Question
When my son raises his arm, his shoulder blade jumps way out of place. It looks really terrible.  We have been told this is nerve damage and he will have to live with it.  Do you have any advise.  We really don't want to give up. Thanks so much.

Answer
Dear Vicki,

What you have described is a condition called scapular winging and it is caused by damage to the Long Thoracic nerve.  The nerve supplies information to the serratus muscles which help to secure the shoulder blade to the chest wall.

There are specific exercise that he can perform to help with the serratus muscle stabilization, but if the nerve is damaged, then the success will be minimal.  Modified pushups where the body is lowered without moving the arms (no bending of the elbow) are called serratus pushups because they work the serratus muscle.  These are definitely worth a try.   

The rhomboids are muscle of the upper back that also help to stabilize the scapula.  They are located between the shoulder blades and attach to the spine.  Shoulder retraction exercises work the rhomboid muscle as well as some rowing activities.  Again these exercise are worth trying to get more stabilization.  You should be able to find specific instructions and illustrations on the Internet concerning serratus and rhomboid exercises.

Starting a work out routine of exercises three times a week for 4-6 weeks is usually sufficient to provide additional stabilization.  If you don't get any improvements at that time, it is unlikely that he will improve.  Good Luck Vickie.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net