Winging Scapula


Scapulothoracic Dyskinesis
a.k.a. Winging Scapula

At MOTUS, we consider ourselves to be movement specialists. When we meet with a patient complaining of pain in a certain area, our attention goes beyond the affected region. We know that the body works as a unit, and discomfort here could be caused by an underlying issue somewhere else.

Scapulothoracic dyskinesis is a perfect example of this. This is an overuse syndrome where the excessive stress on the scapula (shoulder blade) creates abnormal mobility to the scapula. Overuse in this area is very common for overhead athletes, like baseball players, volleyball players, swimmers, and weightlifters. Overhead athletes are reported to be about 61% more susceptible to scapulothoracic dyskinesis than other athletes.

The scapula is connected to multiple muscles, all of which work together to provide the wide range of motion in the shoulder. If anything goes wrong with the mechanics of the scapula, it can quickly lead to problems with the surrounding tissues. That could be the rotator cuff, the cartilage, or the shoulder labrum. The scapula plays a major role in the upper body’s kinematic chain, so if something is off with the scapula movement, things could be off elsewhere.

When a patient presents with shoulder pain, scapulothoracic dyskinesis is a distinct possibility, particularly if the patient is an overhead athlete. However, this condition is often overlooked.

Sometimes the problem itself isn’t addressed, and ends up returning after treatment. At MOTUS, we make a point to diagnose carefully, with the entire body in mind, so that this does not happen.

People with scapulothoracic dyskinesis usually experience anterior shoulder pain, but they could also have pain in the superior shoulder, in the proximal arm, or in the back of the scapula. If you’re an overhead athlete with any or all of these, you should be checked for scapulothoracic dyskinesis. In order to help us get an accurate diagnosis, our clinician will perform a few tests on you to see what increases or reduces symptoms.

When we treat scapulothoracic dyskinesis, we do it within a few steps. We start by reteaching you the proper shoulder movement through exercise and physical therapy. Next, we will introduce more exercise that will help you work on building strength and muscle memory that will help you use safe, correct movements in your daily life. Once you’ve nailed that, we can move on to your athletic performance. Our team will prescribe you an exercise routine designed to teach your body the right way to move, and to give it the strength to do so.