Rotator cuff muscles, back muscles and chest muscles all attach to the shoulder blades (scapulae). When any one of them becomes weak or dysfunctional it can result in issues like scapular winging and cause serious problems for shoulder mobility.
Winging occurs when the medial border of the shoulder blade protrudes beyond the rib cage, often caused by serratus anterior weakness, long thoracic nerve dysfunction or tight scapular muscles. There may be many causes; among the more prevalent are serratus anterior weakness, long thoracic nerve dysfunction and tight scapular muscles.
Scapular Retraction
Shoulder blades, known as scapulae, are surrounded by important muscles that work to move and support them in an ideal state. Unfortunately, these muscles are often neglected when exercising in gym settings – an oversight which can lead to problems like winging of the shoulder blades and other shoulder injuries. Scapular Retraction is a simple exercise targeting these muscles that aims to improve scapular stability and posture; it serves as an excellent warm-up exercise while connecting mind with muscle.
Standing with feet hip width apart, retract your shoulders by drawing them together without shrugging upward towards your ears. Keep this movement slow and controlled for five seconds before releasing slowly – do 10 repetitions before moving onto other exercises.
Strengthen the muscles between your shoulder blades for better posture and reduced stress on neck and shoulders, plus train them to move in multiple directions more resilient to injury – key elements for improving shoulder joint function overall. This standing version of scapular retraction.
If your winged scapula is severe, it may be because your serratus anterior muscle is weak or there’s long thoracic nerve dysfunction present. Furthermore, it could be that your rib cage has lost its natural kyphotic curve leading to unstable scapula formation – either of these issues can be corrected with corrective exercises and consistent practice.
The scapula can move in six different directions, and its muscles that control its movements are essential to shoulder health and movement. Unfortunately, many people have poor habits that prevent them from training these muscles correctly – this prevents people from lifting or training their shoulder joints properly which leads to problems like scapular wings or subacromial impingement.
Practice Scapular Retraction and Protraction Daily to Address Shoulder Issues The best way to address shoulder issues is through daily scapular retraction and protraction practice, until it becomes natural and you gain a natural sense for what the “right” shoulder position should feel like. By including these exercises into your regular routine, you’ll soon experience major improvements in both shoulder stability and mobility.
Scapular Protraction
If scapular winging is an issue for you, it could be related to poor posture and limited shoulder internal rotation. You can quickly check for this by looking in a mirror or taking photos of yourself resting comfortably; if your scapula is winging noticeably it will have an external medial edge that protrudes and this condition can easily be rectified through various exercises and routines.
Winging typically results from weakness of the serratus anterior and long thoracic nerve in the upper back, both responsible for upward rotation, downward tilt or depression and protraction or extension movements of the scapula. Together these movements allow it to move in six distinct directions.
Serratus anterior muscles in the front (antero) portion and medial (inner) border of the scapula can become weak due to shoulder injury or surgery; however, scapular winging could also result from spinal accessory nerve problems or neurological injuries like traumatic brain trauma or stroke.
Physical therapists can help alleviate most winging, which usually does not result in pain, by performing some stabilization exercises for your scapula (retraction and protraction exercises) which should move it more towards your spine. Once this has occurred, more functional exercises such as overhead pressing or racket sports movements where your shoulder needs to move through its range can be implemented by progressing onto more challenging ones like overhead pressing.
Physical therapists can help you achieve lasting relief of scapular winging by helping to find an appropriate balance of strength and mobility to restore scapular stability. You should dedicate at least three or four sessions each week to these exercises in order to see significant change in both appearance and functionality of shoulders. To learn more about how we can help, book an appointment with one of our expert physical therapists by clicking below!
Wall Slides
Wall slides are one of the easiest exercises to help treat a winged scapula. Not only are they an ideal shoulder mobility exercise – opening up space between shoulder blades without equipment – they are also excellent stability exercises as they challenge scapular muscles to maintain neutral back posture. Easy and accessible anywhere you are, wall slides make an ideal solution for people with busy schedules who need effective help immediately.
Scapular winging can often be caused by tight muscles in the back (rhomboids and traps) which push forward, forcing the posterior ribcage against the chest, pushing forward on to it. To correct this situation, pectoralis muscle and serratus anterior must pull on the scapula to pull away from its proximity with the ribcage; this leads to protraction which allows humerus bone movement into an externally rotated position resulting in its characteristic “winginging pattern resulting in classic “winginging.”
These winging patterns are commonly observed among sedentary lifestyles and desk jobs due to an inactive posterior chain, leading to rounded shoulders and forward head posture, creating a domino effect of shoulder pain and dysfunction. Furthermore, postural dysfunction has also been observed among competitive athletes that spend considerable time raising their arms, such as basketball players and baseball players.
To avoid such patterns, we need to strengthen stabilizing muscles and train our brains to connect and control those muscles. By doing so, we can reduce injury risks, improve movement quality, and enhance performance; hence scapular stabilization exercises are crucial for anyone engaging in any type of overhead activity.
When performing a wall slide, begin by standing with your back against a wall with slightly bent knees and adding resistance by placing a weight plate or medicine ball on the floor. From here, slide down gradually with arms behind head until they form a 90-degree angle before returning them back into their original positions – repeat for desired number of repetitions.
Shoulder Blade Squeezes
The shoulder blade, or scapula, is a triangular-ish bone designed to allow movement while providing stability for the upper body. A healthy shoulder should sit snugly against its rib cage with no gap between them – known as “nudging.” However, when placed forward and protruding from this position it’s known as winging and can result in rounded upper back pain, limited shoulder movement, and limited upper body mobility.
Winging of the scapula is a common condition caused by weakness in either the serratus anterior muscle, long thoracic nerve dysfunction or tight scapular muscles. Although usually non-painful, this dysfunction can limit movement in the upper body and lead to other injuries like neck pain or an irritated rotator cuff.
At least, it can be treated effectively using manual therapy and physical therapy combined. Your physical therapist will use various techniques to mobilize and reorient your scapula while also strengthening surrounding muscles so as to avoid future issues like winging.
One of the more effective exercises is Shoulder Blade Squeeze. This exercise targets your rhomboids muscles which pull your scapula back together and keep it attached to the rib cage, and they may become weak from overuse leading to winging scapulae.
Start this exercise by sitting or standing tall with shoulders relaxed and down. Next, grab an exercise band with both hands a shoulder-width apart, relax your shoulders, and slowly pull straight out in front of you – this will pull together and squeeze together shoulders together as well as squeeze back your shoulder blades squeezing them back before relaxing your shoulders after six seconds.
Shoulder Blade Squeeze Exercise can be performed anytime and anywhere and is particularly beneficial to those who spend extended time working at desks. As well as helping prevent rounded upper back posture and hunching over postures, it may reduce shoulder pain while improving breathing.
