What is scapular winging?

Normal, smooth movement of the scapula (shoulder blade) is essential for full range of movement of the arm so that one can place the hand in time and space accurately. The control of the scapula relies on well co-ordinated motion of the multiple muscles attached to the scapula. Disruption of the muscles function could lead to abnormal motion of the scapula, which is known as 'scapular dysrhythmia' or 'scapular dyskinesia'. During motion, the muscle weakness is manifested as winging of the scapula (the shoulder blade becomes prominent or sticks out).   

 

What are the causes of scapular winging? 

Broadly speaking, scapular winging can be caused by skeletal, neural or muscular conditions. Examples are as below:

 Categories  Examples

Skeletal

Shoulder instability

Subacromial impingement

 

Neural

Neuralgic amyotrophy / Parsonage Turner syndrome

Entrapment neuropathy

Trauma

Muscular

Fascioscapulohumeral dystrophy (FSHD)

POMPE disease

 

Which muscles are most commonly affected? 

Serratus anterior is, by far the most commonly affected muscle, followed by trapezius. Rarely, rhomboids are affected.