Scapular Winging
January 1st, 2017
Overview
How to Elicit
- Observe the patient at rest with their arms by their side. Ask the patient to then lean forward with their shoulders flexed and applying pressure against a wall.
Look For
- Scapular deformity at rest
- Scapulothoracic rhythm as the arms are elevated
- Crepitus
- Winging, or excessive protraction, of the scapulae
Causes of Scapular Winging
- Neurologic - trapezius (CN XI) palsy, serratus anterior (long thoracic nerve) palsy, rhomboid (dorsal scapular nerve) palsy
- Bone - osteochondroma, malunion of fracture
- Soft tissue - contractures, muscular rupture, scapulothoracic bursitis
- Weakness of stabilisers - subacromial bursitis, adhesive capsulitis, rotator cuff tear, shoulder instability
- Voluntary winging
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