Winged scapular is something that is common that I find when I asses a lot of my personal training and gym members. The best example of this is if you place the back of your palm in the small of your back the bottom of your scapular lifts away from the back and “wings” up. In extreme cases it may even wing up when your arms are in front of you. This is synonymous with shoulder pain and poor muscular balance around the shoulder joint.
Understanding this condition though is vital for resolving this issue. The anatomy is very relevant in why there is an issue at the shoulder. Now commonly in this situation I have seen people who have been told to strengthen their back or have been giving a theraband and told to strengthen their rotator cuff. In the first line of advice this may be the actual problem and as for strengthening the rotator cuff… well it is probably a waste of time. Hence a lot of shoulder issues become chronic over a period of time.
If you look at the following picture of the shoulder blade you will notice the rhomboids and the serratus anterior muscle are separated by your shoulder blade. In fact you could consider that that shoulder blade is in a constant tug of war between these two muscles. Tightness or over strong rhomboids can pull the scapular away from the rib cage causing an anteriorly tilted scapular which may cause shoulder pain. If the serratus anterior is not strong enough it will not be able to keep the shoulder blade pinned to the rib cage.
If the serratus anterior isn’t fully effective at producing an upward rotation force (keeping the scapular close to the rib cage) and the rhomboid (a downward rotator as it pull the bottom of the scapular downwards towards the spine) is getting trained with both pushes and pulls then you can end up making the condition worse while maintaining a traditional training pattern. Often this leads to tighter rhomboids and tight muscles at the chest. Twining this with peoples habitual posture while driving, at the office and at home and it shows you why some shoulder issues take an age to clear up.
So in this situation what is the answer? Typically we start with waking up the serratus anterior. One exercise we use is 4 point back rocking where we encourage the shoulder blade to move laterally and upwards while not letting the scapular wing away from the rib cage. Please see below- it’s a simple exercise but phenomenally effective.
Poor scapular position also leads to poor rotator cuff strength and excessive challenge to the stability muscles in and around the shoulder such as the rotator cuff. But what exercises can help resolve this? Well the mighty press up- if done properly can be an amazing exercise but is often performed incorrectly. I will cover these in my next post.