Have you noticed someone’s shoulder blade(scapula) travelling towards the other one performing a press up or both? Or maybe you felt that the skin of your back is getting pinched when you lower yourself in a press up.
Perhaps you are constantly in a state of poor posture at work and searching for exercises to bring your spine back to normal. You would be surprised to know how many people suffer from muscle imbalance.
What is winged scapula?
A winged scapula is marked by the appearance of the inner border of the scapula flaring out off the back and can occur for a variety of reasons and cause pain, discomfort and lack of range of motion for the entire upper body.
The scapula or shoulder blade is the largest bone of the shoulder complex and has a large number of muscles attached to it. These muscles both stabilise the arm to the body and move the arm around in space.
Our shoulders allow us to perform movements like no other joint in our body as you can see in the image bellow.
Image source: www.acefitness.org
If any of the muscles around the shoulder joint are not working in the right way at the right time, the balance is broken and with time the performance decreases and pain can occur.
A winged scapula is not an injury but more of a symptom of another condition. Usually is due to Serratus Anterior muscle dysfunction. This is caused by a traumatic injury, pressure lesions or inflammation of the long thoracic nerve. Another reason is Brachial Neuritis condition – the muscles around the scapula are controlled by the nerves arising from the Brachial Plexus (nerves running from the neck to the arm) and this can affect the muscles of the shoulder more than the arm and lead to winging.
Some bodybuilders are using a controversial technique when doing exercises like bench press and pull the shoulder blades towards each other to target even more the chest muscles. This way they eliminate the Serratus Anterior function of scapular protraction and might serve a purpose in bodybuilding but if you are lifting for function, it’s totally inappropriate because it teaches the nervous system unnatural muscular sequencing.
Image source: www.yoganatomy.com
As you already noticed the most important muscle to strengthen is the Serratus Anterior muscle which holds the shoulder blade in place and prevents it from sticking out.
A full rehabilitation and strengthening program consists of a full spectrum of exercises for the whole shoulder girdle(scapula and clavicle) and glenohumeral joint(scapula and humerus).
Exercises to strengthen the Serratus Anterior muscle are similar to the punching type of movement but you should focus on using mainly this muscle and not the Pectoralis or Deltoid group.
Also, the exercises should be performed in safe zone positions. These are areas in space where it is safe to move your arm, preventing significant stress on the surgical repair or injury. If you have had surgery, ask your surgeon what area is safe for you as he tested the strength of the surgical repair at the end of the operation to determine the ‘safe zones’ or have a look at your surgical operation note.
Image source: shoulderdoc.co.uk
Zone A is the safest. You can move in this zone as guided by your therapist and surgeon.
Zone B is next safest. You should be careful moving in this zone without supervision and guidance.
Zone C is the least safe and must be avoided. Your shoulder is most vulnerable to stressing a repair or an injury when your elbow is in this zone.
The exercises below are some of the exercises I use with my clients and just have an informative role. Always consult your therapist before starting any strengthening exercise programme.
Initially start in a lying position with one weight in one of your hands perpendicular to the floor. Push the weight up using your PA muscle and maintain your elbow straight the whole time. Use your free hand to check if your chest muscles are still relaxed. Lower the shoulder back down and repeat.
Start with the end of the band around your shoulder like wearing the strap of a backpack. Push the shoulder forward without engaging the chest muscles, the movements should be done mainly with the Serratus Anterior muscle. Ensure you push through the entire shoulder, trying to reach as far forwards as possible. Perform this exercise with the hand at different heights.
You don’t have to suffer from a condition before starting to work on your weak muscles. I very often notice that even the strongest guys in the gym have poor scapular stability. Basically they can’t keep the shoulder blade in one place when performing exercises like bench press or press ups.
An easy way to fix this is performing scapular press ups by rounding the upper back and further extending your arms through your shoulders then come back slowly to neutral.
Another way is to exaggerate the end range of motion while doing the chest exercises by pushing the arms even further and don’t letting your scapulas to slide one to another when your travel backwards with the weight.