Scapular Dyskinesis | Winging (Myths Busted | Evidence Based)

[@E3Rehab]

Thank you so much for watching! Learn more by reading our blog here: e3rehab.com/blog/scapulardyskinesis

[@eliasacheampong5830]

Can it really be fixed?

[@rasagaul9109]

@@eliasacheampong5830 yo did u ever figure anything out idk if I have a weird case or not but I can't pick my arm up without my collar bone popping out

[@eliasacheampong5830]

@@rasagaul9109 it doesn’t really work.some times one leg is just longer than the other. No amount of exercise can fix that sadly.

[@rasagaul9109]

@@eliasacheampong5830 do u know if it's approved by disability

[@rasagaul9109]

@@eliasacheampong5830 it's set off a chain reaction thru my body my muscles in my chest somewhere has weaken where my rib cage pushes out on the left side

[@C69hJc4]

Finally! A science-based PT who knows how to interpret research and is not blinded by their obsession with postural and biomechanical causes of pain. We need so many more of you. A very well-balanced and grounded video with solid critical thinking md practical takeaways. Thank you 😊!

[@agisilaos684]

I am amazed of how thorough this video is, especially in putting focus on the literature. Great, keep it up!!

[@E3Rehab]

Thank you!

[@igotkiwi]

As an Evidence Based Practitioner in physical therapy, I can say that this video is an excellent assessment of the current scientific litterature. Very well explained. Great job, guys.

[@E3Rehab]

Thank you so much!

[@zachforbes3901]

If you're a physical therapist I hope you know this video is wrong lol, this problem leads to injury regularly, and it led me to a problem

[@danteghazizadeh1656]

⁠​⁠@@zachforbes3901yeah. I kind of get where the videos coming from, because for a lot of people(especially untrained), mild scapular winging is just something aesthetic. But for a lot of people like you and me, we noticed it because it was causing problems for us. You can’t really tell people who are suffering from scapular winging that it’s not a problem.

[@stephaniesealy9375]

Loving this channel! Clear, knowledgeable and well researched with sources available. As a clinician, I say that I am a practising clinician because no matter how long I've worked in this field, I am still learning! I also appreciate how the upload is split including exercise rehab! Keep uploading.... always good to see alternative investigation and solutions. Thank you for sharing your knowledge and experience!

[@karmenwilliams9084]

Glad you covered nerve involvement as a potential contributor to this condition. Good to clear the C/S during the exam of a shoulder dyskinesis

[@tylerasmith52]

You are the Jeff Neppard of PT. SOLID channel, as a new grad this is an amazing gem!

[@E3Rehab]

Thank you so much, Tyler. Hope the new grad life treats you well!

[@johnphillips4017]

This is by far the best and most professional I've seen and heard in the 6 + months since undergoing right shoulder neck artery surgery. Very in depth.Pay attention people,he does one hell of a job! John phillips

[@kaitlinkrumnauer9777]

I think it's important to note that in rare cases if the winging is accompanied by shoulder weakness (ie inability to lift arms above shoulder level without bending and twisting, ect), it can be a sign of fascioscapulohumeral muscular dystrophy

[@lizblake4802]

Thank you so much for mentioning this as a possible cause.....nobody ever does!! I suffer from this condition (diagnosed when I was 56, I'm now 62). Although the FSHD primarily affects my left shoulder (and right leg), I have pronounced scapular winging on both sides, luckily without pain so far!!

[@SweetOsoka]

​@@lizblake4802same problem with same arm

[@SweetOsoka]

May be my issue!

[@monnoo8221]

this is by far the best, though not complete, discussion of that subject. I appreciate the references. What is missing a little bit is a mention of the influence of anatomy and posture. For instance tall people with low to normal muscle mass proportion may have more likely a thoracical spine that is too straight. The scapula then does not fit vey well to the rb cage. That requires special attention regarding mobility (flex+strength). Of course t is clea to me that the shoulder stories are very complex and have ramifications on all adjacent areas

[@deborahschwartz2607]

Scapular winging is a classic sign of Facioscapulahumeral muscular dystrophy (FSHD) aka as Landouzy-Dejerine Syndrome. Winging scapulae & inability to raise arms more than shoulder height or direct overhead arm raising is most likely FSHD. Best practise would be to refer your client to a neurologist for confirmation.

[@Zephromonia]

Brilliant video. Thanks for making these, highest quality on youtube.

[@monnoo8221]

thank you for this transparency. the main parameter however has been neglected by them all: the curvature of the thoracic spine. Look at the portraits @4:25. If the thoracic is more straight, less curved, the scapula will not be able to attach that easily. There are a range of implications of such a condition, of course, one being that the respective muscle weaken etc etc.

[@sportingfemalelegends]

Best video on the topic ive seen.

[@novicetheaf]

Thanks for doing this video, my own physio gave me very little information, but this has cleared my questions up and is great help 👍

[@portableaccount9818]

Wait... So there is no way to solve the problems from an aesthetic point of view? Because I don't have any sorts of pain, but I hate the way my winged scapula looks, so that's my goal. But if the exercise manage to improve mobility & pain without changing the position of the scapula... then it's all pointless if my goal is aesthetic

[@ajax1472]

Same shit man, when I can't even wear t shirts anymore

[@Adude461]

So im not alone, my shoulder blades stick out each time i put my hands behind my back, ive had them for quite a long time and i have no pain

[@manuelfleri88]

I by no means want to give kind of medical advices as I'm no doctor in this field, but I've heard people say that training your serratus anterior should "fix" the winging, I believe also on the aesthetic point of view, also strenghtening lower traps and the rotator cuff should help as well as they all work together during the scapulohumeral movement or any way it is called, try and research a bit you'll sure find something

[@stroudsportsmassageinjuryr3860]

Thank you very much. I’m training over here in the UK as a sports therapist and this evidenced based discussion combined with your rehab knowledge is invaluable. As a rock climber I’ve been very interested in the shoulder girdle and scapular diskenisis. I’ve read a few articles referring to scapula angles found in the rock climbing population as an adaptation to the sport, it’s fascinating to hear of more evidence on the subject regarding other over head athletes. Once again thanks, I look forward to learning more from you.

[@E3Rehab]

Glad it was helpful!

[@Strength_Shield_PT]

Man, this is incredibly helpful & always well done by y'all at E3. I have benefited as a clinician so much from you guys - thank you!

[@momohkakulatombo-misoi126]

So important! Videos like these please algorithms!!! 🙂💛

[@michellemontgomery2354]

Thank you so much for your researched and unbiased video. Great explanation based on facts. Also good to learn that its not necessary to be fearful of slight dyskinesia :-) I look forward to following you and seeing more of your great videos!!

[@reigaterobot4965]

Im 46 and the bottom part of my shoulder blades have always stuck out (since as a child), its never caused me pain or discomfort apart from when leaning my upper back against anything. I have no ROM issues, impingements, difficulty in pushing or pulling, I can comfortably bench about 180. The reason I want to fix it is purely aesthetic. I long to have a flat muscular back :(

[@moonlight-hm4bh]

I'm 18 and also don't like the way it looks in me, I'm trying to put on some muscle in the back, specially trapezium to see if it helps

[@danielrgoldman341]

Im 23 and this problem ive notice since i was 19 y.o when ive done working out and put my tshirt on, my right shoulder doesnt look even to my left shoulder. And its sometimes uncomfortable when i lay my back on a flat surface, it has this odd bump on my right side scapula. Ive tried many exercise recomendation from youtube and it doesnt make any better. Im planning to go on therapist

[@VedantPednekar04]

@@danielrgoldman341 any update?

[@DSweashox]

Professionally presented, thank you for your explanations !

[@E3Rehab]

Thank you!

[@veerakarthikeya4534]

B3st vid so far on Scalpular winging, all other vids make me soo confused, this one is cool straight to the point

[@E3Rehab]

Glad to hear!

[@elenipsh]

Amazing video with clear sound, nice structure, very good job guys!

[@lolzroflcopterzzz]

I'm currently studying to become a physiotherapist at a university in Sweden, and it's so frustrating to realize that a majority of our curriculum is seriously flawed and outdated. Just a few months ago we were seriously taught that a "normal and healthy" scapulohumeral rhythm should consist of a 2:1 ratio, and anything else should be rehabilitated with highly specific motor control exercises. They also taught us about the upper crossed syndrome and the biomechanical model of shoulder impingement (i.e. tissues being pinched). What is the appropriate way to deal with all this without losing your mind?

[@SabaJabba1]

Graduated last year and had a similar situation with an outdated and frustrating curriculum. I found that the lecturers didn't mind being challenged on what they were teaching, they often agreed with me and it seemed they didn't entirely believed in the curriculum. I think a lot of the time they are teaching you what you need to get through the exams, not up to date theory and research. Be critical and challenge!

[@E3Rehab]

I think you just have to figure out what you can glean from the information while being skeptical and open-minded yourself. We all had similar educations to what you describe, but understanding the very traditional biomedical approach and outdated beliefs helps us better understand others' perspectives so we can create these videos.

[@tc-3]

Thank you for such detailed explanation. Great video! I've been dealing with a "winging" scapula for a while and what reassured me that my efforts in "fixing" it were/are not in vain is how you mentioned that symptoms can subside without the change in the appearance of the scapula. Mine is still pointy, frustrates the hell out of me when sitting on chairs with hard back rests and looks bad, but I can finally do some push-up and OHP progressions.

[@maryanderson8746]

Thank you. Great video, it made me less worried about my self diagnosed winged scapula. I’m going to PT for postural, cervical arthritis, upper back pain and perhaps I won’t put the idea in her head that I have winged scapula.

[@alexanderarena3134]

Love this video. Thank you so much for sharing in digestible bits.

[@mcpartridgeboy]

4:27 sorry im doing my pilates teaching exam and need to recognise winged scapulars !

[@youtuber261]

Out of interest, are there any before and after videos where someone has actually made progress and fixed their winged scapula? There is so much content out there explaining what people “should” do in terms of exercises but not one video displaying clear results.

[@KingRockets]

Awesome content! Can you make a video on uneven shoulders? Why is one shoulder higher (and more developed) than the other? Thanks!

[@vickivonbergen8781]

Nice job. Love the references.

[@seaofglass77]

I study and teach classical ballet. While it doesn't cause pain, scapular winging is not acceptable as far as aesthetics. I've been battling the poor posture I had in my teens for the last 15 years and working to keep my students posture not only healthy but beautiful for our art form. This video was very valuable for my studies, thank you. It's good to know that while scapular winging will not cause me or my students pain, there are ways to fix it to improve our alignment, steps that require extraordinary balance, and aesthetics.

[@hiddenrealms9334]

Great effort, sir. That's deeply appreciated.

[@E3Rehab]

Thank you!

[@alfiebailey6165]

Brilliant video, so if your scapula winging isnt causing you pain then its best to just strengthen your scapula but not look for any visual changes because the idea of scapula disformity might just be normal for the individual ?

[@E3Rehab]

Yup!

[@alfiebailey6165]

@@E3Rehab thank you 👍

[@sahabe1883]

I've had this problem for ten years, which has caused me a lack of hands up, I've been treated a lot, but to no avail, for not providing medical resources in my country, I'm suffering a lot.

[@yungbambam5097]

Going on 2 years, such a miserable life it has been

[@pgaquigz1125]

I had Cervical disc surgery c6 c7 3 years ago and I have terrible scapular winging now. I never had it before my surgery. I’ve tried all the PT and exercises and it’s not getting better. I’m assuming it’s muscular atrophy / palsy. Can I get surgery to fix the scapular winging? Or to get it to not pop out?

[@SnakeC666]

Excellent review of this topic! Great job, thank you :)

[@E3Rehab]

Thank you! No problem!

[@Zadnt]

Aside from having a different scapulohumeral rhythm from person to person, what if there is an asymmetrical movement of the scapula in a single individual? Left to right variation of scapula movement resulting in imbalance in exercises ie. Pull ups, push ups. Should it be left alone if it were to not cause any discomfort/pain or should there be any form of rehab - relearning of the movement pattern?

[@E3Rehab]

Sorry if I didn't make that clear in the video. Asymptomatic individuals can have differences side to side as well. We're all a bit asymmetrical. If you have GLARING asymmetries in strength or range of motion side to side that aren't functional adaptations to a sport or activity you participate in, then they might be worth addressing. Otherwise, I wouldn't be too concerned. You could always just perform occasional unilateral movements through a large range of motion.

[@misscoccinell9659]

Thank you was looking for that question and reply! And also wouldn’t an even non painful winging scapula potentially facilitate other issues around the shoulder. My right one is winging and I got 2 shoulder impingements now on that side

[@misscoccinell9659]

Oops ignore the last questions just reached the 8min part where you talk about it. Thanks!

[@dominicrosario1980]

This is great video. Thanks for all guidance. This is soo helpful.

[@E3Rehab]

No problem! Thanks for watching!

[@bhavyasharma8356]

amazing,,, the information was really helpful :)

[@flagshipathletics8323]

You have the best videos!

[@KP-dd2ci]

Just like "slipped disc" issue...pretty much everyone has it...but not everyone with it has pain.

[@alexeymalafeev6167]

Dr Marc, a thought on this -- would it not make sense in most cases to follow a hypertrophy / strength / motor control program focusing on a variety of muscles around the scapula and shoulder to provide additional tissue and motor control for long term stability? I do think that while "normal" function is hard to define, having the requisite motor control and healthy tissue for variety of muscles around the mobile shoulder/scapula system is a benefit. Just because you can hypothetically server supraspinatus tendon or muscle and compensate for it via the trap/delt/infra/teres minor etc for variety of motions, it does not make for fully complete movement pattern. Having close to "normal" motor control and actual tissue for not just the scapula but the rotator cuff etc should likely yield preventative injury benefits. I wonder if there are good studies on this - I agree that just the observation of winging/not winging etc is likely not a great predictor.

[@ryanrodriguez-wright9216]

What correlation would scapular winging have with a possible labral tear?

[@aperture0]

what to do when my left scapula feels sort of restricted during lat pulldown?

[@yashveercheekoory4597]

do you think that a flat thoracic back would would cause the winging of the scapula...because as far as my serratus they are strong but i think i have a flat back. and how to correct a flat thoracic back. i think a minority of people have this problem because most people have a rounded back. but i am quite sure that i have a flat stiff thoracic back. could you help on how to fix it?

[@NicolasBideau]

Hey Mark, what would be the injury mechanism for the spinal accessory nerve (if we exclude surgery)? Thanks! 😉

[@thats_Mr_B]

Could I get more for shoulder stability and scapular training please

[@sammybee153]

Im a swimmer who specializes in the butterfly stroke and have a winging shoulder blade and it causes me pain when it pops in an out

[@mikeblair06]

Great video! I am a 15y/o track and field athlete and I have scapular winging on both shoulders and I’m not experiencing pain at all nor had any shoulder injuries. Is there like really a way to make my shoulder blades lie back down and not wing? If you respond thanks in advance!

[@rudygon426]

May just be how they sit

[@Mr_SamuelAdam]

I only have one shoulder that has the winging? And when trying to contract my lat on that side I can't. Feels like my shoulder can't squeeze my lat and I can volunteerlly "pop" my shoulder out of position. My right one has no issue.

[@MrYodaone902]

Is there any evidence that neck problems could cause scapular dyskensis?

[@masterwrestler1920]

Very detailed and helpful . Thank you.

[@kymmie245]

Love this info, but with my shoulder, I can't do any of these exercises right now, so what can I do to get basic movement back

[@julesbruchez-theartofgrapp9646]

My problem is doing any of the movements without hiking up my shoulders. I can any exercise no problem I just do them wrong

[@tristanwegner]

If it does not correlate with pain, does not predict injury, and might even be adaptive for certain overhead athletes, I say we rename it from the wrong Dyskinesis to a norm variant.

[@jamaln9056]

Are there any exercises you'd recommend for lateral scapula winging?

[@TheAmity]

As an ordinary person who has a good knowledge of anatomy (but not with its technical terms) I desperately tried hard to understand/follow the conversation. I only time I didn't get lost was when the secondary person showed the exercise at the same time of listening to unfamiliar medical terms.

[@alfonsocantor1058]

Punching with my right arm elicit pain in serratus and its endurance is minimal compared to my left arm. I have higher right shoulder as well. It thought its scapular winging but based on this its probably not

[@amadakram5722]

can you workout while undergoing therepy? keep in mind that I usually train till muscular faliure.

[@muhammadiqbal5918]

I have grade II scapular winging.. Sever pain when lying on bed and waking up in the morning.. What will be the 1st exercise option for me??

[@austinkittrell1538]

Does your shoulder impingement program address impingement that could be associated with scapular winging?

[@E3Rehab]

No. The program begins by discussing why "shoulder impingement" isn't really a valid or helpful diagnosis before going into long-term management planning via structured programming and education.

[@nazmakhatun2164]

Very high quality video

[@E3Rehab]

Thank you!

[@tdkimbrell]

Great video E3. Love the message towards the end: determine your current capacity, your end goal, and slowly bridge the gap. Better than gold advice, keep it up y’all 🤙

[@E3Rehab]

Thank you!

[@azadsinghkhalsa6912]

I have scapular winging. Its so bad on right side i cannot even lift my arm over the shoulder and when i do this causes so much pain in lower back.

[@eshwarjadhav1568]

I aslo have shoulder pain ,my pain is from shoulder blade to forarm in night ,and my shoulder is left one in normal position and right one in downward position ,why is it so ,what treament should i do

[@Dudeeeee87]

Thanks for sharing the knowledge! :)

[@E3Rehab]

Thanks for watching!

[@HendersonHinchfinch]

What is different about a baseball pitchers shoulder?

[@absolutelyanaia]

i have scapular winging much like the thumbnail picture, is there a way to get it fully back to normal, if so what exercises should I be doing and how often? I'm also a gym junkie so are there any workouts I should be avoiding that could prevent me from fixing my scapula? Thanks!

[@stopthecap4317]

You developed the winged scapula or always had it? The video says that it's not necessary to try and "fix" it to "normal" since normal varies greatly, and it most likely isn't the cause of any pains you're having or likely to contribute to future injury.

[@kshunter5182]

i have scapular diskynesis , i feel a bit of pain in my scapula when i overuse my hand ,it makes cracking sounds , lost strength also . well i want to know if i can train in the gym ? and if so ? should i be able to heavyweight or should just stay with little/middle weights ?

[@RamanSingh-sq3gz]

You can train heavy weights

[@jblanla]

Should pec exercises be avoided during recovery??

[@CleanTrickz]

Would you want to try and change scapulohumeral rhythm if scapular dyskinesia was present unilaterally?

[@E3Rehab]

The current research would suggest not.

[@krstfxd]

How long do I need to do these till I see improvement?

[@1212alen]

have you experienced any improvement?

[@krstfxd]

@@1212alen I stopped doing these after like 2 weeks and didn't notice anything. But I started to go to the gym last october and my wings look smaller, so I guess I'm doing something right. (:

[@1212alen]

@@krstfxd nice, good to hear. Do you do body weight or mostly use machines and dumbells for exercise?

[@krstfxd]

@@1212alen Mostly machines, sometimes dumbells.

[@jayfoolish]

Request for the Scapular Snapping Syndrome

[@leninha-carioca]

Very good. Thank you.

[@waleedali1076]

I have wing scapular right shoulder Where is your clinic or can connect to me plz

[@karthik_silkroads]

scapular wall slides for serratus anterior?

[@SuperVigilante007]

Do you lock your arms out while training the serratus?

[@danteghazizadeh1656]

Yeah

[@sorencolfax381]

When I’m lifting there’s only pain because my shoulder blade digs into the bench I’m using. It is the motion that is the problem

[@geekygirl648]

How long winging scapula recovered?

[@MrEyadashraf]

GREAT VIDEO GJ

[@E3Rehab]

Thank you!

[@mohityadav24121]

how much tike it takes to recover ?

[@gymfreak659]

True gold❤

[@emiledin2183]

Thanks for providing in detail the studies regarding scapular dyskinesis. I am however very confused about those findings. Firstly, the studies regarding the elite athletes, could those results really be applicable to normal populations? Secondly, we know that inadequate room in the shoulder joint causes wear and tear and pain. Also was it only pain in the shoulder joint or was tightness around it or pain down the arm included? Upper cross syndrome can cause these symptoms, which is scapular dyskinesia (inferior and superior dysfunction). Also most shoulder symptoms are from scapular dyskinesia, but most people with scapular dyskinesia are asymptimatic. The literature is clear on this. Same with knee problems. A lot of people have damaged knees (cartilage damage, ligament tears, meniscus damage) yet are asymptomatic, but most of those who have knee pain, are due to these injuries. Thanks!

[@E3Rehab]

The purpose is to illustrate that their is no "normal." Normal has often been based on a single subject from 1944 and blown way out of proportion. To your second point about inadequate room in the shoulder joint causing wearing and tear and pain - I disagree. The physio profession is slowly moving away from this shoulder impingement model because it hasn't held up well in the research. Upper crossed syndrome is also poorly defined and not validated. Not trying to be rude or confrontational, but honest (and quick) based on my understanding of the literature. No problem if we disagree, though! Thank you for sharing your thoughts and concerns.

[@coreythompson5213]

A big missing point here is pec minor release pushups shorten the pec minor

[@coreythompson5213]

prone movements can stretch the minor though...

[@Johndoe-nb5cw]

Is winging normal when reaching behind the back?

[@aks4752]

Benifits of winging for pitchers?

[@sunminkim299]

great video! helped me a lot

[@E3Rehab]

Glad to hear it!

[@rahebothprayerhousedarimad1874]

How many days cure sir

[@khudabakhs2786]

Is it safe to do workout with scapular dyakinesis? 🙄

[@albeltcastillosegura]

I do. But it hurts

[@centaur188]

is this what causes frozen shoulder?

[@E3Rehab]

No. We have a video on that topic, though.

[@asifalam6794]

Great video Dr. Marc. So I winged my left scapula 17 days ago while doing pike push ups. Now, I'm facing weakness while trying to lift my left arm in front of me and above my head. I am missing that 60 degrees of motion, as you mentioned in the video, provided by the scapula while trying to lift my left arm over head. I have no pain only weakness, I also did a NCV test which says "All nerves are intact around left scapula region, i.e. long thoracic, suprascapular and dorsal scapular nerves. There is no nerve injury or any brachial plexopathy ". I feel that my protraction power is really low, when I try to do the push up plus the left scapula just sticks out and I can't really do the exercise. What should I do now? I would highly appreciate your thoughts on the matter. Sorry for the wall of text.

[@peab9179]

thank you

[@fhgbfpapillon769]

thanks🌺🌺🌺🌹🌹🌹⚘⚘⚘🌸🌸🌸🌻🌻🌻

[@mikewest2402]

for me it is nerve damage from c6 c7 area

[@dark_seid_29]

Do you have numbness?

[@WEF2030SLAVE]

Wow thank you.

[@E3Rehab]

No problem!

[@dineshkumarn9078]

Can i do push ups with this problem

[@stefanangelo5149]

how it is possibly that you know so much and all orthopedic docotors i go look like the have no idea from the body would need you see me and tell me whats wrong after all that injuries i am in mexico yucatan if you want a short vacation hahahahaha :) much love thanks for the videos

[@jb123abc]

I'm skinny af & the bones sticking out dont help I feel nasty will surgery fix my weird looking back ???