 Feb 2013 12:33
Last updated 01 Mar 2016 00:34

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