Although super heroes may have ‘em and energy drink ads promise to give them to you – real life wings aren’t a good thing. An issue called winged scapula can cause serious pain and weakness.
But today I’ll teach you techniques to test for this scapular dysfunction, stretches to release the area and exercises to help strengthen and support your scapulae and your entire shoulder.
Noticing Your “Wings”
Since you’re a Precision Movement reader, I think it’s safe to assume you’re an active guy or gal who hits the gym (or the court, or the ring…) regularly.
Maybe you do some heavy overhead lifts, like to hit the rowing machine or spend some time in the boxing ring, but regardless, you’re dependent on your shoulders and your scaps when it comes to working out.
Then one day, you start to notice some pain developing over your scapulae.
You try to brush it off, but the pain gets worse over the next couple of weeks, and at the same time, your lifts start to feel super weak.
But the day you really notice the weakness, you aren’t in the gym.
You’re reaching into your car to pull out some heavy grocery bags, when your shoulder goes weak and they slam into the driveway before you realize what happened… there goes a dozen eggs and tomorrow’s breakfast…
You finally get inside and collapse onto a dining room chair, hoping to relax for a minute and think about what could be causing the pain and weakness.
But as you lean back into the chair, you notice that something doesn’t feel right. This chair, which you’ve had for years, suddenly feels super uncomfortable on your upper back.
As you wiggle around, trying to find a spot that feels fine for your scapulae, it occurs to you that they might be at the center of all these strange symptoms…
Symptoms of Winged Scapula
Scapular winging is basically a protruding edge of the shoulder blade. It may be related with pain around the scapula, or general pain around the whole shoulder region.
People with winged scapulae may feel weak when trying to lift something out and away from their body, or when trying to lift any weights overhead .
This weakness may show up at the gym, like when trying to press dumbbells overhead, but it also interferes with everyday life, as discussed earlier. Movements like picking up grocery bags or putting dishes away into a high cabinet may be difficult or elicit pain.
It may also feel uncomfortable when you’re not moving at all. Those protruding scapulae can press against surfaces like the backs of chairs, making even sitting feel off .
The Role of the Scapula
To understand what’s going on to cause these symptoms, we’ve got to take a closer look at the scapula.
Your plate-like scapula, or shoulder blade, is an attachment site for 17 different muscles .
Here’s a pic of where some of those muscles attach.
Image by www.theartofmed.wordpress.com
Rotator cuff muscles, arm muscles, back muscles, chest muscles – there are many that connect to your scapulae.
This allows for complex and variable shoulder movement, but also makes it easy for compensations to occur when one muscle isn’t functioning correctly.
These muscles both create shoulder movement while also providing stability.
The scapulae have a socket called the glenoid where the head of the humerus lies and the scapular muscles move the scapulae around so the head of the humerus can remain centered while you move your arm around .
Scapular winging can prevent proper centration from occurring, leading to problems like shoulder impingement and rotator cuff tendonitis and strains.
Why Causes Winged Scapula?
If your serratus anterior (which runs along your side from your first 8 ribs back to the underside of your scapula, near the medial border) becomes weak and unable to perform the function of scapular stabilization, that medial border can start to lift AWAY from the body, “winging” up.
Image by www.physio-pedia.com
This can be caused by general muscle weakness, or from nerve damage to the area.
Athletes who repeatedly use their arm overhead – especially if they do so while tilting their head (something that can happen easily in a sport like volleyball and happens way too often when poor form is used while lifting weights) – are at an increased risk for this type of scapular winging .
Winging can also happen along the lateral border of your scapula if your trapezius muscle isn’t functioning correctly. But this type of winging tends to be from complications related to surgery , rather than the overuse you’re more likely to encounter in the gym.
Testing for Winged Scapula
In some cases, winged scapula can be super easy to spot with just a quick glance. But the dysfunction isn’t always that noticeable… Especially if you’re just trying to catch a glimpse in the mirror by yanking your neck behind you to get a good look.
Thankfully there are two great assessments that will help you determine if scapular winging is behind your pain.
(A quick tip for these tests – you’ll want to grab a buddy for another set of eyes on your back. You can always have them snap a pic or take a quick video so you can see your scapular movements yourself!)
Winged Scapula Wall Test
For this test, stand facing a wall, with your feet about two feet back. Start to lift your arms up toward the wall, rotating your fingers down toward the ground.
Press your palms flat against the wall at around the height of your waist. This position should make any winging of the scapula much more noticeable and visible .
Image by www.shoulderdoc.co.uk
Winged Scapula During Shoulder Flexion Test
For this test, grab a light weight, maybe a 3 to 5-pound dumbbell and a buddy. You may want to forward this article to your buddy to review so they know what to look for.
Having a weight in hand will make the simple movement you’re going to perform a bit more difficult. The added difficulty will make it harder for you to keep any underlying winging under control, thus making it easier to spot .
So, grab that light weight and hold it with your thumbs up. Then, simply flex your shoulder to lift your arms overhead.
You can have your buddy to take a video as you move throughout the entire range of motion on this one – arms up, then back down again. The winging might be more obvious at certain points in the range.
Step 1: Eliminate Restrictions Related to Scapular Winging
If you’ve determined if you’ve got a winged scapula, the ultimate goal is to improve mobility in the region.
However, to improve mobility requires much more than simple static stretching, because mobility is your ability to move, whereas flexibility is your ability to be moved.
Mobility is active while flexibility is passive so if you want better function, mobility is what you’re after.
So you could do some static stretches for Step 1, but for winged scapula, the following technique is more effective.
Pec Minor Release
This move will work to inhibit your pec minor – a commonly overactive muscle that might be taking on too much work – work that should be done by your serratus anterior.
When the pec minor contracts, it pulls the scapula forward and down – the exact same position your scapula is in when it’s winged.
So if the pec minor is shortened, it’ll pull the scapula into the winged position and it will inhibit the opposing muscle – the serratus anterior.
That’s why if this muscle is shortened or otherwise tense (hypertonic), it’s necessary to lengthen/release the tension here first to restore proper muscle balance and allow the serratus anterior to do its job.
A note before you start – this release will feel uncomfortable.
- Grab a lacrosse ball and some open space on a door frame or a wall
- Find the coracoid process of your scapula by following your clavicle all the way to the edge of your shoulder, then moving your fingers down in front of your shoulder – you should feel a small bony prominence
- Place the ball there and lean against the wall, placing the arm on that side behind your back
- Roll the ball around over the area in all directions as you continue to apply pressure into the wall
- Move your shoulder into horizontal extension as you work the pec minor
- Continue for at least 30 seconds and up to 2 minutes
Serratus Anterior Exercises for Winged Scapula
Now that your pec minor is relaxed and lengthened, it’s time to activate and strengthen the serratus anterior.
Level 1: Supine Serratus Activator:
This drill will help teach you to activate your serratus anterior. This will begin to gently strengthen the muscle, plus make sure it’s nice and engaged for the next couple of moves.
- Lie on your back with your upper arms on the ground by your sides and flex your elbows, pointing your fingers toward the ceiling
- Drive your elbows into the ground at about 50% strength and hold
- Maintaining this contraction, try to bring the medial border of your scapulae up as if you’re trying to pull them into your body and open your chest (this is posterior scapular tilt) –try not to squeeze them together
- Hold for 5 seconds, then relax and complete 6-10 reps
Level 2: Shoulder Rotation Robot
This technique makes use of a a reciprocal movement that recruits both sides of the body in opposition and trains your serratus anterior to stabilize the scapulae during internal and external shoulder rotation – critical for shoulder health for athletes who throw or swing rackets or clubs.
You’ll need a wall for this move, and you’ll need to fight the urge to break out into those robot dance moves you “perfected” in high school.
The key cue for this technique is to keep your scapulae flat against the wall the whole time – they shouldn’t move as your rotate the shoulders.
- Stand with your back against a wall, fingers pointing down toward the ground and elbows slightly bent
- Keeping your upper arm and elbow pressing into the wall, start to lift your right fingers and forearm away from the wall as you rotate them up
- Try to get the back of your hand to the wall, fingers pointed up, and pause, pressing both hands into the wall
- As you rotate your right arm back down to the starting position, lift your left arm up, swapping positions
- Continue to move, taking one hand up as the other moves down and pausing in between
Level 3: Overhead Wall Rollout
This last drill will not only encourage strong activation of the serratus anterior, it will train shoulder flexion + core stability and proper scapulohumeral rhythm.
- Stand leaning against a wall with an ab-wheel in your hands
- Protract your scapulae
- Slowly roll the ab-wheel up the wall and ensure you’re shrugging your shoulders to elevate your scapulae as your arms rise up while keeping tension in your core to avoid lumbar extension
- Roll back down slowly and with control and return to the initial position.
- Breathe naturally throughout the movement
Perform these moves and you should see an improvement in the function and strength of your serratus anterior, which will lead to a decrease in scapular winging and a decrease in unpleasant shoulder symptoms if you’re experiencing any.
Just remember to start with the pec minor release first before you hit the serratus anterior exercises so the serratus isn’t inhibited and can be effectively fired up and strengthened.
Now, if in addition to winged scapula you have symptoms like shoulder pain, tightness or immobility issues, check out the Scap Strength program.
Along with further techniques to get the serratus anterior active and strong, you’ll train the entire shoulder girdle to be strong and stable in all positions of the shoulder, so no matter what you do with your shoulders, they’ll have the strength to support you and keep you pain-free.
Learn more about the Scap Strength program here.