Have you noticed one of your shoulder blades sticking out more than the other? Or maybe your shoulder feels weak, unstable, or just… off? You may be experiencing a condition known as scapular winging, and if left untreated, it can result in pain, loss of function, and reduced shoulder range of motion.

Most people don’t realize how important proper shoulder blade function is—until it starts affecting their ability to lift, carry, or even sleep comfortably. As chiropractors, we see scapular winging more often than you might think, and the good news is: it’s often treatable with the right combination of care, rehab, and body awareness.

In this post, I’ll explain what scapular winging is, what causes it, and most importantly, what you can do about it. Whether you’re a weekend warrior, a desk worker, or somewhere in between, this information can make a huge difference in how your shoulders feel and function.

What Is Scapular Winging?

Let’s start with the basics. Your scapula, or shoulder blade, plays a critical role in arm movement and stability. In a healthy shoulder, the scapula glides smoothly along the ribcage as your arm moves. But when certain muscles stop working properly or nerves get damaged, that smooth motion can get disrupted.

Scapular winging happens when the shoulder blade lifts away from the ribcage and visibly sticks out. It can look like a bird wing (hence the name), and it often leads to shoulder pain, weakness, and instability.

Common Signs of Scapular Winging:

1. One shoulder blade protrudes more than the other
2. Shoulder fatigue or pain during lifting or overhead activity
3. Weakness or limited range of motion
4. Numbness, tingling, or nerve-like symptoms down the arm
5. Poor posture or upper back tightness

Common Causes of Scapular Winging

There are a few different causes of scapular winging, and understanding which one applies to
you is key to fixing it.

1. Muscle Weakness or Imbalance: The most common cause we see is weakness in the serratus anterior or trapezius muscles, which are responsible for holding the scapula flat against the ribcage. When these muscles become weak or inhibited, often from poor posture, lack of use, or previous injury, the scapula can drift out of position.
2. Nerve Injury: Sometimes, the problem isn’t the muscle itself; it’s the nerve that tells the muscle what to do. The long thoracic nerve, which innervates the serratus anterior, can get injured through:
   • Repetitive overhead motions (common in sports or lifting)
   • Direct trauma (like a fall or accident)
   • Surgical complications or certain medical conditions
3. Shoulder or Neck Dysfunction: We often find scapular winging in patients with underlying cervical spine (neck) or shoulder joint issues. If the biomechanics of the neck or upper back are off, even slightly, it can cause the muscles around the shoulder blade to compensate, leading to instability and winging.

Misconceptions About Shoulder Blade Pain

Let’s clear up a few common myths we hear in the office:

1. “It’s just bad posture.”
   Posture plays a role, but scapular winging is more than just slouching. It’s often a deeper issue with neuromuscular control and stability that won’t go away just by “sitting up straighter.”
2. “You just need to stretch more.”
   Actually, stretching can sometimes make it worse, especially if you’re stretching already-weak muscles. The key is targeted strengthening and retraining of the right muscles, not just general flexibility.
3. “Surgery is the only fix.”
   Surgery is rarely needed and usually reserved for severe nerve injuries. In most cases, conservative care, including chiropractic adjustments, dry needling, soft tissue therapy, and rehab, is highly effective.

What You Can Do About It

The good news? With the right care, most cases of scapular winging improve significantly, often
without surgery or long-term medications. Here’s how we help in our clinic:

1. Chiropractic Adjustments: We start by assessing the spine and ribcage. If the joints in the neck or upper back aren’t moving properly, they can disrupt the nerve signals and muscle coordination needed for shoulder stability. Gentle, specific adjustments help restore motion and function.
2. Soft Tissue Therapy: We use myofascial release, Graston, and other manual therapies to release tight, overworked muscles (like the pec minor or upper traps) and activate underused ones. This helps reset the balance around the shoulder blade.
3. Dry Needling: One of the most effective tools we use, especially when there’s deep muscle tension or nerve involvement, is dry needling. By inserting very thin, sterile needles into trigger points or tight bands within the muscle, we can:
   • Decrease muscle spasms and irritation
   • Improve blood flow and healing
   • Reactivate underperforming muscles like the serratus anterior
   • Help “reset” the neuromuscular connection around the scapula
     • Patients often report relief from tightness or improved muscle activation after dry needling sessions. It’s especially helpful when scapular winging is related to compensation patterns or chronic tightness.
4. Rehabilitation Exercises: You’ll learn specific, progressive exercises to retrain the scapular stabilizers, especially the serratus anterior, rhomboids, and lower traps. Some favorites include:
   • Wall slides
   • Scapular push-ups
   • Resistance band rows with scapular retraction
   • Serratus punches
5. Postural and Ergonomic Coaching: We’ll look at how you sit, stand, sleep, and move during the day. Small changes in posture and habits can make a big difference over time. Whether it’s adjusting your desk setup or modifying your workouts, we tailor it to your life.

Real-Life Example: Jason’s Journey to Recovery

Jason, a 36-year-old personal trainer, came to us with nagging shoulder pain and a noticeable “wing” on his right side. He had trouble doing push-ups, overhead presses, and even reaching into his car’s back seat.

After a detailed exam, we found long thoracic nerve irritation likely caused by overuse and poor mechanics during workouts. We started with chiropractic adjustments to improve thoracic mobility, followed by soft tissue work on his pecs and upper back.

Then came the rehab. Within a few weeks of consistent serratus and trap-focused exercises, Jason noticed better control and less pain. After two months, his winging had nearly disappeared, and he was back to lifting—stronger and smarter than before.

The Bottom Line: You Don’t Have to Live With Scapular Winging

Scapular winging might sound intimidating, but it’s often a solvable problem. The key is identifying the root cause, addressing it with the right blend of chiropractic care and rehab, and giving your body time to relearn how to move properly.

If your shoulder blades don’t feel quite right, or you’ve been told your posture or strength is off, don’t ignore it. The earlier you catch it, the easier it is to treat.

Ready to Get Your Shoulders Back on Track?

If you’re noticing symptoms of scapular winging, or any kind of shoulder pain, we’re here to help. Our team specializes in finding the root cause and creating personalized plans that work for your body and your goals.

Call us today or schedule your appointment online to start moving better, feeling stronger, and living pain-free.

Content Provided by Chloe Goodwin