What is scapular winging?
Normal, smooth movement of the scapula (shoulder blade) is essential for full range of movement of the arm so that one can place the hand in time and space accurately. The control of the scapula relies on well co-ordinated motion of the multiple muscles attached to the scapula. Disruption of the muscles function could lead to abnormal motion of the scapula, which is known as 'scapular dysrhythmia' or 'scapular dyskinesia'. During motion, the muscle weakness is manifested as winging of the scapula (the shoulder blade becomes prominent or sticks out).
What are the causes of scapular winging?
Broadly speaking, scapular winging can be caused by skeletal, neural or muscular conditions. Examples are as below:
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Skeletal
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Shoulder instability
Subacromial impingement
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Neural
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Neuralgic amyotrophy / Parsonage Turner syndrome
Entrapment neuropathy
Trauma
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Muscular
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Fascioscapulohumeral dystrophy (FSHD)
POMPE disease
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Which muscles are most commonly affected?
Serratus anterior is, by far the most commonly affected muscle, followed by trapezius. Rarely, rhomboids are affected.