Physical Therapy Management

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Winging Of Scapula
Definition:Scapular winging is a distortion of the proper
positioning of the shoulder blade. Scapular winging
not only causes pain, but also decreases function in
the associated arm. If left untreated, this condition
can interfere with normal daily activities such as
pulling a shirt on and off and brushing the teeth.
Causes:1- injury
2- dysfunction of
the muscles
themselves
3- dysfunction of
the nerves that
supply the muscles
Symptoms:1- Pain in Some Cases
2- Noticeable Protrusion of the Scapula
3- Difficulty with Lifting, Pushing, and
Pulling Motions
4- Muscle Weakness in the Affected Arm
how we can try to correct the
winged scapula
When starting exercise to reduce winged scapula through a rehabilitation
program, some of the following areas need addressing:
- Work on serratus anterior activation to hold the
medial border of the scapula down.
- Work on lower trapezius activation to hold the
inferior angle of the scapula down.
- Work on scapula adduction/retraction which will
improve posture.
- When starting any rehab program it's important
to work on muscle activation before
strengthening, as you cannot strengthen a
muscle if it does not have the ability to
activate consistently.
Ruba Saud AlQabani
I have some basic exercises you can start doing to
work on muscle activation which are listed below:
 Serratus anterior activation - Push up plus This
is one of the more basic serratus anterior
exercises as it is only body weight and allow's
you to include a normal push up into it. Note I
have slight winged scapula's so the press up
looks exaggerated.
 Lower trapezius activation - dumbbell hold Can
be done on the floor or on a bed. If your arm is
shaking slightly while you're doing it, it can be
due to triceps brachii weakness which will
improve over time if the exercise is
done regularly.
Ruba Saud AlQabani
 Scapula adduction/retraction - Thoracic
hyperextension over foam roller This exercise
can improve thoracic spine mobility, scapula
adduction and shoulder flexion range, which can
improve your ability to reach overhead.
If you have a severe case of winged scapula or are unsure about
starting an exercise program, always consult a medical professional
such as a physio before commencing.
Surgery for Winged Scapula:If nerve conduction studies confirm significant
damage to the long thoracic nerve the patient
undergoes surgery called a long thoracic nerve
decompression. The goal of the surgery is to help the
affected nerve recover. This is a highly successful
procedure with excellent results. The surgery is
performed under general anesthesia and includes a
small incision line which allows the surgeon to reach
for and decompress the affected nerve.
After the surgery patients regularly undergo
rehabilitation in a form of physical therapy. If there
are problems related to pain in the operated area
patients are usually prescribed painkillers.
THANK YOU
Definition
Shireen Al-Shami•
Loloa•
Ghadir jalal jwaid •
Causes
Munira •
Symptoms
Physical
treatment
Ruba Saud AlQabani•
Noor Labban•
Surgery
•Dana
pictures
Lujain Ayman•
Video
presenting
Power
point
Ghaida •
Bayan •
Saja•
Salam•
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