Winged Scapula Exercises

winged scapula

What is a Winged Scapula?

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

(Ideally – it should sit completely flat!)

A Winged Scapula can be observed in:

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

The content presented on this blog post is not medical advice and should not be treated as such. It is not intended to be used as a substitute for professional advice, diagnosis or treatment. Use of the content provided on this blog post is at your sole risk. For more information: Medical disclaimer


Why you should address it

A Winged Scapula may lead to:

What causes winging of the Scapula?

The exercises that you will need to do will depend on what is causing your winged scapula in the first place.

1. Pectoralis Minor tightness/over-activity

A tight/overactive Pectoralis Minor (along side a tight levator scapulae and short head biceps) can pull the inner border of the shoulder blade off the rib cage.


2. 
Serratus Anterior weakness/inhibition

location of serratus anterior 

The Serratus Anterior is the primary muscle that anchors the scapula flat onto the rib cage.

It attaches onto the under surface of the shoulder blade and to the side of the rib cage.

If you do not have strength and/or control of this very important muscle, it can lead to scapular winging.

(This whole blog post will be going through a range of different Serratus Anterior Exercises)

3. Long Thoracic Nerve palsy

The Long Thoracic Nerve (which originates in the neck) supplies the Serratus Anterior muscle.

If there are any issues with this nerve, it may result in the inability to contract the Serratus Anterior.

Without this muscle activating, it will be difficult to stabilize the scapula on the rib cage.

Other nerves (when damaged) that can result in scapular winging include the:

  • Dorsal scapular nerve and
  • Spinal accessory nerve.

My recommendation: Get EMG testing of the nerve to see if there are any issues with the electrical signals.

4. Flat thoracic spine

The shoulder blade and rib cage have a matching curved shape. (Concave-Convex relationship)

If the upper back is flat, it can result in the mismatch between the surfaces.

This will prevent the shoulder blade from conforming to the shape of the rib cage. (… no matter how many Serratus Anterior exercises that you do!)

For more information: Exercises for a Flat Thoracic spine.


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Winged Scapula Test

a) Static test 

Instructions:

  • Stand with a relaxed posture.
  • Keep your arms by your sides.
  • Get someone to take a photo of your back.
  • Observe the scapula region.

Results: Does your shoulder blade stick out?

If you can see a definite protrusion of the medial border of the shoulder blade, then you have Scapular Winging.


b) Dynamic test

Instructions:

  • Take a video of yourself performing a:
    • Push up against the wall
    • Raising/lowering your arms or
    • Pulling motion.
  • Observe the position of the scapula during movement.

Results: If there is a protrusion of the medial border during the movement, then you have Scapular Winging.


Winged Scapula Exercises

NoteThe following exercises for Winged Scapula are designed to be gentle and pain-free.


 1. Release the pec minor

pec minor release for winged scapula

Instructions:

  • Place a massage ball directly underneath of your Pec Minor.
    • To locate your Pec minor, check it out on Google.
  • Apply your body weight onto the massage ball.
  • Proceed to perform a circular motion over the ball.
  • Make sure to cover the entire muscle
  • Duration: 1-2 minutes

2. Stretches for Winged Scapula

a) Levator Scapula

levator scapulae stretch for scapular winging

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

pec minor stretch

Instructions:

  • Place your hands high up on a door frame. (see above)
  • Tilt your shoulder blades backwards.
  • 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.
    • Do not let your ribs flare outwards.
  • Hold for 30 seconds.
  • Repeat 3 times.

c) Front shoulder stretch

short head bicep 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 tilted backwards.
  • Keep your elbows in.
    • Don’t let them flare out.
  • Do not let your shoulders tip forwards.
  • You should feel a stretch at the front of your shoulders.
  • Hold for 30 seconds.
  • Repeat 3 times.

3. Activate the Serratus anterior

How to fix a Winged Scapula?

… You target the Serratus Anterior!

The main function of the Serratus Anterior is to keep your shoulder blade flat onto your rib cage!

This is the most important part of the blog post: It is VITAL that you know how to activate and feel the Serratus Anterior muscle working when you are performing the Winged Scapula exercises.


Activating the Serratus Anterior:

winged scapula exercises serratus anterior

Instructions:

  • Assume the wall plank position.
  • Activate the Serratus Anterior:
    • Tilt the shoulder blades BACKWARDS.
    • Pull your shoulder blades DOWN and AROUND the ribs.
    • Keep your shoulders long and wide.
  • Keep your neck completely relaxed. (Don’t shrug!)
  • Push your forearms into the wall.
  • Aim to feel the contraction in the lower and side region of the scapula.
    • If you can’t feel the contraction, round your back as you push your forearms into the wall.
  • Hold for 30 seconds.
  • Repeat 5 times.
  • Progression: Whilst maintaining the activation of the Serratus Anterior, slide your forearms up/down the wall.

Once you understand exactly how to ENGAGE this special muscle, let’s get started with the Serratus Anterior exercises!

“Mark! How do I strengthen my Serratus Anterior?”

Check out the following exercises!

Note: The 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

serratus anterior exercise on the floor

Instructions:

  • Assume the plank position with your knees on the floor.
  • Activate the Serratus Anterior.
  • Push your forearms into the floor.
  • Rock your body backwards as far back as possible.
  • Make sure you can feel the Serratus Anterior engaging throughout the exercise.
  • Return to starting position.
  • Repeat 30 times.

b) Push up plus (against the wall)

serratus anterior exercise on wall

Instructions:

  • Assume the push up position on the wall with your arms straightened.
  • Activate the Serratus Anterior.
  • Push your hands into the wall.
  • Whilst keeping your arms completely straight, proceed to protract your shoulder blades.
    • Think of your shoulder blades gliding down and around.
  • Hold this end position for 5 seconds.
  • Make sure you can feel the Serratus Anterior engaging throughout the exercise.
  • Slowly retract your shoulder blades back to the starting neutral position.
  • Repeat 30 times.

c) Push up plus (plank position)

exercises for serratus anterior winged scapula

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.
  • Make sure you can feel the Serratus Anterior engaging throughout the exercise.
  • Retract shoulder blades back to the starting neutral position
  • Repeat 30 times.

Level 2: Serratus anterior Exercises (+ Resistance)

d) Push up plus (with resistance band)

resistance band exercises for scapular winging

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.
  • Make sure you can feel the Serratus Anterior engaging throughout the exercise.
  • Retract the shoulder blades back to the starting neutral position
  • Repeat 30 times.

e) Protraction in lying

scapular winging exercises

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 completely straight.
  • Hold for 5 seconds.
  • Make sure you can feel the Serratus Anterior engaging throughout the exercise.
  • Return to starting position.
  • Repeat 30 times.
  • Progression: Whilst holding the arm in the same vertical position as seen above, roll your body to the side. Repeat 15 times.

Level 3: Serratus anterior activation (+ Shoulder movement)

f) Push up

wall push up serratus anterior exercise

Instructions:

  • Assume a push up position on the wall.
  • Activate the Serratus anterior THROUGHOUT movement.
  • Perform a push up.
  • Keep your shoulders wide and long.
  • Repeat 30 times.

g) Wall slides (with resistance band)

wall slides

Instructions:

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

h) 1 arm pivot

exercises for winged scapula

Instructions:

  • Assume the wall plank position.
  • Activate the Serratus Anterior muscle.
  • Push the forearm (on the side of the Winged scapula) into the wall.
    • Maintain this pressure throughout the exercise.
  • 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)

fix winged scapula

Instructions:

  • Hold onto a resistance band. (as shown above)
  • Activate the Serratus Anterior THROUGHOUT movement.
  • When raising your hand – 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

plank exercise with serratus anterior

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.
  • Do NOT let your shoulder blades cave in.
  • Note: If you are unable to maintain a good position of your shoulder blade, you can do this exercise on your knees instead.

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.
    • Keep the shoulder wide and long!
  • Repeat 10 times.

Level 5: Weight bear (Single arm)

m) Straight arm plank (with pivot)

straight arm plank with pivot

Instructions:

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

l) Plank (with pivot)

  • Assume the plank position on the floor.
  • Activate the Serratus Anterior muscle.
  • Push the forearm (on the side you are targeting) into the floor.
    • Maintain this pressure throughout the exercise.
  • Rotate your body away as you lift your other forearm off the floor.
  • Return to starting position.
  • Repeat 15 times.

Exercise to avoid when addressing Winged Scapula

Do NOT simply just “squeeze your shoulder blades back together”.

(This movement may actually make your scapular winging even worse!)

Instead, learn how to correctly position your shoulder blades:

How to position the shoulders

shoulder posture

Instructions:

1. Serratus Anterior activation: 

  • Reach and stretch out your hands as far to opposite sides as possible. (see above)
  • Keep your shoulders wide and long.

2. Retraction:

  • Bring your arms slightly backwards.
  • Aim to feel a gentle contraction between your shoulder blades.
  • (Do NOT over squeeze your shoulders back together.)

3. Posterior Tilt:

  • Rotate your arms backwards as far as you can so that your thumbs are almost pointing towards the floor.

4. Final step: Take note of your shoulder position.

Keep this position!

… And gently lower your arms by your side.

Other areas to address

If you have persisted with these Winged Scapula exercises and still experiencing issues with the scapula position, you may need to also address the position of the rib cage.

This is influenced by the following:

a) Scoliosis

scoliosis winged scapula

Scoliosis refers to the lateral curvature that occurs in the thoracic and/or lumbar spine.

This can affect the shape of the rib cage on which the scapula sits on.

For more information: Scoliosis Exercises

b) Flat Thoracic Spine

A flat thoracic spine (loss of natural kyphotic curve) can make the back of the rib cage flat as well.

This will affect how the shoulder blade sits on the rib cage,

For more information: Flat Thoracic Spine Exercises

What to do next…

1. Any questions?… (Leave me a comment down below.)

2. Come join me on the Facebook page. Let’s keep in touch!

3. Start doing the exercises!

429 thoughts on “Winged Scapula Exercises”

  1. Thank you Mark for your prompt suggestions.

    I would prefer the resistance bands to perform the arm and other shoulder workouts that involves “hanging” dumbbells instead.

    Chest, lat and back workouts can be continued using a lighter weight with proper postures not to irritate the scapula.

    Bless you !!
    Raj

    Reply
  2. Thank you Mark for responding so promptly. Really appreciated it!! It’s very hard to find people who are so much to help others. Stay blessed !!

    As I mentioned, the pain is not as much but when I try to lift my trapezious muscle (anterior uplifting) on the left side it pains a little. Also, I have been intentionally trying to get my posture right. I am not sure, posture correcting could add to pain as well because the shoulders had been drooping all this while and now I am forcing them to be straight when I am walking or standing or sitting.

    I will follow your suggestions and have already bookmarked this very informative blog.

    Are there any specific exercises that I should avoid coz I am etching to go back to gym and workout with proper posture as you suggested?

    Regards,
    Raj

    Reply
    • Hi Raj,

      It is common to feel a bit of discomfort as you start to address your posture.

      My number 1 tip will be not to try to correct your posture 100% of the way. Sometimes it is better to aim for just 40-50% correction to begin with and increase as the body adapts.

      In terms of what exercises to avoid, you don’t really have to avoid anything. I would just encourage you to avoid allow the shoulders to droop downwards/forwards.

      If you were to ask what exercises what pose a higher risk of this movement, it would be shrugs, dead lifts, farmer carries, any exercise where you need to hold dumbells by the sides of your body.

      All the best.

      Mark

      Reply
  3. Mark, hi!

    Do you have experience working post-op with patients who have had first rib resection; scalenectomy from nTOS and pec minor decompression?

    How do Occupational or Physical therapists evaluate if a winged scapula might be a result of or caused by surgery/nerve damage, and if yes, can this be rehabilitated through rehab?

    Of course I will consult my vascular surgeon but am interested in many perspectives though I understand this might be outside parameters. Curious about what you’ve seen from your practice since a paramount part of nTOS and pec minor decompression recovery is posture correction.

    Also I love your website!!

    Maia

    Reply
    • Hey Maia,

      Yes – I have seen patients following the surgeries you mentioned for TOS.

      You can get nerve conduction study to see if the nerves are impacted. The following nerves control the muscles responsible for keeping the scapula on the rib cage.
      – Long thoracic
      – Spinal accessory
      – Dorsal scapular

      As physical therapist, we usually do muscle strength tests to see if there may be a potential nerve issue.

      If there is a nerve issue, I would still recommend the exercises the strengthen the muscles to regain as much control as possible.

      Other things I would do is strengthen the same muscle on the opposite and electrical stimulation.

      Hope this helps.

      Mark

      Ps. I love your name. My daughter has the same name.

      Reply
  4. Hello Mark,

    First of all, thank you for posting out such a useful and detailed analysis and exercises for the winged scapula and postural issues. Really appreciated it.
    I am 40 and recently I started working out on my traps (most under developed muscle till date) by shrugging with 25lbs weights. I never had this much traps before or should I say never pronounced this much (a little exaggerated) but this came with the cost that I started feeling a little discomfort in my left shoulder. Looking in the mirror, I could see that my left shoulder is little higher than my right shoulder. Although it is not bothering me as much, I have stopped working out with the weights and started using a resistance band. I started working out on stretching my serratus muscle and also little stretches to engage the serratus muscle. Also, working out to improve my posture and get rid of rounded shoulders.

    My question, is my diagnosis, hypothesis correct about winged scapula? Although, it does not seem to be as protruded as I have seen many in the pictures. Could shrugging possibly have hurt the scapula in anyways?
    What all exercises if I need to avoid?

    Appreciate your response.

    Reply
    • Hi Raj,

      If you allow your shoulders to drop and hang downwards whilst holding on to dumbbells ( as seen in the downwards motion after shrugging upwards), it is possible to over stretch the nerves that control the scapula.

      This could lead to scapula winging.

      If this is your issue, you will need to make sure that you maintain optimal shoulder position where the nerve is not stretched.

      A good cue would be to: “Float/Hover your shoulder blades on top of your rib cage”. The shoulder should not be “hanging off”.

      Mark

      Reply
  5. Hi Mark,

    First, I follow you on FB but perhaps you can assist here. I had a large Basal Cell removed from my neck/upper trap that was solid,, 2″ long and as such some of the upper trap was removed resulting in about 60% atrophy of the UT. My right scapula has mild winging and my right shoulder is thus forward due to two possible reasons, if not three. First, I believe my accessory nerve had mild impairment post radiation. I had a nerve conduction test indicating such. Secondly I am pretty sure the atrophy of the UT has not helped. Finally, my mid back had plastic surgery to create a flap and the rhomboid and mid trap were cut into. I have been doing PT for over a year! My mid back muscles are strong….I can move my scapula well but when at rest I still have forward right shoulder. Any idea? And this does affect my posture when running too. Thanks! Dave

    Reply
    • Hello David,

      You need a balance of serratus anterior, trapezius and rhomboids to keep the scapula molded the to the rib cage.

      Surgical removal of the a portion of the trapezius plus the accessory nerve impairment will definitely cause an issue with a muscular contractions around the scapula.

      If you feel that you have strong muscles that bring the scapula backwards but still have rounded shoulders, I would think you still have tight muscles pulling you into rounded shoulders and/or thoracic spine is flexing forwards.

      Mark

      Reply
  6. Hello,

    thank you a lot for your work! i’m having a lot of pain in my shoulder blades and lower back. i’ve been doing the serratus anterior exercise for some weeks already and it made me feel better. but , it still hurts, and i noticed that i have a “hole” in the middle, and my side ribs are very noticeable.
    after some research on the internet, nothing seems to look similar with my case…
    what could be the reason for this hole?

    thanks you very much for your help

    Reply
    • Hey Kyle,

      1. Release/Stretch the Upper trap
      2. Stick with the easier exercises
      3. Only do partial reps until you can control the full movement.

      Mark

      Reply
  7. Hello Mark

    Ive been doing alot of release techniques for pec minor/major and traps with theracane and massage ball for the past 3 weeks, but no matter what i try my LEFT shoulder still seems elevated no matter what, and is mostly noticable on the trap area ( my neck appears to be longer in one side because of the elevated traps)

    It was very difficult for me to perform your doorwall stretch because of how internally rotated my shoulder is.

    I’ve also tried releasing my lats ,but no luck.

    Is there something else that could be causing this internal rotation/elevation of my left shoulder?

    Thanks for for this amazing guide !

    Reply
    • Hey Josuel,

      If you have tried releasing and stretching, the next step you might want to focus on is STRENGTHENING (mainly the lower traps).

      This post might help out as well: Uneven shoulders.

      It could possibly due a side tilt in your spine?

      Another possibility – If your spine is tilted to the right, this will naturally raise your left shoulder upwards.

      See this post: Scoliosis Exercises.

      Mark

      Reply
  8. Hey mark. I have a problem with scapula winging and been trying to fix it for awhile now with no avail. My kyphosis is preventing me from doing wall slides correctly along with my lower body arch. I tried correcting the kyphosis but due to the winging I can’t fully retract my scapula. Even if I properly align my body I still get no activation. What do i do?

    Reply
    • Hey Isaiah,

      Sounds like you might need to focus on getting more mobility in your thoracic spine.

      Check out this post.

      Also – are your shoulder blades already laterally glided over your rib cage? This may make it difficult to engage the serratus anterior.

      Mark

      Reply
    • Hey again mark thanks for the reply and recommendation. Also I think I might have a slight lateral glide Over my rib cage due to the kyphosis. After I do the mobility work what can I do to be able to make the engagement with serratus anterior easy again?

      Reply
      • Hey Isaiah,

        If your scapula is already laterally glided on your rib cage, it might be difficult to feel the serratus anterior engage.

        What I would do is learn how to retract your shoulder blades first, then try to engage the serratus anterior to bring the scapula flat onto the rib cage.

        Mark

        Reply
    • Hey again mark thanks for the reply. But I can’t fully retract my scapula due to the winging and the other imbalances throughout my body specifically the kyphosis what can I do to overcome this?

      Reply
  9. Hi Mark,

    Thanks for the updates on the blog and all your hard work.

    I want to check with you if I’m doing something wrong. But when I bring my shoulders back, down, and around, which makes my shoulder blades sort of flush with my back, I can feel the muscles in the back of my neck pulling. Is this normal, or does this mean that I am doing something wrong? I’m worried I might be exaggerating the stretch too much, as I look like someone performing a strongman position to show off their lats.

    Reply
    • Hey Harry,

      You may be tensing your neck too much as you perform the movement. Try to focus on keeping this area relaxed as you perform the scapula movement.

      If this is difficult, reduce your intensity by 20-30% and see if you are now able to keep the neck relaxed.

      I guess this movement does resemble a lat spread. The main difference being is that you do not want to move your arms to help you move your scapula. Try to think of the scapula moving mainly (as opposed the arms)

      Mark

      Reply
  10. Hi Mark,

    I have been trying some of these exercises already for a few weeks and had some questions.
    I try to do scapular pushups, including the kneeling scapular pushups, if I engage my serratus anterior should my scapular flare out at the top of the push up (like when I am pushing to the top) ,or am I doing this wrong? Should I try to keep my scapular fixed to my body at all times? Or will this flaring of the scapular reduce with time and better strength.
    Furthermore, most of my scapular winging occurs when my arms are behind my body (flexion?) , or when standing neutral. What could this indicate? Weak serratus / rhomboids? I don’t think I have a good mind muscle connection with my serratus and it feels difficult to get it to fire, am not sure if it’s just pure weakness in the muscle, bad mind muscle connection or nerve damage like you mentioned. I’ve had a very dysfunctional body for over 10 years with things like depressed shoulder, inward rotation, tight muscles etc, and have only been fixing my body for the last 2 months, baby steps I know but any insight would be appreciated, am sorry it is so long!
    Regards, Ben

    Reply
    • Hi Ben,

      When performing these exercises, you want the scapula to wrap around the ribs. You do not want the scapula to shrug upwards.

      If you are shrugging it upwards, you might be engaging your upper trapezius to perform this movement.

      It sounds like you might have a downward rotated scapula (“droopy shoulder”) which can often be partnered with winging when extending the arms backwards. (a tight pec minor is usually involved!)

      Keep doing these exercises. Once you have a good feel, start to engage the serratus anterior whilst bringing the arm back.

      Mark

      Reply
  11. Hi Mark! Your exercises have helped me immensely- even after a year of PT – thank you!! I had an undiagnosed left shoulder dislocation for a year that resulted in an injury to my long thoracic nerve and thus the winged scapula. My current issue is, as I work more and more to strengthen these muscles, I notice other side effects – headache above the left eye, left eye sensitivity/pressure and trigger points throughout the left side of neck that are continuous. I’m assuming I may be pinching a nerve as working these muscles may be creating inflammation? Is this an issue you’ve seen in the past? If so, what do you suggest as supplemental to help these issues?

    Thanks Mark! Keep on being awesome!!

    Reply
    • Hey Awesome Brooke!!

      Great to hear that the exercises have helped with your winging.

      If you are feeling headaches and left eye sensitivity after performing the exercises, I usually find that a muscle connected to the base of the skull (left side in your case) could be tensing up.

      Check out this post for the main muscles that cause headaches: How to get rid of a Headache (cause by muscles)

      Make sure that you are keeping your neck completely relaxed and that you are not shrugging your shoulders as you perform the exercises.

      All the best

      Mark

      Reply
  12. Hi Mark, I’ve been doing exercises for a few months and I can’t see any result. Every time when I try to do the non-flexing elbows pushups I can’t feel any struggle. I’ve noticed that I feel it when I lift my arm forward, should I keep doing just it or the other exercises too? I have winged scapula in the right side.

    Reply
  13. Hi Mark,

    How long does it usually take to recover from winged scaupla? if we are regularly performing all the exercises and stretches.

    Reply

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