When your shoulder blades aren’t stable, you may have a shoulder disorder called scapular dyskinesis. It is marked by a loss of range of motion in your shoulder blades. Scapular dyskinesis may be a condition on its own or a symptom of another health condition or injury.
Understanding Scapular Dyskinesis
Your shoulder blade is important for movement and range of motion in your shoulders. Also called the scapula, your shoulder blades provide stability to your rotator cuff. If you sustain an injury to your soft tissue, muscle, or bone around your shoulder, it may affect your shoulder blade, too.
You can easily identify scapular dyskinesis because it causes your shoulder blades to stick out abnormally, either during rest or activity. Scapular dyskinesis is also called winging because your shoulder blades stick out like wings on your back. Although the condition itself may not be painful, it can leave you at a greater risk of injury.
How does scapular dyskinesis affect shoulder function?
Scapular dyskinesis can make raising your arm over your head or lifting heavy things difficult without pain. It can weaken your arm and shoulder strength.
What Causes Scapular Dyskinesis?
Six factors that may lead to scapular dyskinesia include:
- Damage to your nerves
- Loss of flexibility
- Damage to your muscles
- Weakness in your core, hips, or legs
- Weak bones or bone fractures
- Damage to your joints
Your scapula has a normal rotation pattern of:
- External rotation
- Posterior tilt
- Upward rotation
- Medial translation
Damage may disrupt any part of this movement sequence. Playing sports increases your risk of the condition because more than 90% of unidirectional cases result from a dislocation injury. Sports with the highest likelihood of leading to scapular dyskinesis include:
- Gymnastics
- Swimming
- Volleyball
- Baseball, primarily pitchers
Who is at the highest risk of developing scapular dyskinesis?
Men between the ages of 18 and 25 are most likely to be diagnosed with scapular dyskinesis.
What Are the Symptoms of Scapular Dyskinesis?
Common symptoms of scapular dyskinesis include:
- Pain or tenderness around your shoulder blade, especially when you raise your arms overhead or lift something heavy
- Feeling a snap or pop that occurs with shoulder movement
- Losing strength in your affected arm and shoulder
- Changes in your posture, usually one side sagging down so that your shoulders appear asymmetrical
- Shoulder blades sticking out and looking like wings
- Feeling like your shoulder blade is out of place
Your injury may be made worse by:
- Chronic inflammation
- Injury to your rotator cuff muscles
- Shoulder stiffness
- Poor technique when throwing or lifting
How Is Scapular Dyskinesis Diagnosed?
Scapular dyskinesis may not be obvious at first. You may feel pain or discomfort without obvious physical symptoms. Alternately, your shoulder blades may stick out without any pain or discomfort.
If you think something is wrong, talk to your doctor immediately. Allowing the condition to go on without treatment may leave you at greater risk for additional damage, including:
- Weakness
- Muscle imbalance
- Nerve damage
- Damage to your rotator cuff or surrounding cartilage
Usually, an X-ray or MRI isn’t necessary for diagnosis. Instead, your doctor may look for physical signs of other related injuries leading to your shoulder dysfunction. Occasionally, a specialized nerve test is used to check the extent of your damage to help decide the best treatment option.
If you notice that a specific movement worsens your pain, be sure to share that. Include details about what happened when you first experienced a loss of motion or noticed a change in your shoulder blades.
What Are the Treatment Options for Scapular Dyskinesis?
Most of the time, scapular dyskinesis is improved through physical therapy or rehabilitation with a qualified physical therapist or athletic trainer. Therapy usually lasts four to eight weeks, depending on how bad your injury is. It includes exercises to help you gently restore range of motion and strengthen the surrounding muscles.
Keep in mind that physical therapy only helps if you also cease the activity or motion that caused the injury in the first place. While you may be able to continue the activity in the future, it is important to allow your body the chance to heal.
Your physical therapy or rehabilitation is often combined with pain or anti-inflammatory medication to address your symptoms as you heal. Your doctor may also suggest using heat or ice to address pain.
Call your doctor right away if:
- Your condition worsens despite treatment
- You have sudden numbness or tingling in your arms or shoulders
- You have signs of an allergic reaction to a prescribed medication
- Your fingernails begin turning blue or gray
- New symptoms appear that are otherwise unexplained
When is surgery considered for scapular dyskinesis?
If your scapular dyskinesis is caused by muscle weakness or tightness, you will rarely need surgery. But if your dyskinesis is a result of an injury, your doctor may opt for surgery followed by physical therapy and rehab to get your range of motion back to normal.
How Can Scapular Dyskinesis Be Prevented?
You can prevent scapular dyskinesis by:
- Stretching and warming up before throwing or completing any overhead activities
- Following age and league pitch count guidelines when playing sports
- Learning and using proper throwing techniques, especially important for children entering sports
- Not forcing a range of motion when lifting, especially overhead
Takeaways
When your shoulder blades lose their normal stability, you can develop scapular dyskinesis, a condition in which your shoulder blades stick out — often called “winged” shoulder blades. It can limit your range of motion and may sometimes be a sign of an underlying injury, especially in athletes who do a lot of overhead movements. Common signs include pain or snapping when you lift your arm, noticeable shoulder asymmetry, and weakness in the affected shoulder. Typically, taking a break from the activity that caused the problem, along with a few weeks of targeted physical therapy, can help you regain strength and movement.
Scapular Dyskinesis FAQs
How do you fix scapular dyskinesis?
The most common “fix” for scapular dyskinesia involves doing physical therapy exercises for several weeks to improve stability and strength. At home, you may manage pain with over-the-counter pain medicine and hot and cold therapy while resting the affected shoulder. Less commonly, surgery may be needed, especially if your scapular dyskinesis is a result of injury or trauma.
How long does scapular dyskinesis take to heal?
You can expect to see improvement in about four to eight weeks once you start physical therapy. Full recovery may take several more weeks or even months of consistently sticking to your exercise regimen.
How many types of scapular dyskinesis are there?
There are three types of scapular dyskinesis that are based on where and how the shoulder blade sticks out.
- Type I is when the bottom inner corner of your shoulder blade sticks out from your back.
- Type II is when the whole inner edge of the shoulder blade lifts away from your ribs.
- Type III is when your shoulder blade either moves or twists when you move your arm.
How do you test for scapular dyskinesia?
Typically, a physical exam by your doctor is enough to diagnose scapular dyskinesia. Rarely, an X-ray or MRI scan may be used. A nerve test may also be used to examine nerve damage.
What exercises help scapular dyskinesis?
Your physical therapist will create a set of exercises for you based on the cause and type of scapular dyskinesis you have.