Winged Scapula Exercises

What is a Winged Scapula?

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!


About Mark Wong:

Mark is a Physiotherapist who has been helping his patients fix their posture for the past 11 years. He created the Posture Direct blog in 2015 with the goal of helping as many people fix their own posture.

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433 thoughts on “Winged Scapula Exercises”

  1. Hi Mark,

    I have been diagnosed with Neuralgic Amyotrophy and an EMG showed that I have severe long thoracic neuropathy. Rare condition and recovery is long and partial for many people. Your exercises for activating the Serratus Anterior look perfect for me as I haven’t known even if I was activating it in the exercises my PT gave me. It’s hard to find a doctor or PT with much experience with this problem. My right shoulder winging is severe. I’ve also been working on correcting some postural issues and stretching muscles that have been compensating for the weaker muscle(s). My main question is what activities and exercises should I avoid, other than squeezing my shoulder blades together. Any advice particular to this condition would be greatly appreciated.

    Reply
    • Hi Barb,

      With Neuralgic Amyotrophy, you will need to make sure you keep the muscles as strong as possible. Make sure you are strengthening the arm in general.

      In terms of what to avoid: I would caution any exercise that places extra tension/stretch on the brachial plexus. (Do not allow your shoulders to depress downwards.) I usually tell my patients do think of the shoulder blades as “floating” on the rib cage as opposed to “hanging” off.

      Be careful with any exercise where you are holding a weight that drags your shoulder girdle down wards (eg. lowered position of the: shrug, dead lift, bent over row, bicep curl etc)

      Make sure to address the unaffected side as well.

      Mark

      Reply
  2. Hi Mark! I have an S-shaped scoliosis of the thoracolumbar spine. There is a curvature convex right of the thoracic spine measuring 39.5 degrees measured from the superior endplate of T4 to the inferior endplate of T9. There is a compensatory curvature convex left of the lumbar spine measuring 29 degrees from the superior endplate of T9 to the inferior endplate of L3.

    I also have a winged scapula because of the curvature of my thoracic spine which is the main source of my discomfort / pinching behind the shoulder blade.

    I am wondering what is the best way I should be stretching, sleeping, standing, sitting, etc.?

    Thank you so much – I found your entire website to be very educational.

    Reply
  3. I have a question regarding shoulder blade/scapula control and positioning.

    In both the Snapping Scapula Syndrome article and the winged scapula exercises articles you talk about the idea of posteriorly tilting the shoulder blades.

    However in the snapping article you talk about ELEVATING the blades via shrugging upper traps and retraction (pulling blades TOGETHER). Whereas in the winged article you talk about pulling the blades DOWN and pulling the blades APART (to wrap around the ribs).

    Can you clear this up for me? Thank you.

    Reply
    • Hey Luke,

      The main issue with snapping scapula is the depression (downward motion) of the scapula onto the rib cage. This can rub and irritate the structures underneath the scaula.

      This is why you want to focus on gently elevating the shoulder. From this slightly elevated position (which is actually more neutrally positioned in comparison to being depressed), you will still want to lightly retract and posterior tilt.

      With the winged scapula, the main focus would be keep your shoulder long and wide (as to engage the serratus anterior to keep the medial border kept flush against the rib cage). From this position, you will still want to slightly retract, posterior tilt and if required, even pulling slightly downwards (if the shoulder blades are sitting too high)

      Basically – ii is the same positioning for both but has emphasis on whatever is lacking.

      Mark

      Reply
    • Hi Mark,
      Please I need ur help,I hav been suffering from right shoulder discomfort over 2 to 3 years now,initially how it started was, I felt my left pec muscles was bigger than my right of which I was given one hand program in d gym to balance it up which didn’t corrected it but resulted in building my right back and my shoulder blade looks more prominent like winging scapular,I hav carried out lots of stretches but still dsame..it pains me when sleep or wash clothes or do some chores with d hand..pls help

      Reply
  4. Hey Mark,

    Where are you located and do you offer Zoom appointments? Four years ago my costovertebral joints froze from horrible posture for 20 years and likely incorrect weight lifting. I unlocked those joints using the backpod but have been battling the typical upper and lower cross syndrome. I completely ignored the SERRATUS ANTERIOR! It is extremely weak and tight. Recently I started doing your exercises and massaging it. When I loosen it up, I can finally take a full breath with no rib and back pain. Within 2 minutes it tightens again, so I understand I need to completely reactivate this chronically tight muscle and it will take time.

    When I use the computer or during my daily life, should I be activating the serratus anterior constantly or only during the exercises?

    When I stretch or massage it also doesnt seem to help much aside from 2 minutes of relief, should I simply focus on strengthening exercises?

    I also find massaging my subscapularis helps my shoulders/scapula move better and reduce upper back pain.

    If I had to guess my major issues in order are: Weak/tight Serratus, Weak Lower Trap, Weak/Tight Subscapularis, Tight Lats,Tight Pec Minor, Weak Abs, forward head posture. I am focusing on my Serratus though because that gives me the most relief when it relaxes and isnt chronically tight.

    Does this make sense? I had dry needling on my lats before and was completely pain free for 2 weeks which makes me think the lats/serratus are the main culprit.

    Thanks for your time,

    Mike

    Reply
    • Hey Mike,

      Sounds like you might need to focus on engaging the serratus anterior in its full range of motion.

      However – if you are on the computer, you do not want this muscle engaged all the time. A very faint contraction is required to keep your scapula in a more ideal position.

      Releases are still important to do, but focusing on the strengthening is where your focus should be at. (especially if you know it gives you the most relief)

      On top of this, sounds like you will need to do something about your thoracic spine as well? See post: Hunchback posture.

      Mark

      Reply
  5. Hie mark….. i hsve scapular winging on right side and right side of ribs are forward than left and the same side shoulder is also forward rotates and the bone doen the breast on right side is also forward than left

    Reply
    • Hi Mark, Sorry if I have to resort to this again. I’m thankful for the reply, A strong typhoon just hit us recently, They keep coming nowadays.

      I’ve already been 2 months into the rehab and my shoulders feel great! Long way to go though. As for the winging, I can’t really say much.. I can see a change.. Although insignificant. To answer your question, my shoulders aren’t really impinged, I did the Kennedy Hawkins tests and many others that mimic the same movement, and it didn’t really reproduce any pain. I don’t think it’s a tear either, Did the drop arm and arm abduction test and no pain were reproduced either. Although I’m recovering, I really don’t know where I’m heading to.. My recovery seems so vague. I plan to hit the gym once again once the next year hits and I’ll be focusing on rehab exercises and continue strengthening the serratus, and implement deadlifts for my back pain and mid traps aswell as y raises for the lower traps and core exercises. Are you fond though of my training regiment?

      Reply
      • Hello Phillip,

        Firstly – I hope you and your family have been keeping safe from the recent typhoons.

        Great to hear that your should are feeling better after 2 months of doing the exercises. The winging might take a bit longer to see some results.

        Going to the gym will be great for the shoulder. Progressively load the shoulder in as many different ranges as possible (of course- without causing any symptoms).

        Mark

        Reply
  6. Great Blog,

    I am a nurse and have noticed that my scapula is winging on the right side and am wondering if it is related to my sitting at a computer and using my right arm on a regular basis. Bad desk posture, etc. Also shoulder hurts a bit when I lye down to go to sleep. So can suggest what the best position for sleep and or mattress type? I have been making myself not sleep on my stomach with my arms above my head.

    Reply
    • Hi Nurse Lisa,

      Winging scapula can be caused by incorrect posture whilst sitting in front of the computer.

      I usually suggest sleeping on the back as this promotes the most symmetry of the body. However – many people are habitual side sleepers of which I suspect their forward slouching posture is a main factor.

      If you can not sleep comfortably on the back, you can try sleeping in a quarter off supine position with pillows supporting your back.

      Mark

      Reply
    • Hi Mark, I don’t really know how to leave a comment here in your website so I hope I can resort to this.

      I’ve had scapular winging every since I was a kid, and when I start hitting the gym at 17, I undertrained my back due to some bad advices I received over my training course. I hurt my shoulder, and now during the quarantine my other shoulder flared up as well, which I believe is a result of the winging. I’ve been stretching many muscles everyday, particularly the subscapularis, pec minor, lats and levator scap and along with these, I do strengthening movements 2/3/4 a week, external rotations and serratus muscle strengthening movements. Been a month and a half now, I really can’t see that much of a significant change, both scapulas still winging. Can it be from a nerve injury? or is it just simply weak? I haven’t had a traumatic injury before.. Should I keep on persisting? Please help, I keep getting debilitated day by day, and I just want an answer to finally scorn this endless researching frenzy i’ve been in for the past 2 month

      Reply
      • Hi Phlip,

        Before addressing your scapula winging, try to get the shoulder symptoms down first. (I say this because you probably didn’t have shoulder pain before you started the gym.)

        Aim to reclaim full pain-free range of motion, strength and control of the shoulder.

        Is it possible that you have shoulder impingement?

        In regards to your winging – If you believe there is nerve damage, you can opt to get them tested via nerve conduction study.

        Mark

        Reply
  7. Hi Mark,

    Allow a comment on your exercises. I had radical neck surgery which mildly to moderately affected the spinal accessory nerve, or cranial nerve 11. Luckily I had great surgeon. Your exercises are meant really for long thoracic nerve/serratus issues. I saw you did refer to the SAN however.

    Often spinal accessory nerve issues need either surgery or a valiant attempt at lower to mid trap exercises, but PT usually does not work. The degree of winging and pain will determine and luckily mine is minor. If severe winging then the modified Eden Lange muscle transfer is what brings positive results in many cases if the nerve can not be surgically restored.

    Reply
    • Hey Dave,

      From what I’ve seen, it is very difficult to address winging that is caused by issues of the Spinal Accessory nerve with exercises alone.

      Did you get the Eden Lange muscle transfer surgery? I haven’t seen a patient with this surgery before.

      Mark

      Reply
  8. Hi Mark,

    Thanks for your reply. Yes I do have quite a long curved back you’re right. My back is quite S shaped when looking at it from the side.

    Reply
  9. Hi Mark,

    Thanks for all of your information and useful replies.

    One thing that I really struggle with is this pain where the lower trap meets the spine. More specifically, where the bottom of the lower trap meets the spine. When I bring my shoulder blades back and around, this muscle is very tense, and is raised. It sort of looks swollen. I’m not sure if it’s my trap that is the issue, or the erector spinae, but does this ring a bell for you at all? I perform stretching for my serratus, and the lats, and my rhomboids, and I stretch the erector spinae, and use a tennis ball on this area of pain. However, I find sometimes that the more I stretch, the worse this particular pain gets. It’s so bad sometimes that even if I take ibuprofen, I struggle to sit and do work. Due to Covid it’s difficult in the UK to see anyone to help me and I can’t really find any information online on this specific problem. I’m at a loss and it’s really affecting me. Any help would be really appreciated! Thanks

    Reply
    • Hi Harry,

      If stretching makes this area worse, it could mean that you are stretching a relatively elongated muscles already.

      This area is more likely the erector spinae. Do you have a long curved upper back by any chance?

      Mark

      Reply

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