The winged scapula is one of the most common postural faults we see today. And even though we are talking about winged scapula in this article the information and exercises provided will relate to ALL shoulder injuries. The term winged scapula gets its name from its appearance, a wing-like resemblance, due to the medial border of the scapula sticking straight out from the back. As I mentioned at the start this is a postural fault that can greatly affect a person’s ability to lift, pull, and push weighty objects and can cause pain and discomfort with simple daily activities such as taking your shirt off or playing a sport. When pain sets in people resort to the treatment of trigger point massage, stretching, and acupuncture which all may help in some way but the real answer lies in providing stability. Why? The shoulder is such an amazing joint in that it has an incredible amount of mobility and is able to perform some incredibly powerful and dynamic movements like serving in tennis or simply throwing a ball. But this awesome mobility comes at a cost, as the stability of the shoulder can be very easily compromised. And when this happens is when injury and pain takes over. If we lose that stability, we get some extra mobility of the humeral head within the joint, and that begins to pinch some of the structures around it and you eventually end up with common postural problems like the winged scapula that progress to much worse problems such as injuries like a shoulder impingement or rotator cuff tears. This article we provide you with 5 of the most effective and simple to do stability exercises that you can begin using to improve your posture and get your shoulder movement back, without pain and compensation.

Don't Make These Common Mistakes!

There are 2 big mistakes I see people make when trying to overcome shoulder pain or injury.

1. Firstly relying on physical therapy alone that focuses on the area in pain with trigger point release, massage and stretching is a great start, and at times crucial in the rehabilitation stage, but if this is as far as you go you will only end up back in pain. Trigger points develop from the body overworking due to poor posture and poor movement strategies placing joints in unstable positions. Many of the stabilizer muscles will become weak and disabled and now the body must create a new method of stability and it does this by creating stiffness in some muscles and trigger points in areas where stability is needed. Just releasing the trigger point without correcting the stability deficit is a waste of time. This is a common trait of the people who do not exercise or go to the gym and their solution is to get someone to fix their problem.
2. The second mistake is more for the gym person who believes that strength is needed. Often they neglect the value of mobility work, using trigger point release and especially stability training. If you try to strengthen areas of the body without adequate stability and mobility present you will only teach the body better ways to compensate and find ways to use global prime mover muscles how to stabilize instead of the small local stabilize muscles how to do it.

In both cases, you will end up at the same point, in pain. For the missing step is in between where you must teach your body how to stabilize and move correctly. Often these exercises are very low level in intensity but can be very frustrating as there is a high level of coordination and body awareness required in order to find the right timing, sequence of movements and motor control.

What Muscles & Movements Do You Need To Target?

Make sure you watch the video above or read our article The 3 Key Factors Needed For Optimal Shoulder Function

It is not so much the muscles you need to target, but more the movement patterns that engage these key muscles and becoming aware of your posture.

Most of you would have heard of the rotator cuff muscles being:

1. Supraspinatus
2. Infraspinatus
3. Teres minor
4. Subscapularis

These four muscles work together to externally rotate and internally rotate the shoulder but they are very important in keeping the humeral head stable and centered within the joint. If we lose that stability, we get some extra mobility of the humeral head within the joint, and that begins to pinch some of the structures around it. The weakness of the stabilizers forces greater activation of the prime mover muscles like the pecs, upper traps, rhomboids, and the lats. They will continue to work and become short and tight creating trigger points throughout the shoulder region until the real problem is addressed.

The other two key muscles are

1. Serratus Anterior
2. Lower Trapezius

These two muscles play a pivotal role in keeping the scapula attached to to the thorax and in optimal alignment. And also providing the upward rotation and posterior tilt needed for optimal stability. Without these muscles firing together correctly, your body will find another way and this is when postural adaptions occur such as the winging of the scapula, stiffness, trigger points and ultimately pain will surface at the end. Of all the shoulder problems we see you will find the serratus anterior is a massive contributor to the winged scapula. If you find a way to engage this muscle in movement patterns and eventually strengthen it you will be able to effectively get rid of this problem for good!

You can read more about this in the article Why Serratus Anterior Is So Important To The Shoulder

In Even Oscar's book "Corrective Exercise Solutions For Common Shoulder & Hip Injuries" , a must read, he provides a table of what happens when stability muscles are inhibited.

If you are not 100% with anatomy this might be a bit confusing but this shows how the stabilizer muscles to the left that are labelled as inhibited, will recruit the larger more powerful muscles who are not able to provide stability of the joint. This leads to instability and where all the problems lie.

So to help you out here is the Top 5 Exercises we might use. I use the word "might" for there really is no one size fits all approach. You have to assess all the possible factors and judge each person as though you have never seen them before. While the exercises I am about to provide you are usually great in some cases there might be better choices.

If you are dealing with a shoulder injury right now I highly suggest getting a copy of our latest report "Step By Step Guide To Getting Rid Of Shoulder Pain" by clicking here or the image below.

Before we get straight into the exercises I did mention that the use of trigger point release and even some simple stretches will be needed. Even though they will not solve the problem on their own you will need to do this FIRST, before trying any of the following exercises in order to "shut down" the hypertonic and overworking muscles driving the dysfunctional stability. Using these simple muscle release techniques might be enough to remove the pain, but be very clear that you have not actually done anything about your problem yet.

You MUST follow these muscle release methods up straight away with stability exercises.

Below is some videos of how to do this. I suggest you do all of these before trying each exercise and in between sets to prevent the tonic muscles from coming back and creating dysfunction.

Trigger Point Release

I like to use several different tools for doing this. A foam roller, spikey ball and a small tool called Pocket Physio or muscle mate. You can get these from AOK Health or Lockeroom Sports. Below are videos of how to release trigger points in two of the most common areas we see with winged scapula or shoulder instability. These muscles must be shut down using this process before trying to strengthen and move. A quick note of caution, this will be quite painful so take your time.

Pec Minor Release & Thoracic Mobility

The Pec Minor is a massive problem and you absolutely must shut this muscle down if the following exercises are to stand a chance of restoring function. The pec minor dominates over the small stabilizers and pulls the shoulder into internal rotation and consequently disrupts the timing and placement of the scapula. In addition to this, the thoracic region is one where we see people adopt a hunched posture (known as kyphosis) and just like the pec dominance leaving this unattended will make it near impossible to complete the following exercises effectively.

1: Wall Slides

This is a great way to learn how to retrain the stability and control of the scapula. The video on the right is standard version I use and the video on the right shows a regression for those who have too much pain or discomfort trying to lift their arms overhead.

1. Start with your arms against the wall as if in a plank position standing up.
2. Position your arms so that you are in a V angle. This encourages greater activation of the lower trapezius muscle.
3. Position your scapula in perfect alignment and begin to slowly slide your arms up the wall
4. The key to this exercise is to feel your scapula wrap around you as your arms lift up without losing your posture and posterior tilt of the scapula.
5. You may feel you need to step into the wall as your arms slide up which is fine
6. Lastly, make sure you can control the movement on the way back down as this is where most people will lose form.
7. Repeat and perform 6-10 reps

2: Single Arm Stability Drills

This test is quite difficult to do and integrates the entire body with a huge emphasis on shoulder stability. Mobility and stability of the shoulder are maximally challenged along with the stability of the trunk and core. This may be too painful for most with shoulder pain, so if it hurts leave it out until your pain has subsided. However, this can be a great test to use when you are not in much pain and want to know if your shoulder is ready to complete functional exercises or activities without aggravating your joint and going backwards.

3: Push Ups

Push-ups are arguably the best exercise for strengthening the serratus anterior and getting rid of a winged scapula. As long as your technique is of high quality! If you can manage to get these right you are well on the way to being strong and stable forever. There are several versions of push-ups I might like to use. Below I have provided you with a video of a few versions to try, however, I encourage you to read our detailed article with more versions here Why Push Ups Are The Best Upper Body Exercise

4: Upper Trapezius Activation

This is a very misunderstood part of shoulder rehabilitation and many people are constantly trying to weaken the upper traps. When in reality the upper traps are overstretched and need to be strengthened, especially with the person suffering with a winged scapula. Unfortunately it can be very difficult to strengthen this area without creating all types of trigger points and stiffness. One way to overcome this is using the Yoga Push-up shown below on the left. This is an excellent way to encourage thoracic extension, shoulder stability, and upward rotation of the scapula without needing to move your arms. Because it is a closed chain exercise it provides greater stability for the shoulder allowing more control and improved mobility at the thorax and often becomes a favourite exercise for people with neck pain.

As they improve you gradually progress to a slightly harder movement where we use open chain exercises to specifically target the upper trapezius. Arguably my favourite exercise for achieving this are shown below on the right.

5: Turkish Get Up

Last but not least is the Turkish get up. It could be argued that this is more of a mobility challenge for some or a strength exercise for others. It is one of those very unique exercises in that it is all of them! This really puts all of the pieces of the puzzle together in one exercise with stability being the biggest requirement for completing the exercise which is why it is the ultimate shoulder stability movement.

To give you an idea of just how good this is here is a list of the benefits:

1. Greatly improves shoulder stability and thoracic mobility at the same time!
2. Improves overall body stability and integration between upper and lower body
3. Promotes reflexive stability of the torso
4. Encourages great mobility of the hips and thoracic spine, the two areas most people are lacking
5. Improves the body's ability to coordinate and enhance balance from lying to standing
6. Develops upper body strength, trunks strength, and glute strength

You can read more about this awesome exercise and all of the things it can do in the article Why The Turkish Get Up Is The Ultimate Exercise

Once you have completed all of these exercises, you have no pain and you can confidently say you know how to correct your postural faults you are ready for strength training. You must evolve to this stage for this is where you can strengthen these muscles to hold their positions more comfortably and be able to stand up to the pressures of daily activities. This is where you can move towards much more weighted exercises and begin to put the movements like pulling actions and even leg movements using the entire body together. A very important stage in finishing the job.

Again you will find more on how to do that in our special Shoulder Pain Report.

Conclusion

I hope this article gives you some better insight into the causes and treatment of shoulder dysfunction like a winged scapula. As I said at the beginning the exercises and information I have shown here is relevant to all shoulder injuries and pain for the problems encountered in all of them are 95% of the time due to instability and inhibition of small rotator cuff muscles, serratus anterior and the lower trapezius. By using specific drills to reprogram these muscles into movements of everyday life is how to get your function back without pain and restriction.

There are some great PDF Reports you can get below by clicking on the image of the book you require. The Functional Training report is FREE!

For more ideas and information on specific topics I may not have covered in detail be sure to check out our INDEX PAGE on the website that has over 300 of our best articles. These are all sorted into categories for quick reference so you can find what you are after more easily. You can also subscribe to our FREE fortnightly newsletter by clicking here.

If you live in Melbourne and need specific help with your exercise program please feel free to reach out to me for help and we can set you up with your individualised program.

About The Author

Nick Jack is owner of No Regrets Personal Training and has over 15 years’ experience as a qualified Personal Trainer, Level 2 Rehabilitation trainer, CHEK practitioner, and Level 2 Sports conditioning Coach. Based in Melbourne Australia he specialises in providing solutions to injury and health problems for people of all ages using the latest methods of assessing movement and corrective exercise. He has worked with professional athletes in Golf, Tennis, Basketball and Football but is known throughout the local community more for his work with injury prevention and rehabilitation.  Having participated at high level in many sports himself and also recovering from several serious injuries he has spent considerable time developing detailed assessments and programs to cater for injury and pain.

References

• Movement - By Gray Cook
• Shoulder & Scapula Injuries in Athletes - By Chris Mallac
• Corrective Exercise Solutions for the Hip & Shoulder - by Evan Osar
• Diagnosis & Treatment Of Movement Impairment Syndromes - By Shirley Sahrman
• Fixing Shoulder & Elbow Pain - By Rick Olderman
• Low Back Disorders - by Stuart McGill
• Back Pain Mechanic – by Stuart McGill
• Anatomy Trains - by Thomas Meyers
• Motor Learning and Performance - By Richard A Schmidt and Timothy D Lee
• Assessment & Treatment Of Muscle Imbalance - By Vladimir Janda
• Scientific Core Conditioning Correspondence Course - By Paul Chek
• Scientific Back Training – By Paul Chek