Scapular Winging Test

 Scapular Winging Test

What is Scapular Winging?

Scapular Winging is a clinical syndrome that is caused by a loss of the normal scapular stability that make the inferior border of scapula moves medially or laterally.

Medial Scapular Winging is seen in:

  1. Serratus anterior muscle  weakness.
  2. Long thoracic nerve dysfunction.

While Lateral Scapular Winging is seen in:

  1. Trapezius muscle weakness.
  2. Spinal accessory nerve (CN XI) dysfunction.

The Long thoracic nerve can get directly injured during thoracic surgery (first rib resection, introduction of chest drain etc.) or in case of direct trauma of the chest wall. Indirect injury can happen when the arm is overstretched in elevation. When there is no injury in the history, virus infection may be the reason of the nerve lesion

How would you test for winging of scapula?

Scapular Winging test
Scapular Winging Test

What does a positive Scapular Winging Test mean?

Related Anatomy

Scapula:

Long thoracic Nerve:

Serratus anterior Muscle:

Trapezius Muscle

This muscle traditionally is divided into middle, upper, and lower parts, according to anatomy and function:

  1. The middle part originates from C7 and forms the cervicothoracic part of the muscle.
  2. The lower part, attaching to the apex of the scapular spine, is relatively thin.
  3. The upper part is very thin, and yet it has the most mechanical and clinical importance to the cervical spine.

Scapular Winging Syndrome

This syndrome is characterized by an inability to elevate and/ or lower the arm without the scapula winging or its inferior angle tilting. This syndrome results from a weakness and adaptive shortness of the serratus anterior, with accompanying shortness of the pectoralis minor and scapulohumeral muscles.

Intervention should focus on stretching the pectoralis minor to correct the tilting and serratus anterior for strengthening and retraining.

Reference


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