What can be the reason of my shoulder blades sticking out?


What can be the reason of my shoulder blades sticking out?

Apart from its connection to your clavicle, your shoulder blade (scapula) is a floating bone nearly completely stabilised by a group of seventeen muscles.[1]

If you have shoulder pain, restricted movement or have noticed that one of your shoulder blades is sticking out more than the other, or both protrude a large amount, you may have a winged scapular.

What does the scapular do?

Your scapula is the essential link between the thorax and the upper extremity, performing abduction, rotation and tilting motions on a daily basis.

A normal functioning scapula helps you lift, pull, and push heavy objects, as well as brush your hair and teeth and carry the groceries.

Weakness or a decrease of the scapular motions can cause shoulder pain and abnormalities with how your shoulder blades look and feel.

What is scapular winging, or a winged scapular?

Scapular winging can a painful and debilitating condition, however it can also fly under the radar asymptomatically for some time.

Scapular winging causes can be broken down into two groups: primary and secondary.[2]

  • Primary scapular winging happens when of one or more of the main muscles that hold the scapula steady stops working as it should.
  • Secondary scapular winging is the result of a problem somewhere else in the shoulder complex such as a rotator cuff tear, frozen shoulder, shoulder instability or dislocation.

Winging of the scapula is sometimes caused by weakness of the thoracoscapular muscles, which allows the scapula to lift off the chest wall during shoulder movements.[3]

Signs and Symptoms of scapular winging

  • Pain/limitation with reaching or repetitive shoulder activities
  • Weakness that limits overhead activities or activities involving arm out to side or across the body
  • Impaired (sub-optimal) posture
  • Muscle imbalances
  • Decreased thoracic range of motion
  • Rotator cuff overuse/fatigue

How does physiotherapy help reduce scapula winging?

After your Lane Cove physio has completed a thorough assessment to determine which muscles are contributing to your winging scapula, we may use a variety of different treatments to try and relieve your symptoms and reduce the winging itself.

We may use a variation of:

  • Massage to relieve tension of tight muscles
  • Postural education and correction
  • Muscle strengthening and re-training to correct muscle-imbalances
  • Dry needling to relieve muscle pain and tightness
  • Hydrotherapy sessions for improving range of motion

A winged scapular is a condition that hands-on expert physiotherapy can improve over a period of time. If you are suffering shoulder pain, movement limitations or your shoulder blades are visibly uneven, make an appointment on (02) 9428 5772 or send us an email at info@lanecovephysio.com.au.

[1] Crowe MM, Elhassan BT. Scapular and shoulder girdle muscular anatomy: its role in periscapular tendon transfers. J Hand Surg Am. 2016;41(2):306e314

[2] Kibler WB, McMullen J. Scapular dyskinesis and its relation to shoulder pain. J Am Acad Orthop Surg. 2003;11(2):142e151.

[3] Meininger AK, Figuerres BF, Goldberg BA. Scapular winging: an update. J Am Acad Orthop Surg. 2011 Aug;19(8):453-62. doi: 10.5435/00124635-201108000-00001. PMID: 21807913.