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Scapular Winging



    • 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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