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Why Is Your Shoulder Blade Sticking Out? Scapular Winging Explained

by | Jan 1, 2023 | Shoulder Pain | 0 comments

scapula and clavicle skeleton front view

Your shoulder blade sticks out (also known as scapular winging) because it is required to increase your available range of motion during a movement or you may be experiencing a nerve palsy.

Scapular winging can be a normal phenomenon that occurs oftentimes when you are reaching behind your back and trying to reach as far as you can. 

There are also occurrences when it is not normal that I will go into through the remainder of this article.

If you want a few exercises to help you strengthen your shoulder blade I’d recommend you check out this article I’ve linked to in this sentence!

 

What Are the Primary Causes of Scapular Winging?

  • Reaching behind your back to undo your bra, scratch your back, or clasp your hands together, you might see some scapular winging. This is your bodies way of trying to increase the available range of motion so that you can accomplish the task. The scapula (shoulder blade) is tilting in order for you to have more space to move
  • Weak subscapularis muscle. The subscapularis is a rotator cuff muscle that is responsible for “gluing,” the scapula to the rib cage. Generally a weakness is this muscle group is due to a nerve injury
  • Nerve injury. Injury to the long thoracic nerve (which innervates the serratus anterior muscle), dorsal scapular nerve which innervates levator scapula, rhomboid major, and rhomboid minor (source), and the upper and lower subscapular nerves which innervate the subscapularis muscle.  

When Should You Be Concerned About Scapular Winging?

You should be concerned about scapular winging if you have:

  • Decreased upper extremity strength on one side versus the other
  • Pain around the shoulder or shoulder blade
  • Numbness and tingling around the shoulder blade or that travels from the neck down to the arm, hand, and fingers. 

If you are experiencing any of these symptoms then you’ll want to move onto the next step i’ll discuss below.

When Should You See a Doctor for Scapular Winging?

You should see a doctor if you have any of the symptoms that I just shared above. 

It’s fine to also see a physical therapist as they will be able to perform a detailed physical exam looking at your range of motion, strength, pain levels, etc. 

It’s my (biased) opinion that most people if they are having a musculoskeletal issue should see a physical therapist (physio) first as we have better diagnostic capabilities than physicians when it comes to musculoskeletal issues. 

So, if you’re having this issue, it’d be worth seeing your PT first and you’ll likely get a better outcome in a shorter period of time!

Dr. Nate Kadlecek, PT

Nate Kadlecek, PT, DPT is a Columbia University-trained physical therapist committed to providing high-quality health information, largely focused on lower back pain and the gross overuse of diagnostic imaging, medication, surgery, low-quality treatment methods, and the over-diagnosis of pain conditions. He competes in powerlifting and has recently taken up longer distance running, played football and baseball in college, successfully completed one mountaineering trip (barely), Shoe Dog by Phil Knight (a memoir about Nike) is his all-time favorite book and captures his own ethos, and few things get him as excited as presenting to groups of people eager to learn about the science of pain and talking about future tech and its integration with health.