The scapula or shoulder blade is a triangular-shaped bone surrounded by muscles that work together to help your shoulder move and function normally.
Usually, the scapula rests flat against the back however, in individuals with scapular dyskinesia, also known as scapular dyskinesis or scapular winging, the scapula sticks out like wings.
Scapular dyskinesia is the abnormal or altered movement of the scapular. It is a rare condition that can affect movement, range of motion, and daily activities.
The scapula and surrounding muscles are responsible for the following movements:
Downward and upward rotations
Anterior and posterior rotations
Internal and external rotations
Individuals with scapular dyskinesia have an altered or abnormal range of motion for the movements mentioned above.
What causes scapular dyskinesia?
The causes of scapular dyskinesia may vary depending on the type of scapular dyskinesia, but general causes include:
Muscle weakness or imbalance: weakness in the upper back muscles such as the trapezoid, scapular muscle, and serratus anterior can contribute to scapular dyskinesia. Imbalanced muscles can also cause scapular dyskinesia.
Nerve injury: injury to the nerves that control the back muscles can cause scapular dyskinesia. Nerve injuries can be the result of surgery, illnesses, medication, and blunt force trauma.
Reduced or loss of flexibility: this can cause your muscles to become imbalanced which in turn leads to scapular dyskinesia.
Joint damage: damage to your shoulder joint— where the humerus head sits in the glenoid cavity, can also cause scapular dyskinesia.
What are the symptoms of scapular dyskinesia?
Symptoms of scapular dyskinesia may vary between individuals but general symptoms include:
Pain, discomfort, or general tenderness around the shoulder blade during overhead movements.
Snapping or popping during shoulder movements.
Change in posture due to muscle weakness or imbalance.
Winged scapula or scapular that do not sit flat on the back, but rather, protrudes out like wings.
Displaced shoulder blades.
It is important to note that scapular dyskinesia can often occur in conjunction with other shoulder injuries such as shoulder dislocation, shoulder impingement, rotator cuff tears, etc.
If you notice any of the symptoms, make an appointment with an orthopaedic specialist to get an accurate diagnosis and treatment.
Dr Puah KL is our Senior Consultant Orthopaedic Surgeon at Artisan Sports & Orthopaedic Surgery. He used to serve the sports service of Singapore General Hospital - the highest volume trauma centre for orthopaedics in Singapore.
While some individuals with scapular dyskinesia are asymptomatic, meaning they do not experience any symptoms, others may experience symptoms such as pain, reduced range of motion, and displaced shoulder blades.
Who is at risk of scapular dyskinesia in Singapore?
Anyone can develop scapular dyskinesia in Singapore, but several factors increase your risk, these are:
Athletes: sports or hobbies such as swimming, gymnastics, volleyball, and baseball / softball, increase your risk of developing scapular dyskinesia.
Age: young and active individuals have a higher risk of developing scapular dyskinesia.
Gender: men are more prone to scapular dyskinesia than women.
Medical conditions: individuals with prior shoulder injuries or diseases such as rotator cuff disease, shoulder instability / dislocation, etc, are at an increased risk of scapular dyskinesia.
How is scapular dyskinesia diagnosed?
Some individuals with scapular dyskinesia may not show any symptoms, therefore, diagnosis may be tricky.
A number of tests and examinations are required for the proper diagnosis of scapular dyskinesia, such as:
Physical examination: be sure to share your medical history (e.g. history of shoulder injuries or diseases, medications, illnesses) so that your doctor can conduct a proper physical examination for accurate diagnosis.
Electromyography (EMG): checks for any damage or injury by testing the condition and health of your nerves and muscles.
What are the treatment options for scapular dyskinesia in Singapore?
Scapular dyskinesia can be treated in the following ways:
Physiotherapy:physiotherapy uses gentle and therapeutic exercises to help rebalance and strengthen your muscles.
Surgery: depending on the cause of scapular dyskinesia, different types of surgerycan be performed to help improve your mobility and function.
Frequently asked questions
Can scapular dyskinesia be fixed?
What muscles are weak in scapular dyskinesia?
How do you know if you have scapular dyskinesia?
Feeling aches and pains?
Book a consultation with us for a more comprehensive diagnosis and a personalised treatment plan best suited to your needs.