How to fix a Winged Scapula

winged scapula

Image from ePainAssist.

What is a Winged Scapula?

A Winged Scapula is when the medial (inner) border of the shoulder blade protrudes off the rib cage.

 (… Ideally – it should sit completely flat!)

Winging of the scapula can be observed in:

  • Natural resting posture (static) and/or
  • Certain shoulder movements (dynamic).

It is often one of the causes of shoulder impingement and shoulder blade pain.

 

What are the causes?

1. Pec minor tightness/over-activity:

Have a look at your posture. Are your shoulders rounding forward?

If they are… I can guaranty that your pec minor muscle will be tight (along with the upper trapezius, levator scapula and biceps). And this is a problem!

Why?…

Not only will it pull the shoulder blade off the rib cage, it will also place the shoulder blade into an ineffective position.

This will lead to…


2. 
Serratus anterior weakness/inhibition:

The Serratus anterior is the primary muscle that keeps the scapula flat on the rib cage.

If you do not have control of this muscle, it may result in a winged scapula.

 

 

3. Long thoracic nerve palsy:

The Long thoracic nerve supplies the Serratus anterior muscle.

Therefore – any damage to this nerve will result in the inability keep the scapula flat onto the rib cage.

(However… from what I have come across in the clinic, Long thoracic nerve damage is actually very rare!)

 

Quick tests – “Do I have it?”


Image courtesy of Stuart Miles at FreeDigitalPhotos.net

a) Static test

Take a photograph of your back.

Can you see the inner border of the shoulder blade pop out?

b) Dynamic test:

Take a video of yourself performing a push up onto the wall.

Observe for any winging of the scapula during movement.

How to fix a Winged Scapula


Note: All exercises are to designed to be performed pain-free. If you are unsure of anything, please feel free to contact me on the facebook page.


 1. Release the pec minor

The pec minor is actually quite a difficult muscle to stretch properly.

Solution?… Release it!

Instructions:

  • Place massage ball directly underneath of your pec minor.
    • To locate your pec minor, you can see it here.
  • Apply pressure into the ball using your body weight.
  • To increase the release, move your arm around.
  • Hold for 1  minute.
  • Repeat 3 times.

 

2. Stretches

These tight muscles pull the shoulder blade into a position where the Serratus Anterior muscle is unable to function properly.

(For a more great stretches, check out the post on How to fix Rounded shoulders.)

a) Upper trapezius

Instructions:

  • Hold onto a stationary object at hip level.
    • (You can also use a stretch or resistance band if you have one.)
  • Lean away from that hand to lock the shoulder blade down.
  • Tilt your head in the opposite direction.
    • To increase stretch: Pull the side of your head further using your other hand.
  • Aim to feel a stretch between your shoulder and neck.
  • Hold for at least 30 seconds.
  • Repeat 3 times.

b) Levator scapula

Instructions:

  • Hold onto a stationary object at hip level.
    • (You can also use a stretch or resistance band if you have one.)
  • Lean away from that hand to lock the shoulder blade down.
  • Tilt your head towards the opposite arm pit.
    • To increase stretch: Pull the side of your head further using your other hand.
  • Aim to feel a stretch between your neck and shoulder blade.
  • Hold for at least 30 seconds.
  • Repeat 3 times.

c) Pec minor

Instructions:

  • Place your hand on a door frame. (see above)
  • Keep your shoulder blades locked downwards.
  • Lunge forwards.
  • Aim to feel a stretch in the chest area.
    • Make sure that you do not arch your lower back as you push into the wall.
  • Hold for 30 seconds.
  • Repeat 3 times.

d) Front shoulder stretch

Instructions:

  • With both hands on a bench behind you, let your body sink down as low as possible. (see above)
  • Keep your shoulder blades squeezed together.
  • Keep your elbows in. Don’t let them flare out.
  • You should feel a stretch at the front of your shoulders.
  • Hold for 30 seconds.
  • Repeat 3 times.

 

 

3. Wake up your Serratus Anterior!

The Serratus Anterior is the most important muscle in fixing your winged scapula! It keeps your shoulder blade flat on your rib cage!

** Hey you! – Read this! **

In all of the following exercise, it is VITAL that you know how to activate and feel the serratus anterior muscle working.

Activating the Serratus anterior:

Instructions:

  • Assume the wall plank position.
  • Activate the Serratus anterior. (… Remember this!! I’m going to keep repeating it below.)
    • Tilt the shoulder blades BACKWARDS.
    • Pull your shoulder blades DOWN and AROUND the ribs.
  • Push your forearms into the wall.
  • Aim to feel the contraction in the lower and side region of the scapula.
    • (… This is where the Serratus anterior muscle is!)
  • Hold for 30 seconds.
  • Repeat 5 times.
  • Progress this contraction with your arms in different positions to get a good feel of the exercise. (see above)

Once you understand exactly how to ENGAGE the serratus anterior, let’s get started with the exercises!

Note: The below exercises are arranged in order of difficulty. Aim to progress to the next level only when you are ready.


Level 1: Isolate the Serratus anterior. 

a) Rock back

 

Instructions:

  • Assume the plank position with your knees on the floor.
  • Activate the Serratus Anterior.
  • Push your forearms into the floor.
  • Rock backwards and forwards.
  • Repeat 30 times.

b) Push up plus (wall)

Instructions:

  • Assume the push up position on the wall with your arms straightened.
  • Activate the Serratus anterior.
  • Push your arms into the wall.
  • Whilst keeping your arms completely straight, proceed to protract your shoulder blades.
    • Think of your shoulder blades gliding down and around.
  • Do not round your back.
  • Hold this end position for 5 seconds.
  • Slowly bring your shoulder blades back to the starting neutral position
  • Repeat 30 times.

c) Push up plus (plank position)

Instructions:

  • Assume the plank position on the wall. (see above)
  • Activate the Serratus anterior.
  • Push your forearms into the wall.
  • Whilst keeping your forearms on the wall, proceed to protract your shoulder blades.
    • Think of your shoulder blades gliding down and around.
  • Hold this end position for 5 seconds.
  • Bring shoulder blades back to the starting neutral position
  • Repeat 30 times.

 

Level 2: Serratus anterior isolation (+ Resistance)

d) Push up plus (with resistance band)

Instructions:

  • Hold onto a resistance band as shown above.
    • (Make sure you choose a resistance you can handle.)
  • Assume the above position on the wall with your arms straightened.
  • Activate the Serratus anterior.
  • Whilst keeping your arms completely straight, proceed to protract your shoulder blades.
  • Hold this end position for 5 seconds.
  • Bring shoulder blades back to the starting neutral position
  • Repeat 30 times.

e) Protraction in lying

Instructions:

  • Lie on your back with your knees bent.
  • Whilst holding onto a weight, lock your arms straight in front of you.
    • Use a weight that you are able to control properly.
  • Activate the Serratus anterior.
  • Push the weight up towards the sky whilst keeping the arm straight.
  • Hold for 5 seconds.
  • Return to starting position.
  • Repeat 30 times.

Level 3: Serratus anterior activation (+ Shoulder movement)

f) Push up

Instructions:

  • Assume a push up position on the wall.
  • Activate the Serratus anterior THROUGHOUT movement.
  • Perform a push up.
  • Repeat 30 times.

g) Wall slides (with resistance band)

Instructions:

  • Hold onto a resistance band. (see above)
  • Assume the wall plank position.
  • Activate the Serratus anterior THROUGHOUT movement.
  • Slide your forearms up/down the wall.
    • Maintain pressure on the wall through the forearms
  • Repeat 15 times.

h) 1 arm pivot

Instructions:

  • Assume the wall plank position. (see above)
  • Activate the Serratus anterior muscle.
  • Push the forearm (on the side of the winged scapula) into the wall.
  • Whilst keep that arm fixated on the wall, rotate your body away.
  • Return to starting position.
  • Repeat 15 times.

i) Arm raises (with resistance band)

Instructions:

  • Hold onto a resistance band. (as shown above)
  • Activate the Serratus anterior THROUGHOUT movement.
    • Try to push your hands as far away from the body whilst keeping your shoulder blades back, down and around throughout movement.
  • Raise and lower your arms from your side.
  • Repeat 15 times.

 

 

Level 4: Weight bear (Both arms)

j) Plank

Instructions:

  • Assume the plank position on the floor. (see above)
  • Activate the Serratus anterior muscle.
  • Push the forearms into the floor.
  • Hold this position for 30 seconds.
    • (If you can not hold this with good technique, try to do the exercise with your knees on the floor)
  • Do NOT let your shoulder blades cave in.

k) Push up

Instructions:

  • Assume the push up position on the floor. (see above)
  • Activate the Serratus anterior muscle THROUGHOUT movement.
  • Perform a push up.
  • Do NOT let your shoulder blades cave in.
  • Repeat 10 times.

 

Level 5: Weight bear (Single arm)

m) Straight arm plank (with pivot)

Instructions:

  • Assume the straight arm plank position. (see above)
  • Activate the Serratus anterior muscle THROUGHOUT exercise.
  • Lean your weight into the hand that is on the side of the winged scapula.
  • Whilst keep that arm fixated on the floor, slowly rotate your body away.
  • Return to starting position.
  • Repeat 10 times.

 

l) Plank (with reach)

Instructions:

  • Assume the plank position. (see above)
  • Activate the Serratus anterior muscle THROUGHOUT exercise.
  • Lean your weight onto the forearm that is on the side of the winged scapula.
  • Whilst keep that arm fixated on the floor, slowly reach forward.
  • Return to starting position.
  • Repeat 10 times.

 


Remember…

Now that you know how to engage your Serratus Anterior muscle, it is important that you practice activating it throughout the day.

Keep your shoulder blades tilted backwardsdown and around.

 

Any questions?… Leave me a comment down below!

About

I am a physiotherapist who has personally experienced the pain as a result of bad posture. I would like to offer you some of the solutions that I and my patients have greatly benefited from.

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45 thoughts on “How to fix a Winged Scapula

  1. Hi Mark. I’ve suffered with scapular winging for about 8 years now. At the time the doctor that originally saw me said that he was calling it shoulder dysfunction so he really didn’t know what it was.

    That said they were saying that they thought that my thoracic nerve was “asleep.” Is there true, real hope for me?

    Thank you!

    1. Hey Eric,

      Is there any reason why your long thoracic nerve would be injured/compressed? (Past injuries, traumatic accidents, etc)

      If not – it is likely that you just need to learn to activate the muscles the flatten the scapulae back onto the ribs.

      Mark

  2. Hi mark,
    thank you so much for posting this.
    I have one question.
    Im going to gym, and im doing once a week chest. Can i fix winged scapula if i do every day your program and once a week chest ?
    Thank you

  3. Hi Mark,

    I have winged scapula from doing push-ups and dips with bad form once I correct this. Will I ever be able to do strength training again with proper form or will my scapula re wing ?
    Thank you for this great article,
    Massimo

    1. Hey Massimo,

      Once you fix your winging, you can focus on your strength training again whilst making sure you are keep your scapula flat on your ribs.

      Mark

  4. Hi mark,Thank you about this information you write..
    Im 21 yrs old
    one year ago I have been doing surgery (biopsy) of Lymphocyte biopsy in my neck after-after the surgery- a month of resting I felt my shoulder movement is so bad and then I went to the doctor and he told me that I have a “winging scapula” due to the scratch in long thoracic nerve..
    in the right shoulder and its have little pain and make me embarrassing due to its a appearance my shoulder bone its very obvious.
    I wondering why my trapezius in atrophy case ? I mean (the trapezius) very small ! and my lat is too lose its mass but not like the trapezius what is the reason of ?
    I wonder what is the effect of Long thoracic nerve on this two muscles !
    and dose one year enough to fix it ?
    and what do you think if I goes to the surgery treatment ?
    its better than the exercises?
    it will be great to have a replay,,
    thank you.

  5. This was a great read! Just a couple questions though. I went through shoulder impingement 2 years ago. Stretched the pecs a lot, stretched internal rotators, performed external rotations and did a lot of pulling motions. The only pushing I did for a year was push-ups. The impingement got a lot better and so I incorporated more chest work, but no more than: 3sets of flat bench and dips, then 3 sets of overhead press and 3 sets of pushups…well now the impengment is back with severe winging mostly on the right side. So stretching my pecs and doing these releases/these excersises..how often should these be performed, sets and reps and also, what other back exercises can I do? along with any others I can perform to stay in shape without assiting in this shoulder problem. Also, should I only stick to push-ups from now on once I rehab this back to normal? it seems like no matter how little chest I do, my pecs grow really easy. Also, is it safe to do pull-ups and chin-ups? I live doing those

    Thank you!!!

    1. Hey Ricky,

      You can do these exercises 1/day.

      In terms of what exercises you can do whilst having shoulder pain… you pretty much can do everything as long as it is not causing your symptoms to worsen. Anything that doesn’t hurt you, is likely to help you more than anything.

      You can progress your push ups to very light weights with the dumbbells. You may need to keep your elbows closer to the sides of your body as you push through. This is to take some stress off the shoulder.

      Pull up and chin ups are fine as long as it is not causing more pain. Generally speaking, over head exercises cause more problems with shoulder impingement. Just be careful and listen to your body.

      Mark

  6. Hi Mark, I had shoulder surgery about a year and a half ago and ever since I’ve had a severe winged scapula. I’ve tried mostly everything from stretches, to serratus strengthening exercises but nothing has worked. I also feel that my trapezius muscle has stopped working entirely and I can’t even contract it during rows or shrugs. My scapula almost pops around when I retract, it’s very strange. I’m 17, so I feel that I shouldn’t be having some of these problems. If you could offer any imput as to how I should go about my winged scapula I would greatly appreciate it. Thanks. I also told my doctor and he was also very puzzled. He said with proper strengthening it should be fine, but I’ve been seeing a physical therapist for it for almost 2 months and it hasn’t changed one bit. Thanks again.

  7. Thank you so much for posting this information! I was carrying a five gallon bucket (full of water) to water some plants that the hose doesn’t reach. The next day, my shoulder blade ached terribly. It got worse over the course of several days. I saw my chiropractor three times last week, getting some relief but it still felt like my shoulder was protruding. Tonight, I finally decided to look at it with a second mirror. Whoa! Winged scapula, all right!

    I just went through the exercises and stretches, and now I am icing. My husband says it isn’t sticking out as much. I can’t thank you enough for providing this information!

  8. This is literally exactly what I have been looking for! I have a big mind-body disconnect and it has been very difficult to know whether I am activating the serratus anterior and if I am, am I doing it correctly? I have been in and out of PT for years with no luck, but your cues, pictures, and descriptions now give me the confidence to proceed with strengthening it correctly. Thank you so much!

  9. Hi,

    Whilst doing these exercises daily should I avoid any exercises? Also should I be focusing on pulling my shoulder blades back/down when sitting/standing or letting them hang neutral? Im pretty sure I have a winged scapula, is there anyway to make sure? I can see two lines which are the inside edges through my t-shirt, I also have a lot of right shoulder pain and it feels like my scalene muscles are tight. I’m in real need of help as I tried for a long time to correct this by rowing and doing serous exercises without really putting much effort into releasing pec minor etc

    Thanks for your great article

    1. Hey Lewis,

      Rowing might actually make your winged scapula worse!

      The key player is the Serratus Anterior muscle as this muscles causes the shoulder blade to hug the rib cage.

      When sitting, you want to aim to pull your shoulder blade DOWN and AROUND. (as opposed to down and in).

      Mark

      1. Hi again,

        Thanks for your response. So do you mean I should pull them down and protract them whilst sitting and standing? This sort of makes me round my shoulders?
        Thanks

        1. Hey Lewis,

          You want to tilt your scapula backwards (posterior tilt) and upward rotate your shoulder blade whilst keep the shoulders back.

          Mark

          1. thanks for your response again.. I’m sorry but I’m not getting it, how do I do all these things at once without causing my shoulders to round?

            thanks again

          2. Hi Lewis,

            Your shoulders will not round forward if you do the scapula movements as stated before.

            If they round forward, then it is likely you are not performing the right movements with your shoulder blade.

            Mark

  10. This is really nice of you to post for free!! As a aspiring physical therapist, it’s nice to see someone else trying to take away people’s pain. I have a quick question. When I look into the mirror, my traps are obviously not symmetrical. On the side that my scalpula is winged it drops down, what do yowe make of this?

    1. Hey Jon,

      If you are winged on that side, the scapula is in a position of medial rotation.

      This would make your Upper trapezius slope down on that side.

      Correcting this scapula position should improve your assymetrical shoulders.

      Mark

        1. Follow the exercises on this website. I had same problem as you for 4 years. Just found this site and fixed my issues. Awesome information

  11. Hi Mark,
    Thanks so much for these exercises.
    Do you have suggestions for how many sets / times per day we should be doing these?
    Thanks again

    1. Hey Matt,

      You can go through these exercises 1 to 2 times a week to start off with.

      As you get better, I would try to progress to every day.

      Mark

  12. hi mark

    Ive been trying to sort out a winged scapula for a long time, but when i try to do any of the exercises i am recommended, all i can feel is my scapula sticking way out of my back. when i follow the step above called “activating the serratus anterior”, no matter what i do, i just end up with my shoulder blade sticking way out of my back.

    i know that my trap, pec area and levator scapula are all very tight, i feel as if its impossible to get my shoulder into the right position because of this. what would you suggest? thanks

    1. Hello Winged Goblin!

      You might need to keep releasing/stretching those particular muscles first to help you get into a position where you can start to engage your serratus anterior muscle.

      If those muscles are tight, it places the serratus anterior in a stretched/inhibited position which will make it very difficult to even feel the contraction, let alone get it pulling the shoulder blade in the right direction.

      Once released, you can start to focus more on the activation part 🙂

      Mark

      1. i feel like the pec release method you described is going to help so i’ll focus on that for a while. thanks for replying, have a great day

  13. Hi Mark, I got serratus palsy due to parsonage-turner syndrome two and a half years ago, my serratus has been left paralysed until very recently where it has started waking up. How many times per day should I do the stretches and exercises?
    Can’t lift my arm vertical or anything yet, also my shoulder blade seems to pull right into the centre of my back when I try, not sure entirely what’s causing that though, could be overcompensation by other muscles.
    Thank you,
    Tom

  14. Hi Mark,
    I don’t think I have scapula winging but my right scapula does not come in life the left one when I pinch them together. The left one comes in to nearly straight but the right one stays 30 degrees out. Will these excersize help?

    1. Hi Kawser,

      Sounds like you may have an issue with your Rhomboid not being able to bring the right scapula back in line.

      You may also have an issue with tightness/hypertonicty with the serratus anterior muscles as well.

      Do you have a picture of it?

      Mark

  15. Thank you so much mark!!!
    I am getting this pain from last 1 week and it gets horrible at night. I am doing these exercise and i am getting relief , as the pain is reducing.
    Thank you 🙂

    1. Hi Ravi,

      It depends.

      But it certainly is not an over night fix.

      It’s very hard to give a time frame (and that’s even if I assess you in person)

      Takes time, effort, consistency! Keep up the good work!

      Mark

  16. Mark,

    THIS IS EXACTLY WHAT I WAS LOOKING FOR!

    Thank you so much for posting it.

    I am so excited to start these exercises.

    I’ll keep you up to date!

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