Question
Hi,
About a fortnight ago i went for a 'relaxation' massage. I didn't notice anything at the time so am not sure if it is related but the next day, i had a REALLY painful right shoulder, it was a hard ache all of the time. It felt like it was all over the shoulder, and it was painful to move. Was also painful to move my head, in a 憀eft-ear-to-left-shoulder' position. I thought at the time that maybe that massage (which had been light) had woken up some knots or something that were now near a nerve or muscle. So i then went to an osteopath for a sports massage.

They didn't notice anything about my shoulder, but at the time i didn't know there was a problem (other than the pain which i told them about) and couldn't draw their attention to it.

A few days later, the pain was beginning to subside, but i looked at my back in the mirror and noticed that one of my shoulder blades sticks out in a weird way / angle. Especially when i hold my arm out forward - in front of me, and even more so when i do this holding something.

I have now been to the doctor who tells me that it is a winged scapula - he is referring me to an osteopath, to diagnose and then maybe physiotherapy. Now, it doesn't really hurt, but it is uncomfortable lift things like a kettle with water, and i have decreased mobility, driving is also less easy.

My question is how did this happen? It really came on just one day; i know it wasn't like it before. I do exercise, running and toning and step, but don't do any regular sports like tennis or sports that are hard on the shoulders.

Any advice such as what can cause the scapula to wing and how is it repaired would be very helpful.

Thanks in advance

Rach


Answer
Hi Rach,

A Winging Scapula is typically caused by a weak Serratus Anterior muscle.  The Serratus Anterior muscle is also known as the boxer's muscle, because that is one of the motions it does:  it protracts (or brings the shoulder forward).  If this muscle is weak, it does not hold the shoulder blade as close to the ribcage and the result of that is called winging.

Several things can cause weakness in this muscle:  Poor posture over time, excessive irritation to the muscle from overuse, a trigger point (knot) in the muscle, etc.  On a more serious note, sometimes the muscle itself is just fine but the nerve isn't telling it to contract.  That would be a neurological problem.  

This condition is fairly common in younger females.  The shoulder/shoulder blade joint is very complex and involves many muscles (over 20).  I'm glad you will be seeing a specialist.  They will figure out why the muscle isn't functioning properly and then help you fix it.  If it is a simple strength problem, they will show you specific exercises that target the muscle.

In the meantime, really be super conscientious about having good posture:  by that I mean keep your shoulders back and your head back.  It's important because the muscle is already having some issues and you don't want to overload it by keeping it stretched out of shape all the time.  Sometimes, sitting/sleeping with a small pillow under the elbow can help relax the shoulder muscles and decrease pain.

For more information, I'd recommend doing a google search on "serratus anterior", "winging scapula", and "scapular stabilization exercises".

Best wishes!
Jenny