Scapular Winging & Snapping Scapula

What is scapular winging?

There are two scapulae (shoulder blades) made of flat bones that connect the upper arm to the collar bone. They normally lay flat. In scapular winging one or both scapulae become more pronounced and stick out from the back.

Scapular winging is a rare, painful, and debilitating condition that leads to limited function of an upper arm, making the activities of daily life challenging. It impacts the ability to lift, pull, and push objects and can even make brushing one’s hair and teeth painful. It is diagnosed by observation, and questioning about recent injuries, illnesses and surgeries that might affect your neck, arms and back.

What causes scapular winging?

Scapular winging is caused by nerve damage that results in paralysis of trapezius muscles that control the back, arms and/or neck. Shoulder muscle weakness and/or muscle wasting cause the deformity.

Damage can be caused by:

  • Trauma such as a shoulder dislocation or simply by an abnormal twist of the neck.

  • Repetitive motion is the cause among athletes and is well documented among both professional and amateur athletes who play archery, ballet, gold, basketball, weight lifting, bowling, golf, gymnastics, hockey, soccer and tennis. However, it can develop from the daily actives of life like digging, washing the car and using your arms to prop up your head while lying down.

  • Unknown causes that may include an allergic reaction to medication, drug overdose, viral illness, toxins and some genetic diseases including a congenital heart defect and some types of muscular dystrophy.

  • Surgeries such as mastectomies and any surgical procedure that requires the use of general anesthetic.

What is snapping scapula syndrome?

This syndrome is defined as an audible or palpable clicking of the scapula with movement of the arm. It typically affects young, active individuals who report a history of pain, caused by repeated overhead and throwing shoulder movements or during sports. It is found in weight lifting, swimming, baseball and stocking shelves. However, it is also a problem with the soft tissues or bones in the shoulder and chest. Snapping scapula is rare and can cause severe pain and limit function.

What causes snapping scapula?

Causes include:

  • Overuse of the arm

  • Poor posture

  • Incorrect training

  • Abnormal joint motion

  • A birth defect in bone formation

  • A fracture

  • Weak shoulder muscles

  • Nerve damage

  • Tight muscles in the chest, neck, shoulders

  • Some neck conditions

  • Bursitis in the shoulder is inflammation or irritation of the bursae, fluid filled sacs that are designed to reduce friction between the tissues in a joint. Bursitis is a common complaint of people over the age of 40 usually as a result of high-risk activities like gardening, raking, carpentry, shoveling, painting, tennis, golf, skiing and throwing. Symptoms include clicking, crunching, grating or snapping felt with shoulder movement. Referred pain to the neck is common. Early identification is crucial to reduce disability.

  • Benign soft tissue tumors that grow slowly and are common among women aged 55 to 70.  They are believed to occur in response to repetitive microtrauma caused by friction between the shoulder blade and the chest wall. It can cause moderate discomfort or pain, crackles, clicking/snapping.

  • Benign bone tumors can cause cracking, winging, and compression of nerves and blood vessels, fractures, bursitis and in rare cases can become malignant.