Summarized in simple terms, scapular winging is a movement dysfunction of the shoulder blade.
A normally functioning scapula rests on the rib cage during all movements. Yet, with scapular dyskinesis, the shoulder blade comes off the rib cage.
Perhaps, you or a friend, has once shown the other what crazy stuff they can do with their shoulder blade. As things go, some people can force their scapula to wing. I remember a soccer teammate in my youth who got some serious fame for it.
There are two types of scapular winging:
- Medial Scapular Winging: the inside of the scapula lifts of the rib cage
- Inferior Scapular Winging: the bottom part of the scapula comes off
Scapular winging reduces the strength of your shoulder and is both a risk factor to injury as it can be a result of it.
Before we dive deep into scapular dyskinesis though, let’s understand the shoulder joint.
How Should the Shoulder-Girdle Work?
The head of the humerus (your upper arm bone) should be at the center of your glenoid (the articular surface on the scapula). Preferably, at all times.
This means that if you have your arm hanging by your side, the humeral head is “centered”. When you lift (abduct) your arm sideways your scapula will not move until your arm passes an angle of 30 degrees. After, the top of your shoulder blade will move inward and the bottom out. As you continue to lift your arm your scapula will rotate up.
Why is this important?
Because this way, the head of your humerus is always fully supported on top of the glenoid. This ensures that you can generate the most force while maintaining stability.
Besides, the shoulder joint is super mobile. This is a consequence of the flat glenoid which is only surrounded by the labrum. A thin edge of cartilage which provides a bit more stability. Still, this is nothing compared to the hip joint, where the head of the femur (the upper leg) fits deep into the acetabulum (hip socket).
Our mobile shoulders are great tools to use our arms and hands. And to swim of course.
Yet, another result of its mobility is that the shoulder girdle is prone to injuries. Definitely when doing a lot of overhead movements, like swimming, volleyball, and basketball. As things go, overhead is a weak position of the joint.
Who is at Risk for Scapular Winging?
People that engage in overhead movements often are at risk for scapular winging.
These are a couple of reasons for why it’s an issue for these people specifically:
- Overhead is a position where it’s harder to generate a force which makes it susceptible to compensation (the wrong muscles doing the job)
- Because it’s hard to generate force your tire quicker working overhead
- With your arm lifted there’s a higher chance on compression of sub-acromial structures because of the reduced space which in turn affects scapular function
What Causes Scapular Dyskinesis?
Scapular winging can be the result of thoracic kyphosis, a collarbone fracture that didn’t heal, instability in the shoulder girdle, or an internal joint derangement. Besides that, a lesion of the thoracic nerve also affects scapular winging.
Yet, this is not the most common cause.
The most common cause is the inflexibility of the pectoralis minor and short head of the biceps. These pull on the scapula from the front and create a protraction and a forward tilt.
Do you know when you use your pectoralis minor while swimming?
When you crawl, every time you move your arm forward out of the water and pull it back in the water. That’s quite often if you do long-distance swimming.
Furthermore, shoulder impingement (a shoulder problem where the infraspinatus tendon is affected) and shoulder pain, cause the serratus anterior muscle to function differently. The serratus anterior is essential for scapular stability.
Scapular Dyskinesis and Swimming
Scapular dyskinesis is common in swimmers and even seems to be more prevalent when swimming practice progresses. Not all swimmers experience pain though.
Nevertheless, scapular winging does result in malposition of the shoulder and makes you prone to shoulder injuries. Even more so, if you have a history of shoulder pain.
In this case, even if you don’t have shoulder pain now it would be a great idea to follow a prehab exercise program to strengthen your scapula and shoulder girdle to prevent further injuries.
Furthermore, I believe, as a swimmer it’s always a fine idea to train your shoulder stability. First, in isolation to develop control over your scapula and shoulder joint. And later integrated into a specific strength exercise program that mimics swimming movements.
How to Prevent Scapular Winging
Can scapular winging entirely be prevented?
I don’t think so. But you can make sure it doesn’t turn into a long-lasting shoulder injury with the following measures.
1. Take Sufficient Rest
As one scientific study found out, scapular dyskinesis became gradually more during training amongst elite swimmers. The logical conclusion of that observation would be that fatigue increases the chance of scapular dyskinesis.
So, what would be the best solution for that?
Rest. Both within training as between training moments. It’s worthwhile to consider that your cardiovascular system might have recovered from training when your muscles didn’t.
2. Stretch the Pectoralis Major, Minor, and Biceps Often
Since most scapular winging is the result of inflexibility of the pectoralis minor and short head of the bicep, you’ll benefit from stretching these muscles often.
3. Strengthen the Serratus Anterior
The serratus anterior is the most important muscle when it comes to scapular motion and stability. The stronger it is, the stronger the foundation of your shoulder.
I hope this article about scapular winging gave you valuable insights into the workings of the shoulder and scapular winging.
If you have scapular dyskinesis it’s a good idea to address it, even more so if you have a history of shoulder pain.
On my website I made an exercise plan especially for readers of Better Triathlete. I share 4 great exercises to improve scapular control and stability. These movements will help you develop a strong scapula and reduce the chances of (re)injury. Moreover, the stronger your shoulder-girdle the faster you’ll swim. Click here to get it right away!
- Benjamin Kibler W, Sciascia A, Wilkes T. Scapular dyskinesis and its relation to shoulder injury. J Am Acad Orthop Surg. 2012;20(6):364-372. doi:10.5435/JAAOS-20-06-364
- Borstad JD, Ludewig PM. The effect of long versus short pectoralis minor resting length on scapular kinematics in healthy individuals. J Orthop Sports Phys Ther. 2005;35(4):227-238. doi:10.2519/jospt.2005.35.4.227
- Cools AM, Dewitte V, Lanszweert F, et al. Rehabilitation of scapular muscle balance: which exercises to prescribe? Am J Sports Med. 2007;35(10):1744-1751. doi:10.1177/0363546507303560
- Madsen PH, Bak K, Jensen S, Welter U. Training induces scapular dyskinesis in pain-free competitive swimmers: a reliability and observational study. Clin J Sport Med Off J Can Acad Sport Med. 2011;21(2):109-113. doi:10.1097/JSM.0b013e3182041de0
- Maor MB, Ronin T, Kalichman L. Scapular dyskinesis among competitive swimmers. J Bodyw Mov Ther. 2017;21(3):633-636. doi:10.1016/j.jbmt.2016.11.011