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Scapular Winging

August 21st, 2017


  • 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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