From the Research
A winged scapula is primarily caused by damage to the nerves that control the muscles stabilizing the scapula against the thoracic wall, with the most common cause being injury to the long thoracic nerve, as reported in a recent case study 1. The causes of a winged scapula can be categorized into several types, including:
- Nerve damage: injury to the long thoracic nerve, spinal accessory nerve, or dorsal scapular nerve can result in scapular winging, as seen in a study on dorsal scapular neuropathy combined with suprascapular neuropathy 2
- Muscular disorders: conditions such as muscular dystrophy, facioscapulohumeral dystrophy, or direct muscle injury can lead to scapular winging
- Structural abnormalities: scapular osteochondromas or rib cage deformities can also cause scapular winging
- Trauma: direct trauma, stretching during surgery, or repetitive shoulder movements can damage the nerves controlling the scapula, resulting in winging, as reported in a study on scapular winging due to prone plank exercise 1 The diagnosis of a winged scapula is typically made through physical examination and electrodiagnostic studies, such as electromyography, as seen in a study on pectoralis major transfer for winging of the scapula 3. Treatment for a winged scapula depends on the underlying cause and may include:
- Physical therapy: exercises to strengthen the muscles surrounding the scapula and improve range of motion
- Nerve gliding exercises: to help restore nerve function and reduce symptoms
- Surgical interventions: such as nerve transfers or muscle transfers, may be necessary in persistent cases, as reported in a study on scapular winging due to rhomboid muscle paralysis 4 Recovery from a winged scapula can take months to years, depending on the extent of nerve damage, with complete nerve transection having a poorer prognosis than nerve compression or stretching injuries.