Winged scapula and its Physiotherapy Management

What is a Winged scapula:

The term ‘winged scapula’  is used when the muscles of the scapula (trapezius, serratus anterior, and rhomboid muscle) are too weak or paralyzed, resulting in a limited ability to stabilize the scapula. As a result, the medial or lateral borders of the scapula protrudes from the back, like wings. The primary causes of this illness are musculoskeletal and neurological in nature. Winging of the scapula contributes to loss of power and limited flexion and abduction of the upper extremity and can be a source of considerable pain. This debilitating condition can affect the ability to lift, pull, and push heavy objects, as well as to perform daily activities of living, such as brushing one’s hair and teeth and carrying grocery bags.

Causes of Winged scapula:

  • Acute Traumas, for example, a direct shock on the shoulder during a car accident with sudden traction on the arm. It has also been seen among professional and amateur athletes in a variety of sports, including archery, ballet, baseball, basketball, bodybuilding/weight lifting, bowling, football, golf, gymnastics, hockey, soccer, tennis, and wrestling.
  • Micro Traumas, repeated stretching of the neck in later flexion as in tennis or by wearing a heavy backpack. Occupational injuries in individuals working as car mechanics, navy airmen, scaffolders, welders, carpenters, laborers, and a seamstress have also been reported.

Sign & Symptoms:

  • Pain
  • Difficulty raising items and elevating the arm over the head.
  • Muscle fatigue.

Physiotherapy Management of Winged Scapula:

The primary aim of physiotherapy is to reduce the pain and discomfort, also activity modification to limit further injury to the shoulder.

In the supine position, do range of motion exercises.

Avoid stretching of serratus anterior muscle.

A scapular brace may fulfill both functions of maintaining the scapula against the thorax and avoiding serratus anterior muscle stretching.

Passive stretching of rhomboid, levator scapulae, and pectoralis minor muscles.

Exercises to strengthen all shoulder girdle muscles, including the trapezius.

Kinesio taping.

Therapeutic Modalities such as-

Dynamic scapulothoracic muscle training such as

  • Elbow push-up.
  • Press-up.
  • Low rowing.
  • Horizontal abduction.
  • Retroflexion against resistance.
  • Serratus punch upright, prone, and fitter.
  • Dynamic hug.

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