Friday, June 27, 2008

"Stop Slouching!": Winged Scapula

Winged scapula is a common biomechanical deficiency which is caused by two things: short (tight) pectoralis minor and long (weak) serratus anterior/lower trapezius. In severe cases, it looks like a person's shoulder blades are poking up out his or her back. I saw one guy on the bike course at Lawrence 70.3 who made me cringe, his scapulae were so poky. But in a less severe case, the condition will show itself if you push hard against a wall with palms flat at waist level (not sure on the biomechanics of why this is the case, beyond the fact that this movement should use the serratus anterior and if they're weak it'll show up here). One of the other trainers at my gym did this once and completely grossed me out. He looked like a frickin' gargoyle.

So why should you care that your shoulder blades stick out like a pterodactyl's? First off, it destabilizes your shoulders. The shoulder is a pretty intricate area, and little things that might seem small (like an imbalance in the muscle that holds the shoulder blade against the ribs) can really FUBAR the joint in a dozen years or two. Injury is the first and primary concern with any imbalance I bring up.

But in a more immediate sense, it can also impede your performance; not like having no shoulders in twenty years isn't going to impede your performance (yeah, I have some athletes you might wanna ask about that . . .) The serratus anterior is a muscle you need for swimming, especially if you want to get that nice Serape Effect rotation going. Besides which, it's totally common for winging scapulae to go along with a protracted shoulder girdle, which probably means your rhomboids are weak too. And guess what other muscles operate in that Serape Effect thing. That's right . . .

What do you do about winging scapula? Here are some exercises and stretches that will probably help you (unless your problem arises from an impinged nerve in your neck/traps, but in that case you'd probably only have one wing).

Incline Shoulder Raise
Lie on your back at a slight incline. If you're at a gym you can use an incline bench. Otherwise, you can lean against a stability ball. Hold dumbbells (always start light!) in hands with arms extended. Your hands should be positioned directly above your shoulders. Now without bending your elbows, raise your hands; the movement should come from scapular protraction (pulling your shoulder blades apart). You can also add this exercise onto the end of a bench press--that is, protract your shoulder blades at the top of your bench press, using your serratus anterior to extend your range of motion. Although if you have winged scapula, you probably shouldn't be spending a lot of time on bench press; your pecs are too strong, remember?

Standing (Dumbbell) Scaption

Don't start with dumbbells. This is not an exercise that you use to pack meat onto your deltoids. This exercise is not intended to give you a good cut. It primarily strengthens the supraspinatus, which has got to be one of the most exposed and vulnerable muscles in your body. So do yourself a favor and take it easy when you begin this exercise.

Stand in a stable position, hands at your sides, thumbs facing forward (palms turned towards your body). Make sure your shoulders are back and down, your chest is lifted, and your back is in a neutral position. The movement is halfway between a front raise and a lateral raise. Raise both arms to the front and sides at about a 45 degree angle, simultaneously rotating your thumbs to face behind you (palms still rotated medially). Combination flexion, abduction, and external rotation! Whee!

Supine PNF Patterns on Ball
Lie with a stability ball under your shoulders and upper back, thumb of your right hand on your left thigh. Lift your arm up and over your head, rotating your thumb to face down. Similar to the above movement, except the movement is diagonal and you're reclining.

Isometric Wall Press
Stand about two feet from a fall. Raise your arms to roughly shoulder level and place them on the wall. Make sure shoulders are back and down, chest is lifted, back is neutral. Press into the wall by protracting the shoulders (not by leaning forward!) and hold. This is an isometric contraction for the serratus anterior.

Doorway Modified Chest Stretch
Stand next to a doorway or wall of some sort. Bend the shoulder and elbow and place the the forearm against the wall. Lean into the wall slightly and turn the body away from your arm. You should feel the stretch in your upper chest and arm. This is to stretch the pectoralis minor.

Cobra

During this yoga pose, focus on lifting yourself with your back extensors, rather than pushing yourself up with your arms. Keep the shoulders back and down, the shoulder blades retracted, and the chest broad and lifted. Stretch long through the spine and then try to pull the breastbone away from the hips. Yoga poses are really too complex for me to adequately explain in this manner; follow the link for a more complete set of directions. Or--even better--go to a yoga class and have an actual yoga instructor help you! You should be going to yoga anyway.

Downward Facing Dog
Same note as above; I can't adequately explain a yoga pose in this blog. Partly because it's too complex, but partly because I'm not qualified. I can tell you that one of the many, many benefits of this posture is that it causes a continuous eccentric contraction in the serratus anterior, as long as you remember to keep your shoulders broad and low. Follow the link (or your yoga instructor's instructions) for more help than I've given you!

I should mention at this point that my scapula wing. You can't tell just by looking (they're not that bad), but if I do the wall test, you can definitely see my wings ("Every time the dumbbells clank, a bodybuilder gets his wings!"). So these are exercises and stretches that I do on a regular basis. And Downard Facing Dog is very difficult for me in yoga class, because my serratus anterior doesn't much care to hold an eccentric contraction for very long.

I really hope that these exercises provide useful material for your weight training programs, and help prevent injury and enhance performance. If you have particular questions or suggestions for this series, sound off in the comments or send me an e-mail!

Note: Videos for the exercises can be found here.

56 comments:

  1. Hi Jamie,
    I found www.yogajournal.com to be really helpful in learning the correct way to do poses with pics and everything. :-)
    Lisa

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  2. Hi
    I appreciate your post a lot, I have recently began cheerleding and am having so much problems because I can't raise my arms above my head. My shoulder blades stick out so far. I am waiting to see a specialist about it, but whos knows how long I will wait. I will deffinatly try your suggestions

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  3. I always thought my shoulder blades were sexy. Didn't know I had a "problem", which I do! I'm going to be doing double cable lat pull downs, with my back to the machine, concentrated cable rows, and this little shoulder exercise that I cannot explain...

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  4. My son 12 yrs 5'8" was diagnosed with this condition by Pediatrician went to Orthopedic and he blew it off as well nobody has a perfect shape. My son also has Pectus Carinatum which could be described as a barrel looking chest. Orthopedic blew off also as not so bad. He did say however this last visit that he thought one leg was a tad bit longer than the other. My concern is that the scapula sticks out far and they are uneven quite a bit. And the collar bones also stick out. Is there a brace for helping them to go back to normal? Or in your study does the exercise work really good that he will notice difference in a matter of time?

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  5. Your 12 year old son is 5'8"? Wow.

    I would guess that your ortho blew it off because winging scapula is a very common condition with kids. If they're not gone by the time he's 18-20, then you might have cause for concern. And for most people, it really isn't a serious concern; it puts the shoulders at great risk during loaded flexion exercises, but I've never seen a case where that led to severe injury (i.e. subluxation or dislocation of the shoulder joint).

    More importantly, I'm just a personal trainer, and your ortho knows way more than I do! But I think that's why he told you not to worry about it; in most kids, it goes away as their bodies develop.

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  6. Hi there.
    My 4 year olds shoulder blades protrude so much I worry that someone is going to think she doesn't eat/eat enough. But she eats the same as her 2 year old sister and her sister is heavier than her! She has always been small (skinny) but I am sure her shoulder blades weren't this bad a year ago.
    They don't just stick out when she moves her arms. They are sticking out when her arms are down by her sides... they stick out about an inch or so. You can see it through her clothing and feel it of course.
    Are we doing something wrong? Is it because she isn't exercising/running around and climbing things enough? Or is it just because she is skinny? I took a photo today which I can give you a link to if you want.

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  7. At 4 years old, don't worry about it. Kids don't develop the muscular tonus to hold down the scapulae until well into their teens. So it's not at all unusual for children to have winged scapula. If she gets to 16 or 18 and it's still there, it might be time to do some shoulder stabilization. Or if she gets super involved in swimming, or some other shoulder-dominant movement.

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  8. Im 16 and i always wear fitted shirts but i hate the way my back look in them because my back bone sticks out....YUCK!!! I really hope the excercises works. And i just started doing yoga...I LOVE IT! Cant wait to you get the videos up.

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  9. My son is 13 years old, 6 foot tall, very loose jointed throughout his body, and has uneven very winged scapulas. The problem for us is that he is a baseball pitcher. He loves baseball, throws extremely fast pitches, and because of the stress applied, is prone to shoulder and upper arm strains. We were told that passing through puberty might help as the joints fully form and muscle mass builds up in the body to stabilize his various upper parts. On the advice of a physical therapist, we bought and use stretch resistance bands, but I don't see any improvement. Can your exercises be of better help in our case? Are their any risk factors?

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  10. Dear Bob S.

    Im also a pitcher.Im a senior in high school and have already committed to play college baseball.
    I was informed yesterday that the pain that has kept me out the past 2 weeks is scapula winging.
    There is a surgery availible to fix this matter,but rehab is 6 months to a year.Im still undecided about having the surgery,but this couldnt have came at a worse time.You should definantly seek several opinions from your sons doctors on where to go..But the condition does get worse if it is played through

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  11. hello im 17 years old!! i have winged scaoula for the last 2 years!! my shoulder blades are almost perpendicular to my back!! And on the other side my shoulders come forward and my chest barrells inwards!this is hereditary because my brother also has the exact same condition!!
    i was wondering will these exercises still work seen as it is hereditary and not an injury!!??
    Thanks...

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  12. @Anon: Well, I'm really not sure. It gets into the difference between functional problems (i.e. muscular, which can be because of weakness or inflexibility) and structural problems (i.e. related to bones, joints, ligaments). It sounds like your problem is probably structural. In that case, these movements might not be as effective for you. But I don't think that they will hurt you, either. If nothing else, you can try these exercises and see what happens.

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  13. I took notice of my " Winged shoulder blades" only just recently, because i didn't think it's nice to look at.

    I thought that my shoulder blades would be forever " curved " and would not be able to reverse this " condition ".

    So this is just a problem of the muscles and not the shoulder blades itself? That would mean there is hope for me!

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  14. can someone please tell me if the exercises, work for someone who's shoulder blades stick out, but have no difficulties what so ever nor pain in the back. Because when i wear my t shirt or tank top it's just horrible, I get depressed when i look at myself in the mirror, please help .

    Thanks a lot everyone :)

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  15. Hi, my 13 year old daughter has winged scapular but also her shoulders are very very rounded,and progressivly getting more so.she is being investigated for muscular dystrophy but so far biopsi has come up with nothing. she has a raised ck level also. would these excersices help in her case? could it bring her shoulders back to a more normal position do you think? ant advice appreciated.
    sarah.

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  16. My 5-year-old daughter had a right hand fracture in August and now of late I am noticing winged scapula only in the right shoulder. I am sure the fracture is the cause because she also still cannot abduct her arm as well as the left arm. Is this serious or something that will go away as she grows. I will be visiting the ortho soon but pls tell me what to expect as I am really worried.

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  17. My shoulders are rounded and my scapula sticks out so far you can see it through my shirt. I have actually subluxated my shoulders several times because of this, and strained back muscles. I know I need to do something, but what would you reccomend my first step to be?

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  18. For those of you who are describing children who are very tall and have "loose joints" and winging scapulae,especially with any rib cage abnormalities, I URGE you to take that child to a Marfan Syndrome specialist for screening, especially if they are an active athlete. It may save their life. Those can be signs of Marfan syndrome, which can also cause weakness of the major blood vessels, which can rupture during athletic activity (or at any time). Get that kid checked out!

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  19. Thanks for your comment, Tina! Right on.

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  20. Hey, thanks for the workout information on the winged scapula! I am an exercise enthusiast that slowly developed this the past few months.....and the orthopedic surgeon found it to be Parsonage Turner Syndrome..he had to go home and look it up on the internet after my appt...and it's textbook for what happened to me! Go for EMG tomorrow to see if the nerve is dead or asleep, but will add these excercises to the ones I am doing now...thanks!

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  21. Hey!

    20 Year old boy

    I got a winged scapula about a year and a half ago. Went to the hospital and got it diagnosed. My best guess is that i damaged the nerve while training my trapezius muscles doing shrugs. The doctor said not to worry, it would msot likely fix itself. But it hasen't yet. I've recently started training weights again, is this unhealthy for the shoulder? Do you have any thoughts to what I should do?

    Thanks alot.

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  22. hi i am 15, 5'9 and i am 60 kg. i have winged scapula and you can see it through my shirt. i am wondering if back workouts would help it go away?

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  23. Nice blog you got here. I'd like to read more concerning this theme. Thanks for sharing this information.

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  24. Hey. I'm 30 years old and have been able to do a stupid human trick since I was a child in which I am able to stick both scapulas out about 3-4 inches, and my right one about 2-3 inches. I don't notice it protruding when I am standing with my arms down though.
    I'm 6'2'', was a high school baseball pitcher, an all state golfer, and am now a surfer in Northern California. No amount of exercise has ever made a difference in how my shoulder blades come out. This is the first time I've ever looked it up, because I have noticed a slowly worsening level of pain in the muscles under my scapula in the past 5-6 years. I have had multiple subluxations, but never connected the two. I'm considering yoga to work on trying to stretch the muscles underneath the scapula....but perhaps some of these exercises would be helpful. I've just always tended to assume that those exercises all get covered when I'm out surfing....

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  25. Should I sleep in a "special" way? On my back? Side ways? On my belly?

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  26. i plan on doing the 2 first exercices mentionned 3 times a week.

    i know it aint an exact science, but approx how long do you think since i start seeing an improvement, id like to be able to wear tshirts this summer.

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  27. I'm 20 and I've had this since I can remember. I remember getting checked out for pscoliosis (sp) when I was a kid, but I didn't have it. This must've been what they were talking about. Unfortunately no one has ever recommended to me any exercises or anything that would help.

    Hopefully after doing these I'll see an improvement. However, I kind of doubt that. I feel like its structural, as I've never really damaged any muscles or tendons in my back or chest as far as I can tell. It doesn't really bother me except the fact that they protrude sooo far. It sucks to be on the beach.

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  28. Has anyone tried the "Push-up Plus" technique. Go to Youtube and type in Push-up Plus. it has helped me alot with my winging.

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  29. I have one winged scapula on my right side. If I extend my arms in front of me, it is easily seen. I recently had shingles on my face and am wondering if this could be result of that. My mother died two weeks before I noticed the winging; could trauma or stress be a result? I've read it can be caused by sleeping; I assume if arms are in a certain position too long. Can you comment on that? Are exercised enough for my situation?

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  30. My mother is 57 years old & has suffered for 3 years now & was just diagnosed with winged scapula due to injuries at work. I'm wondering if yoga will help her at this point? She walks with her neck slightly cocked to the side like she has a kink 24-7 & her rib cage & stomach constantly hurt.

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  31. As Tina said, look up Marfan Syndrome. Also, I have winged scapulae, loose and (now) painful joints, fatigue, etc., and I have Ehlers-Danlos Syndrome-hypermobility-type. Please look it up! It is thought to be "rare", but I believe it is just grossly mis/underdignosed.

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  32. This has been very helpful!! I'm on the swim team at my high school and my shoulder has been hurting for quite some time. Our school's personal trainer said I was starting to wing and since I'm right handed, I also over-use my right arm while swimming and whatnot.. I didn't know what this meant until now, and I will definetly do some of these excersizes!!

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  33. I'm 14 and i have winged scapula and its pretty bad, I am embarrassed to remove my shirt when people are looking because of it.Everyone says it is because I'm skinny. My parents won't let me go to a gym until next year.... Should I be worried a lot?

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    Replies
    1. an injured long thoracic nerve is the only thing that causes a winging scapula.causes paralyzes of the serratus anterior.slouching has nothing to do with it!!sometimes heals with time.surgery may work by relieving pressure on the nerve in the neck(between the scalenes)or under the shoulder blade.you can not exercise the serratus anterior if the nerve is not firing.

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    2. No, that's not the only thing that causes winging scapula. That's a neural problem. Winging scapula can also be structural or muscular. I did have one client with a severely winged scapula whose serratus anterior was paralyzed. The nerve was severed in a motorcycle accident. But winging scapulae can also be caused by an underactive serratus, protracted shoulder girdle, underactive rhomboids, or a combination of those. The underactivity isn't always a result of neural inactivity.

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  34. Hi!
    I'm a cyclist and have been having horrible shoulder pain for a couple of years now. Symptoms just as you wrote about: hurts when I lean against a wall or chair (especially driving), and after mile 20 on my bike, I'm riding with my arm behind my back most of the time to lessen the pain.
    Had surgery a year ago to decompress it and the doc gave me a 'harness' to help stabilize the joint. Basically it's a spandex material tee shirt, zips up the front, with a gigantic piece of velcro around my entire waist (like a kidney belt) and velcro straps from the top of my shoulders that criss-cross my back and velcro very snuggly around my waist.
    The thing is hot and tight but I wear it almost daily for a few hours and it does help with the pain. I cannot wear it on my bike or I'd pass out from heat exhaustion and dehydration.

    The crux of my e-mail is this: I still have pain. It affects my riding, working, driving, etc. And that affects me. The last doctor I went to said he's not a magician and that if it hurts to ride...then don't ride. HA!

    I'm tired of PT, and tired of seeing a different doctor because I don't have a specific diagnosis but it sounds like a winged scapula. The first doc said that my left shoulder blade does 'wing'.

    What do I do? I'm not going to stop riding.

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    Replies
    1. Man, I don't know. That sounds like a conundrum. The best I can do, within my scope of practice, is just tell you to strengthen the muscles. The brace works because it keeps your shoulders in an optimal position. Theoretically, your muscles should be able to do the same thing. But sometimes other problems get in the way, like muscle or ligament tears, or inactive nerves. That's the best I can tell you, I'm afraid :-/

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  35. Also try leaning against a wall having your arms inline with your shoulders, keeping your elows on the wall and bent @ a 90 degrees. Then try to push your back off the wall with your elbows and watch were your arms go because they will try to lower themselves keep them up high to get the most out of this exercise and keep your elbows on the wall do 12 to 15 reps sounds easy enough but if you have scapula winging you'll find it ver difficult to keep your arms up but you will love the feeling in your back when your done

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    Replies
    1. Love that exercise. I call it Scarecrow A. You can also work on keeping your shoulder blades, forearms, wrists, and backs of hands against the wall while trying to slide your arms overhead. That's Scarecrow B.

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  36. Hi,

    I have been trying to fix a protracted shoulder girdle and winged scapula, that I have had for as long as I can remember (I'm 18). I'm have been told countless times I just need to strengthen My Serratus Anterior, however my scapula does not stick out when I do pushing activities, and I can do a variation of an incline bench press where I just protract my shoulder blades forward (Incline shoulder raise? -(http://www.exrx.net/WeightExercises/SerratusAnterior/BBInclineShoulderRaise.html) with over 50 kg no sweat. The problem is mainly with retraction, instead of staying flush against the thoracic wall my scapula just seem to go more or less straight out, they also sit at rest quite far apart out and the bottom of the medial border (Inferior angle) is sticking out quite substantially. I have stretched my pecs right out, (Believe me they are very flexible) As well as my anterior deltoid. Right now I have a program consisting of cable rows and low rows in an effort to really strengthen and shorten my mid/lower traps and rhomboids, which since they don't seem to stay stable on retraction I believe is the problem not the serratus anterior. I have always had terrible posture which I now always think about and try to correct. i just wish to have your opinion on this, and if you believe I am on the right track. The physios i've seen have been less than useless.

    ( I do not have an account so I'm hoping this will post.)

    Frustrated Kiwi (In New Zealand)

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  37. Hey!

    My name is Gard Valaker, and I saw my post by accident (by searching my own name in google :D)

    You can find my post about in the middle of this section/page. I had winged scapula (got it in about 09 or something), and I have now trained it completely away. I almost never feel any uncomfortable with the shoulder any more or anything.

    I have used this exercise for maybe 2 years in a straight now (im training alot of strenght).

    http://www.youtube.com/watch?v=iY9Vuo27pCs

    In the beginning I could only do maybe 6-7 reps with no added weight, and my shoulder/scapula hurt when I did it. Now I'm doing the exercise with an added 15kg plate (and planning to raise it to 20 soon)

    Anyway, this worked for me, and I hope this might be helpful to any poor souls that gets winged scapula in the future. I had a hard time finding any tips on this subject when it happened to me.

    Gard Valaker

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  38. People need to look into IMS or what is known as dry needling, may help if the muscles are too tight for the shoulder blade to go back into position.

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  39. Will scapula winging keep you out of the Navy?

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    Replies
    1. No, I don't think winged scapula will keep you out of the military unless there's some deeper issue that's causing it, such as nerve damage. Usually, it's just a muscular imbalance.

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  40. Sorry if this question is retarded, but is it normal to have a protrusion of the scapula during any part of the shoulders ROM?

    I pretty much don't have any problems with my scapula ( no pain, no lack of range in motion ) yet when I raise my arms above my shoulders in any way ( my arms vertically above my head or my wrists parallel to the walls hands pointing upward ) then my scapula slightly protrudes. I'm pretty sure my serratus anterior needs a bit of work but I was just curious if it's normal to see it a bit during this part of the ROM or if slight winging of the scapula is something that happens to a lot of people ( modern age of desk jockys and bad posture from slouching in front of a screen. ) pls respond.

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    Replies
    1. Yep, that's normal. Work on your serratus anterior strength, but don't stress about the protrusion. Most of us have chronically weak serratus muscles. Never hurts to work on them!

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    2. Hi there. I have two scapulas winging statically and dynamically. No pain... full ROM but have been wondering... does the actual winging go away with strengthening and stretching exercises? Or are those things just to get rid of pain? I just want to get these damn scapulae to sit flat because it looks gross. If exercises do flatten the scapulae, may I see evidence (case studies or before and after pictures ect...)?

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  41. I have equally winging scapulae. No pain, no ROM problems. Just have a strong issue with the appearance of it.. Looking to achieve an aesthetic goal and this issue needs to be fixed. Why aren't there any photos of before and after PT exercises... (winged then not winged due to exercises)? I just want these to not stick out of my back in a static position. I went to a PT. Got given lower trap strengthening exercises, Serratus anterior strengthening exercises, upper trap stretches, pec minor stretches and rotator cuff exercises. Should these do the trick if I do it for a maximum of 2 years? I am very frustrated with the look and would love to beat this issue and I am horrified of spending 2 years of this all to see no results... need to know how likely it is that people actually fix the winging appearance. Thank you

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  42. I am just seeing this blog as I search for my 7 year old son. He is a competitive swimmer, and his shoulders have broadened out to the point that his shoulders are about 7 inches apart. Part of his swimming regiment includes wall ups (pull up/push up) onto deck from side of pool, push ups, as well as all four strokes. He is very good at the back and fly. Is his just his back and chest muscles developing? He has had winged scapula for a while and I understand that is normal in children. He does not ever complain of pain in his shoulders, neck or chest. What other excersizes can he do to strengthen his back muscles?

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    Replies
    1. I wouldn't worry about it too much, since he's still so young. The best thing to do, I think, is teach him to be aware of his posture. Winging scapulae probably won't do him any harm, but they may indicate poor shoulder mechanics, which could lead to injury in the future. The exercises that I've given above will help him develop awareness in the stabilizing muscles around his shoulders. The ultimate goal is to teach him to use those stabilizers in all activities. Mindfulness in movement will help prevent injuries in the future, and now is a great time to instill it.

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  43. Hi there, I have the exact same issue as the person in the picture with two equally winging scapulae. I don't show any symptoms of Thoracic Nerve Damage, nor do I have any pain with this, I have a full ROM and am physically able to do anything anyone else can do, I am a healthy individual. I just hate the appearance of these two wining scapulae. They seem to just jut out with my arms by my side, the seem to jut out most at the bottom. They too wing out when performing a push up, or when I hold my arms out in front of me, yet no pain, and I can move my arms freely. I know tight chest muscles are a factor, along with weak serratus anterior, lower traps, middle traps and occasionally weak rhomboids. I know rhomboids retract while the serratus protracts, and that a weak serratus can be overpowered easily. My question is, do people manage to fix this? Have people performed exercises, stretches and what not, and had the success of no longer having shoulder blades that stick out? Or are all these physical therapy exercises nd stretches allocated to alleviate pain? I would like to see evidence (videos,pictures) of people getting their scapulae to sit flat rather than winging out in both static and dynamic poses. I want to become a natural bodybuilder and I highly doubt I could buld enough muscle to fill in the spaces these protruding shoulder blades cause. Thank you.

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  44. exercises to be avoided in mild winging of scapula ie muscle workout not to do?

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  45. I'm 32 years old, average weight, not an athlete. I have had winged scapula for as long as I can remember. They protrude about 3 or 4 inches only when my hands are behind my back. I have no pain and complete range of motion. They just look really weird. Is it possible that this is just natural?I never thought to worry about it but decided to google it today and came across to this blog and to be honest it has worried me a little bit. I've never had any injuries.

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  46. Great tips on getting proper posture. My shoulders have a bit of an anterior tilt to them and I have been working on fixing that. I will try some of those stretches you mentioned. I am also thinking about seeing a physical therapist because some of the muscles in my shoulder feel really tight as well.
    http://www.easternshorephysicaltherapy.com/Rehabilitation-Services-Linwood-NJ.html

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  47. Just as an FYI ...winging scapulae is also a symptom of FSH, a form of muscular dystrophy that affects the face, shoulder and larger leg muscles. It is one of the most common types of MD but also the one less known and the one least funded .. many people who have it may not even know ... they just know they can't reach overhead as well as they could ..

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  48. Like doing cobra's off a stability to help avoid the dreaded slouch.

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