Scapular Winging

Scapular winging is a rare condition wherein the shoulder blade moves abnormally compared to the shoulder. This can cause pain and can be debilitating. While therapy is the most common treatment, sometimes surgery is necessary to restore strength and function.

The scapula is the shoulder blade and is the largest bone of the shoulder complex. It has the greatest number of muscles attached to it, which stabilizes the arm and allow the arm to move. Sometimes the muscles do not work together in the right way and leads to a break in rhythmic motion of the shoulder blade.

“This is a condition where your shoulder blade moves in an abnormal sequence compared to your shoulder,” says Michael D. Riggenbach, M.D. “It can be fairly debilitating, depending on the extent of the involvement.”

Scapular winging can cause pain, weakness and a cosmetic deformity It can be caused by injury or dysfunction of the muscles or the nerves that supply the muscles.

What Are the Treatment Options for Scapular Winging?

The most common treatment for scapular winging is physical therapy. Sometimes, surgery is needed to restore function of the shoulder blade and allow for better shoulder motion.

“Depending on the condition and the injury, a tendon transfer procedure may be used to help restore strength and proper motion to the shoulder blade,” says Dr. Riggenbach. “In addition, a nerve transfer procedure can be used to restore function.”

When a tendon transfer is performed, an extra tendon is taken from another limb and is used to restore function that way. A nerve transfer  involves using an extra nerve and transferring it to the nerve that is not functioning to repair the scapular winging.Typically, surgery produces positive results in restoring function to the shoulder blade.

“It’s a patient-to-patient situation and recovery is variable,” Dr. Riggenbach says. “Usually good recoveries are seen with the tendon transfer procedure as well as the nerve transfer procedures. It just depends on how well you can get to the problem”

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