Why do my shoulder blades stick out?

Shoulder blades sticking out is also known as scapular winging. Scapular winging or winged scapula is a health condition that happens when one or both shoulder blades stick out or protrude from the back rather than lying flat. 

This is a rare condition but when it happens it can be very painful. The shoulder blades mostly rest flat against the back of your chest wall but in some very rare cases, they stick out leading to scapular winging.

There are many causes for this condition and if you read on you will get to know why your shoulder blades stick out, the causes, possible treatments, and other relevant information you might not know of. Make sure to read to the end of this article.

What is scapula winging?

This is a condition that affects the shoulder blades making them protrude or stick out from the back instead of lying flat against the back of your chest wall. It is a rare condition as stated earlier but when it occurs, it comes with a lot of pain making daily activities very difficult to carry out.

What are the symptoms of scapular winging?

The symptoms of scapular winging differ from person to person. This is due to the underlying causes as well as the muscles and nerves of the individual. A lot of people suffering from a winged scapula usually have their shoulder blade sticking out.

This can make sitting in a chair or wearing a backpack uncomfortable. A winged scapula caused by nerve damage can cause weakness in the muscles located around your neck, shoulders, and arms. This can make activities such as lifting, pulling, and pushing very difficult. 

It also affects the ability to raise your arms above your shoulder. When you try to do this, you can experience intense pain. 

Other symptoms of the winged scapula include:

Fatigue, pain or discomfort around your back and shoulders, a dropping shoulder, etc.

What are the causes of winged scapula?

Winged scapula is mostly caused by nerve damage. These nerves are purposely made for controlling the muscles in your arms, back, and neck. Some of these nerves include:

• Spinal accessory nerve which is responsible for controlling the trapezius muscle (one of the widest back muscles)
• Dorsal scapular nerve which is responsible for controlling the rhomboid muscles (a large group of muscles in your upper back that hold your shoulder blade)
• The thoracic nerve. This nerve is responsible for controlling the serratus anterior muscle (a muscle that originates on the top surface of the eight or nine upper ribs)

Here are some of the causes of a winged scapula

Traumatic injuries

Serious injuries or traumatic injuries just like blunt trauma can cause a winged scapula. Blunt trauma to the nerves that control the muscles of your neck, upper back, and shoulder can lead to scapular winging. Examples of blunt trauma include dislocating your shoulder or twisting your neck

Repetitive motion injuries

Movements that are repetitive can also cause a winged scapula. Repetitive movements can cause injuries and are usually common among athletes. Day-to-day activities like digging, trimming hedges, washing bowls, washing cars, etc can all cause damage or result in your shoulder blades sticking out.

Non traumatic injuries

These are injuries that are not caused by physical force. These injuries can be caused by diseases, drug overdose, allergic reactions, exposure to toxins, etc. Non-traumatic injuries are also one of the causes of a winged scapula.

Surgery

This is also another cause of a winged scapula. Nerve damage, which is a major cause of a winged scapula can be caused by rib sections, mastectomies, and procedures that need general anesthesia (which are all involved with surgery).

A study in Supportive Care for Cancer followed people who had undergone axillary dissection, a surgical breast cancer treatment. Among the 112 surveyed, 8 percent exhibited scapular winging 15 days after surgery.

How to diagnose winged scapula

Physical examinations conducted by qualified medical personnel are one way to diagnose scapula winging. The doctor takes a look at your shoulder blade for any obvious signs of winging. You can also be asked by the doctor to perform certain arm or shoulder movements. 

If you have any recent injury or illness that can affect your neck, arms, and back, make sure to inform your doctor. If your doctor decides you do have a winged scapula, they may use electromyography to find out if it’s related to the serratus anterior, trapezius, or rhomboid muscles.

How to treat scapula winging 

Treatment of scapular winging depends on the nerves and muscles causing it. Scapula winging has both nonsurgical and surgical treatment options.

With the non-surgical options, light physical therapy or braces will be recommended by your doctor. 

If nonsurgical treatment options aren’t providing any relief, your doctor may recommend surgery. With the surgery option, part of a nerve or all of a nerve or muscle can be taken and moved to another part of the body.

Static stabilization is also another option that can be used to treat winged scapula. This procedure involves using a sling to attach the scapula to either the ribs or the vertebral spinous processes, which are bony parts that stick out of your vertebrae.

Home remedies like stretching and exercising can help treat this condition.

How to prevent a winged scapula?

You can perform or use these tips to help reduce your chances of getting a winged scapula. Below are some of the tips you can apply

• Make sure to avoid repetitive shoulder or arm movements when possible
• Maintaining a correct posture is very important in reducing your chances of getting a winged scapula
• Use an ergonomic chair or pillow
• You can also use shoulder-friendly ergonomic bags and backpacks
• Avoid carrying too much weight on your shoulders
• Stretching and strengthening the muscles in your neck, shoulders, and upper arms can also help reduce your risk of getting a winged scapula.

The takeaway from this article

Your shoulder blades sticking out is usually caused by nerve damage around your neck. This is as a result of extreme pressure placed on the nerves responsible for moving and controlling muscles around your neck, back and arms. 

This condition can be treated. Mild cases can be treated with home remedies whereas severe cases require surgery. It is recommended you know the type you are suffering from to know what type of treatment you will need.