May 21, 2013 Dr. Tushar Mehta For Students / PG Aspirants. The articulation takes place at … Injury may be traumatic, iatrogenic, or idiopathic and the clinical interpretation requires careful history and examination. Your doctor will first look at your shoulder blade for any obvious signs of winging. The main reasons for this condition are musculoskeletal- and neurological-related. In doing so, the scapula … The composite scapular motion of rotation, abduction, and tilting is necessary for proper shoulder function. Anatomically, it is the “G” of the glenohumeral (G-H) joint and the “A” of the acromioclavicular (A-C) joint. Neurological Musculoskeletal Results: Scapula winging was severe in 10 of 16 patients (63%), moderate in 2 patients (12%), and mild in 4 patients (25%) in our present study. Anatomy of Scapula: Scapula serves as the attachment site for 17 muscles Its normal function to stabilize the scapula to the thorax, provide power to the upper limb … The scapula is also known as the shoulder blade. A study in Supportive Care for Cancerfollowed people who had undergone axillary dissection, a surgical breast cancer treatment. The serratus anterior gets a lot of attention because it’s anterior to the scapula, and attaches to the scapula. Scapula winging can be corrected, though the treatment that works will depend on the nerve and muscle causing it. lar winging are many, understanding the anatomy of the scapulothoracic articulation is essential to prescribing treatment. While the condition is rare, itâs usually painful and makes day-to-day activities, such as lifting grocery bags or brushing your teeth, difficult. Try scapular stabilization exercises to strengthen your shoulders. The cuts may not be in the correct plane, the detachment scar is not easily demonstrated, the lower trapezius is detached from the spine but then lays back over in the supine retracted imaging position, or the chronic changes are too subtle for the static imaging processes. The most common causes reported in the literature for scapular winging are dysfunction of the serratus anterior from long thoracic nerve injury causing medial winging or dysfunction of the trapezius from spinal accessory nerve injury causing lateral winging. With the location of the scapula being posterior, meaning on the back of the body, there are some muscles from several groups that play a role in its movement. People with winged scapulae may feel weak when trying to lift something out and away from their body, or … Find out what's causing your shoulder blade pain and how to relieve your pain. Reattachment of the rhomboid muscle is performed initially (, Postoperatively, the arm is protected in neutral rotation for 4 weeks but gentle scapular retraction is encouraged immediately. Example of long thoracic nerve palsy creating scapular winging, Surgery for long thoracic nerve palsy may be indicated for patients with 1 year of symptoms, functional deficits, and no signs of recovery. It can affect a person's ability to lift, pull, and push weighty objects. As a result, the medial border of the scapula protrudes, like wings. Although the sources of scapular winging are many, understanding the anatomy of the scapulothoracic articulation is essential to prescribing treatment. Disorders of the Scapula: Winging and Snapping Ben W. Kibler Aaron D. Sciascia Trevor Wilkes INTRODUCTION Optimal scapular function is a key component of all shoulder functions. Instead, they can be caused by: Rib resections, mastectomies, and procedures that require general anesthesia may cause nerve damage. In most cases, scapular winging can be fixed through physical therapy, massage, stretching and strength exercises. Clinical presentations of scapular winging include neurologically based scapular winging, scapular muscle detachment, snapping scapula , and kinetic chain or muscle inhibition based scapular dyskinesis. Three of the more common problems involving the scapulothoracic joint include snapping scapula syndrome, scapular winging, and scapulothoracic dissociation. Less commonly, palsy of the trapezius or rhomboids may cause lateral winging. Last medically reviewed on September 25, 2017, If you want to work your trap muscles, you don't need a ton of fancy gym equipment. ), I’m winging my scapulas for you there. The front of the scapula (acromion) is also connected to the clavicle (collarbone) through the acromioclavicular joint. Peripheral nerve disorders, cervical spine disease could also mimic scapular winging and should be ruled out. Most people with scapular winging have a shoulder blade that sticks out. Nonsurgical treatment options can start working almost immediately, while surgical treatment will likely take a few months to produce results. In rare conditions it has the potential to lead to limited functional activity in the upper extremity to which it is adjacent. The main part of the scapula, the body, consists of a somewhat triangular-shaped flat blade, with an inferiorly pointing apex, referred to as the inferior angle as well as lateral and superior angles. Clinically, this rotation causes the inferior angle to become notably prominent in both static and dynamic examination (Fig. Posteriorly, the scapula is divided into a supraspinous fossa and infraspinous fossa by the scapular spine. Fasciodesis procedures (sling) have also been utilized but can result in high rates of attritional loosening and poor function. Scapula is the anatomical term for the shoulder blade. Transfer of the sternocostal head of the pectoralis major has found the greatest measure of success [, Scapular winging can also be the product of injury to the, Less commonly, weakness of the major and minor rhomboid muscles is encountered in deficits of the, This problem is not well known or well categorized with limited results reported [. Scapular winging, sometimes called a winged scapula, is a condition that affects the shoulder blades. The scapula (shoulder blade) is the largest bone of the shoulder complex and has the greatest number of muscles attached to it. If they have failed an appropriate scapular rehabilitation program and do not demonstrate other anatomic defects, surgical reattachment is indicated. This involves attaching the scapula directly to the ribs. These muscles both stabilise the arm to the body and move the arm around in space. Repetitive movements can also cause injuries. However, acute traumatic tears of the serratus anterior, trapezius, and rhomboids off of the scapula are important and under-recognized causes of scapular winging and dysfunction. Results from a 2-year follow-up of a small cohort show that pain scores decreased from 8/10 to 2/10, and ASES scores improved from 38/100 to 68/100 [, The diagnosis and management of snapping scapula can be clinically challenging. Consistency of the history and physical exam findings allows for a reliable clinical diagnosis. Cases of scapular winging caused by damage to the serratus anterior nerve sometimes heal on their own within two years. Here are four trapezius exercises you can perform using your ownâ¦. Together with other muscles, it is part of the fleshy mass in the first webâ¦, The zygomaticus major muscle is a muscle that controls facial expression, drawing the mouth's angle upward and outward. Scapular winging occurs when a shoulder blade sticks out. head, neck, and body. 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