Skip to main content

Anatomy of Scapula Winging

  • Chapter
  • 3478 Accesses

Abstract

Multiple pathologies can result in the alterations in position and motion that have been called scapular winging. The neurologically based factors traditionally thought to be the causation are less common than other causative factors. Abnormal scapular motion, most commonly classified as scapular dyskinesis, is a physical impairment which can either cause or result from shoulder injury. While winging caused by neurological and traumatic origins can be resolved with surgical interventions, scapular dyskinesis is most often seen as a result from a loss of coordinated muscle activation which directs clinicians to a nonoperative treatment regimen. The clinical assessment of the position of the scapula at rest as well as during dynamic arm motion, including medial border prominence, should be observed. A clinical understanding of the possible causes of winging will assist practitioners in determining the correct means of resolving the abnormal scapular position and/or motion.

Keywords

  • Winging of the scapula
  • Scapula dyskinesis
  • Sick scapula

This is a preview of subscription content, access via your institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • DOI: 10.1007/978-3-662-45719-1_29
  • Chapter length: 8 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
eBook
USD   169.00
Price excludes VAT (USA)
  • ISBN: 978-3-662-45719-1
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Softcover Book
USD   219.99
Price excludes VAT (USA)
Hardcover Book
USD   219.99
Price excludes VAT (USA)
Fig. 29.1
Fig. 29.2
Fig. 29.3
Fig. 29.4

References

  1. Aval SM, Durand P, Shankwiler JA. Neurovascular Injuries to the athlete’s shoulder: part 1. J Am Acad Orthop Surg. 2007;15(4):249–56.

    PubMed  Google Scholar 

  2. Aval SM, Durand P, Shankwiler JA. Neurovascular injuries to the athlete’s shoulder: part 2. J Am Acad Orthop Surg. 2007;15(5):281–9.

    PubMed  Google Scholar 

  3. Kibler WB. Scapular surgery I–IV. In: Reider B, Terry MA, Provencher MT, editors. Sports medicine surgery. Philadelphia: Elsevier Saunders; 2010. p. 237–67.

    Google Scholar 

  4. Kuhn J, Plancher K, Hawkins R. Scapular winging. J Am Acad Orthop Surg. 1995;3:319–25.

    PubMed  Google Scholar 

  5. Galano GJ, Bigliani LU, Ahmad CS, Levine WN. Surgical treatment of winged scapula. Clin Orthop Relat Res. 2008;466(3):652–60.

    PubMed Central  PubMed  CrossRef  Google Scholar 

  6. Tauber M, Moursy M, Koller H, Schwartz M, Resch H. Direct pectoralis major muscle transfer for dynamic stablization of scapular winging. J Shoulder Elbow Surg. 2008;17(1):S29–34.

    CrossRef  Google Scholar 

  7. Romero J, Gerber C. Levator scapulae and rhomboid transfer for paralysis of trapezius: The Eden-Lange procedure. J Bone Joint Surg Br. 2003;85(8):1141–5.

    CAS  PubMed  CrossRef  Google Scholar 

  8. Kibler WB, Sciascia A, Uhl T. Medial scapular muscle detachment: clinical presentation and surgical treatment. J Shoulder Elbow Surg. 2014;23(1):58–67.

    PubMed  CrossRef  Google Scholar 

  9. Kuhne M, Boniquit N, Ghodadra N, Romeo AA, Provencher MT. The snapping scapula: diagnosis and treatment. Arthroscopy. 2009;25(11):1298–311.

    PubMed  CrossRef  Google Scholar 

  10. Bagg SD, Forrest WJ. A biomechanical analysis of scapular rotation during arm abduction in the scapular plane. Am J Phys Med Rehabil. 1988;67:238–45.

    CAS  PubMed  Google Scholar 

  11. Lehtinen JT, Tingart MJ, Apreleva M, Warner JJP. Quantitative morphology of the scapula: normal variation of the superomedial scapular angle, and superior and inferior pole thickness. Orthopedics. 2005;28(5):481–6.

    PubMed  Google Scholar 

  12. Ebraheim NA, Rongming X, Haman SP, Miedler JD, Yeasting RA. Quantitative anatomy of the scapula. Am J Orthop. 2000;29(4):287–92.

    CAS  PubMed  Google Scholar 

  13. Kibler WB, Sciascia AD. Current concepts: scapular dyskinesis. Br J Sports Med. 2010;44(5):300–5.

    PubMed  CrossRef  Google Scholar 

  14. Putnam CA. Sequential motions of body segments in striking and throwing skills: description and explanations. J Biomech. 1993;26:125–35.

    PubMed  CrossRef  Google Scholar 

  15. Sciascia AD, Thigpen CA, Namdari S, Baldwin K. Kinetic chain abnormalities in the athletic shoulder. Sports Med Arthrosc Rev. 2012;20(1):16–21.

    CrossRef  Google Scholar 

  16. De May K, Danneels L, Cagnie B, Cools A. Are kinetic chain rowing exercises relevant in shoulder and trunk injury prevention training? Br J Sports Med. 2011;45(4):320.

    Google Scholar 

  17. Reeser JC, Joy EA, Porucznik CA, Berg RL, Colliver EB, Willick SE. Risk factors for volleyball-related shoulder pain and dysfunction. Phys Med Rehabil. 2010;2(1):27–35.

    Google Scholar 

  18. Radwan A, Francis J, Green A, Kahl E, Maciurzynski D, Quartulli A, et al. Is there a relation between shoulder dysfunction and core instability? Int J Sports Phys Ther. 2014;9(1):8–13.

    PubMed Central  PubMed  Google Scholar 

  19. Vad VB, Bhat AL, Basrai D, Gebeh A, Aspergren DD, Andrews JR. Low back pain in professional golfers: the role of associated hip and low back range-of-motion deficits. Am J Sports Med. 2004;32(2):494–7.

    PubMed  CrossRef  Google Scholar 

  20. Ellenbecker TS, Roetert EP. Age specific isokinetic glenohumeral internal and external rotation strength in elite junior tennis players. J Sci Med Sport. 2003;6(1):63–70.

    CAS  PubMed  CrossRef  Google Scholar 

  21. Nadler SF, Malanga GA, Feinberg JH, Prybicien M, Stitik TP, DePrince M. Relationship between hip muscle imbalance and occurrence of low back pain in collegiate athletes: a prospective study. Am J Phys Med Rehabil. 2001;80(8):572–7.

    CAS  PubMed  CrossRef  Google Scholar 

  22. Nadler SF, Malanga GA, Bartoli LA, Feinberg JH, Prybicien M, DePrince M. Hip muscle imbalance and low back pain in athletes: influence of core strengthening. Med Sci Sports Exerc. 2002;34(1):9–16.

    PubMed  CrossRef  Google Scholar 

  23. Kibler WB, Ludewig PM, McClure PW, Michener LA, Bak K, Sciascia AD. Clinical implications of scapular dyskinesis in shoulder injury: the 2013 consensus statement from the “scapula summit”. Br J Sports Med. 2013;47:877–85.

    PubMed  CrossRef  Google Scholar 

  24. Wilk KE, Meister K, Andrews JR. Current concepts in the rehabilitation of the overhead throwing athlete. Am J Sports Med. 2002;30(1):136–51.

    PubMed  Google Scholar 

  25. Reagan KM, Meister K, Horodyski M, Werner DW, Carruthers C, Wilk KE. Humeral retroversion and its relationship to glenohumeral rotation in the shoulder of college baseball players. Am J Sports Med. 2002;30(3):354–60.

    CAS  PubMed  Google Scholar 

  26. Myers JB, Laudner KG, Pasquale MR, Bradley JP, Lephart SM. Glenohumeral range of motion deficits and posterior shoulder tightness in throwers with pathologic internal impingement. Am J Sports Med. 2006;34:385–91.

    PubMed  CrossRef  Google Scholar 

  27. Burkhart SS, Morgan CD, Kibler WB. The disabled throwing shoulder: spectrum of pathology part I: pathoanatomy and biomechanics. Arthroscopy. 2003;19(4):404–20.

    PubMed  CrossRef  Google Scholar 

  28. Crockett HC, Gross LB, Wilk KE, Schwartz ML, Reed J, O'Mara J, et al. Osseous adaptation and range of motion at the glenohumeral joint in professional baseball pitchers. Am J Sports Med. 2002;30(1):20–6.

    PubMed  Google Scholar 

  29. Kibler WB, Sciascia AD, Moore SD. An acute throwing episode decreases shoulder internal rotation. Clin Orthop Relat Res. 2012;470:1545–51.

    PubMed Central  PubMed  CrossRef  Google Scholar 

  30. Reinold MM, Wilk KE, Macrina LC, Sheheane C, Dun S, Fleisig GS, et al. Changes in shoulder and elbow passive range of motion after pitching in professional baseball players. Am J Sports Med. 2008;36(3):523–7.

    PubMed  CrossRef  Google Scholar 

  31. Wilk KE, Macrina LC, Fleisig GS, Porterfield R, Simpson Ii CD, Harker P, et al. Loss of internal rotation and the correlation to shoulder injuries in professional baseball pitchers. Am J Sports Med. 2011;39(2):329–35.

    PubMed  CrossRef  Google Scholar 

  32. Tyler TF, Nicholas SJ, Roy T, Gleim GW. Quantification of posterior capsule tightness and motion loss in patients with shoulder impingement. Am J Sports Med. 2000;28:668–73.

    CAS  PubMed  Google Scholar 

  33. Shanley E, Rauh MJ, Michener L, Ellenbecker TS, Garrison JC, Thigpen CA. Shoulder range of motion measures as risk factors for shoulder and elbow injuries in high school softball and baseball players. Am J Sports Med. 2006;39:1997–2006.

    CrossRef  Google Scholar 

  34. Kibler WB, McMullen J, Uhl TL. Shoulder rehabilitation strategies, guidelines, and practice. Oper Techn Sports Med. 2000;8(4):258–67.

    CrossRef  Google Scholar 

  35. Sciascia A, Cromwell R. Kinetic chain rehabilitation: a theoretical framework. Rehabil Res Pract. 2012;2012:1–9.

    Google Scholar 

  36. Kibler WB, Sciascia A, Wilkes T. Scapular dyskinesis and its relation to shoulder injury. J Am Acad Orthop Surg. 2012;20(6):364–72.

    PubMed  CrossRef  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and Permissions

Copyright information

© 2015 ISAKOS

About this chapter

Cite this chapter

Kibler, W.B., Sciascia, A. (2015). Anatomy of Scapula Winging. In: Bain, G., Itoi, E., Di Giacomo, G., Sugaya, H. (eds) Normal and Pathological Anatomy of the Shoulder. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-45719-1_29

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-45719-1_29

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-45718-4

  • Online ISBN: 978-3-662-45719-1

  • eBook Packages: MedicineMedicine (R0)