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  • Winged Scapula
    And How to Prevent It

    A winged scapula is when the inner border of the shoulder blade sticks out the back of the body.

    In the picture above my scapula is winged because of the position my arm is in. But I used to have the problem even when my arms where hanging down by my sides.

    It seems that now I've programmed my brain to such an extent that I can't even wing my scapula consciously. How can you do the same?

    Shoulder Girdle Anatomy

    anatomy for yoga teachers, scapular landmarks, neil keleher, sensational yoga poses.

    To develop exercises to prevent scapular winging it helps to understand some basic shoulder girdle anatomy.

    The Shoulder Girdle and The Ribcage

    The collar bone attaches the shoulder blade (or scapula) to the sternum at the pit of the neck. These two bones attach to the shoulder blades to form a collar like structure for the neck. This "collar" sits on top of the ribcage. At the point where the two bones connect (at the peak of the shoulder) the shoulder blade could be thought of as hanging down the back of the ribcage.

    Because the shoulder girdle rests on top of the ribcage, the shape of the ribcage and it's inclination can affect (or help cause) winged scapulae. And so a first type of exercise is to work on ribcage posture. This can be done using the easy breathing technique.

    The Scapular Stabilizers

    Muscles like the rhomboids and trapezius (and associated connective tissue) prevent the shoulder blades from sliding around to the front of the body. However the shoulder blade is designed to move relative to the ribcage and other muscles that control the position of the shoulder blade relative to the ribcage include the serratus anterior, pectoralis minor and levator scapulae.

    The video below focuses on serratus anterior.

    Having learned how to control ribcage attitude and posture, a second type of exercise for winged scapulae is developing control of these muscles. Note that the ribcage exercises are important because they lead to stabilizing the ribcage. With a stable ribcage the muscles that move the scapulae (particularly the serratus anterior) then have a stable foundation from which to act on and control the scapulae.

    The Shoulder Rotators
    (And Not Just the Rotator Cuff)

    The shoulder sockets are mounted high up on each shoulder blade, just below where the shoulder blades connect to the collar bones. The shoulder sockets are angled slightly forwards (as well as downwards). The weight of the arms (both the bones and attached muscles) pulls downwards on the shoulder socket and tends to cause the shoulder blades to want to slide forwards and downwards.

    Muscles that attach the arm to the shoulder girdle include the rotator cuff muscles (subscapularis, supraspinatus, infraspinatus and teres minor) as well as teres major, the deltoids and pectoralis major (not shown). Because the arm is relatively heavy compared to the shoulder blade (and collar bone) these muscles can also be used to move the shoulder blade relative to the arm as well as moving it relative to the ribcage. And so a third set of exercises for dealing with scapular winging involves learning to control these shoulder muscles (which includes but is not limited to the rotator cuff muscles.)

    Basic Exercises for Ribcage Control

    For ribcage control a very basic exercise is to bend the ribcage backwards and forwards. This action uses the spinal erectors initially and can be augmented by learning to use the intercostal muscles. It can be practiced as a breath control exercise. Learn to do the movements slowly and smoothly and the accompanying inhales and exhales (which the movement can drive) also become slow and smooth.

    When holding the ribcage lifted and stable, breathing can be taken over by the diaphragm and transverse abdominus. The ribcage can then be kept stable and used as a foundation for scapular awareness exercises.

    Scapula Stability Exercises

    The next set of exercises involves moving the scapulae relative to the ribcage. The important point here is to learn to feel the scapulae so that it is easier to sense when they are winging so that you can consciously unwing them. The focus here is on using the muscles that connect the scapulae to the ribcage. These muscles can be used against each other or against gravity to stabilize (and position) the scapulae relative to the ribcage. Exercises include spreading (protracting), retracting, lifting and depressing the shoulder blades.

    To develop a feel for the scapulae do these exercises first with the arms free, not bearing weight. Then try the same movements with the hands supporting a gradually greater proportion of body weight.

    Scapula Landmarks

    While doing these exercises focus on feeling the inner edge of each scapulae (where the rhomboids and serratus anterior attach), the accromion process (the peak of the shoulder where the middle fibers of the trapezius in part attach), the inner-upper edge of the shoulder blades (where the levator scapulae attach) and perhaps most importantly for scapular winging, the bottom tip of each shoulder blade.

    (The scapular ridge, in particular the tubercle to which the lower trapezius attaches could also be important).

    Shoulder Rotation Exercises

    Because the arms are fairly heavy, they act as anchors for the rotator cuff. As a result,when the arms are hanging natural, an even when they are not, actions of the rotator muscles not only cause a rotation in the arms, they also cause a corresponding movement of the shoulder blades.

    Practice rotating the arms first with the arms down, then in other positions to get used to feeling and controlling the rotator cuff and other shoulder rotator muscles.

    Controlling Winged Scapula

    Fine tuning scapular control is a mix of using the scapular stabilizers and the shoulder rotators. Rather than focusing on which muscles are being used, instead focus on controlling the position of the scapular itself, hence the earlier suggestion to focus on particular points of the scapulae.

    But first adjust ribcage posture. You will probably find it hard to keep the chest lifted at all times. The goal isn't to keep the chest maximally lifted, but lifted just enough that tension is balanced among the aforementioned muscles. Ribcage posture will affect head position and head position will affect ribcage posture. And so a part of positioning the ribcage is also positioning the head. With practice of being aware you'll get a feel for when your head is balanced. In this case the ribcage will be open just enough that there is no feeling of work in either the neck or the ribcage. Just a feeling of relaxed (and alive) openness. It sounds oxymoronic, but it's a feeling of relaxed tension.

    A Note On Tension

    Generally, we think of tension as a bad thing. It's what we label the feeling when shoulders are too tight from sitting at a desk or worrying. This is actually muscle activity that creates a feeling of excess tension. Muscle tension in and of itself also isn't a bad thing since it can be used to help feel and control the body. It's when we don't know how to control our muscles, so that we can activate and relax them at will that we suffer from muscle tension.

    Another type of tension is generated by smaller muscles. These muscles, either thin like the serratus anterior, or small in size and/or in number are hard to feel directly. When active they don't create a lot of direct "muscle tension" sensation. Instead we can learn to feel these via the tension they create in connective tissue. As an example we can learn to feel when the serratus anterior are active by recognizing the feeling of openness they create between the shoulder blades, a result of the connective tissue there (perhaps within the rhomboids) being stretched.

    This is what I mean by "relaxed" tension. The relaxation is due to the fact that the larger muscles aren't active. Instead the smaller muscles are.

    And that's the feeling you can look for when adjusting ribcage posture, and then shoulder blade posture.

    Balancing Tension (and Unwinging the Scapulae)

    So with the ribcage "open" and the head balanced on the neck, you can spread the shoulder blades (or retract them) while looking for the position where there are no points of excessive tension. However just spreading or retracting the shoulder blades isn't enough. From there the next step is adjusting the angle of the shoulder blades and this is where the bottom tips of the scapulae are important as well as the rotator cuff muscles.

    The bottom tips of the shoulder blades could be pulled outwards by the lowermost fibers of the serratus anterior. But an alternative is using teres major and/or infraspinatus, which externally rotate the arm and attach low enough on the shoulder blade that using the weight of the arm as an anchor, pull outwards on the bottom tips of the shoulder blades. And so with arms down by your sides an action you can practice is just pulling outwards on the bottom tip of the shoulder blades, as if trying to pull it between the arm and ribcage (like holding a purse.)

    Rather than rotating the arm, hold the arm still and create the feeling of external rotation (a feeling of tension at the rear of the shoulder blades.
    You can also focus on the peaks of the shoulders. Draw them back as you pull the bottom tips of the shoulder blades outwards.

    Winged Scapula When Doing Push Ups etc.

    To prevent scapular winging in push ups, doing yoga poses like chaturanga dandasana or plank, practice feeling the shoulder blades. Notice when they are winging. Adjust ribcage posture (chest open or rounded.) Use your scapular stabilizers in such a way that your shoulder blades no longer wing out.

    This is more difficult when they arms are bearing weight so practice with incremental weight increases. I.e. lift only the ribcage while using the arms and while keeping the shoulder blades protracted. Then try lifting ribcage and pelvis.

    They're Still Winging!?

    What if your scapula are still winged despite the above exercises? One muscle that you can look at is the pectoralis minor. If overactive and not balanced by other scapular stabilizer muscles this muscle can act to pull the bottom tip of the shoulder blade off of the ribcage. If one scapula is more winged than the other then it may be due to motor control problems elsewhere in the body. You may need to look at your lower back and hips.

    Try lateral ribcage slides as a means of finding and remedying these sorts of problems.

    If the problem is just an over-active pec minor, then learn how to feel it and control it so that it isn't a problem. Here again the solution is to gain more awareness of the shoulder blade and the muscles that control it.

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