Do your shoulder blades stick out? Scapula Winging - what is it and what you can do about it?

Did you know that your scapula only has one bony attachment to the rest of your skeleton - and that is your collar bone. Now if you think about the amount of weight, pressure and strength your arm can create - that collar bone just doesn't seem big enough to handle the job.

But this is where the muscles that surround the shoulder and shoulder blade come into play and create the ideal mix of strength and flexibility the shoulder needs.

But in some people the muscles of the shoulder get out of balance, perhaps they become short and tight, or weak and under-active - and all of a sudden your shoulder just isn't working the same.

One example of this is scapula winging - see pic above left - which is when you see one shoulder blade or both popping out from your back in certain arm positions or when loaded in a certain way. But remember - some winging of the shoulder blade can be perfectly normal and part of how we get our arm where it needs to be - but in other cases it highlights that something may not be working as it should.

So what are some of the causes?

Well they range from serious nerve injury through to just tight muscles - but lets look at two common ones:

A short Pec minor and a weak Serratus Anterior.

Now thats a mouthful - but its pretty simple when you try to think about what these muscles do.

Pec minor - lives in the front of the shoulder/chest. It attaches to a part of your shoulder blade that pokes from the back to the front - and when this muscle shortens it tips the shoulder blade forward and rounds your shoulders in.

For your shoulder blade to move normally down and around the rib cage - this muscle needs to let go - otherwise things have to move in a different way. Winging can be one of those ways.

It is also suggested that a tight pec minor will have an inhibitory effect on the other muscle of interest to us - the serratus anterior.

Why? Well, if one muscle is constantly wanting to do stay short and tight - an opposing muscle has to become less active (or used) - basically bullied into submission.

But why is the Serratus anterior important?

Well this muscle lives under the scapula and attaches around to the side of your rib cage. It helps pull the scapula around the rib cage and point it in the right direction when moving your arm.

But - importantly - it also holds the scapula to your rib cage to provide a whole bunch of stability and strength.

Think of it like this - if you were to push your car - would it be easier to do it if you could put your foot against a fixed object to push off?

Yep - well, if your serratus is weak - as you push through your arm your scapula which is meant to act as the fixed object - is popping off your rib cage and moving about trying to take the load elsewhere.

So what are some of your options to control winging? (as long as the nerves aren't damaged)

If your serratus anterior is just weak - then specific exercises targeting it are the best way to go. Perhaps all you need is to load the muscle and get it active again. A classic example of this is a modified push up - commonly called a push up plus. (stay tuned for an example of this soon).

As for the pec minor - some simple stretching and postural changes are the first line of defense.

See our video on using a ball to release the pec minor tension and our simple shoulder reset exercise for ways to change your shoulder posture and tightness.

But dont forget - some winging is not always abnormal - in fact some people look like they have bad scapula winging - but as soon as they have to do a specific action - everything kicks in and works - no winging at all.

As always if pain persists give Ash a call on 5310 6259 or book an appointment online at https://www.bodyandspinesolutions.com.au/online-booking

Until then keep moving.

Andrew