Can scalpular winging cause a muscle imbalance? My right shoulder has some scalpular winging and causes my shoulder to be able to stretch more… and recently I’ve seen that my right lat/ and back are becoming alot bigger than my left. I’ve tried dumbbells instead of a barbell to try and isolate but it doesnt seem to work. Any ideas?
[quote]bushidobadboy wrote:
LOL, I did read onedge’s posts and had a chuckle to myself, but then decided I couldn’t be bothered getting into a long debate, since all the recent typing/posting since my exams finished has brought my RSI back.
Suffice to say that there are different ‘grades’ of scap winging, ranging from complete paralysis of the serratus anterior via a long thoracic nerve palsy to minor weakness or easy fatigueability of the S. ant. or rhomboid muscle.
There are specific manual tests for it (look up ‘muscle testing of serratus anterior’) and specific exercises to cure it. However only the relatively minor forms of dysfunction can be exercised around.
Bushy[/quote]
No debate necessary. Pictures speak a thousand words. On this site we have Cressy, Thib, Waterbury and others. Combined they have thousands of clients, some come to them with Scapular Winging. I want to see one set of before and afters. I’ll be on this site for at least a few more years, this thread will still exist, there’s plenty of time boys, I’m patient.
To be clear, I’m not debating there can be dysfunction around the scapula. There absolutely can. I just don’t believe it leads to winging. I would not be surprised if the side that “wings” more is a little more vulnerable to dysfunction, as it may create more angular stress on the muscles.
Try this; get a mirror and press your scapula up against the corner of a wall. Press in such a way to mimic the pulling of the Rhomboid or S.A. You will see just how hard those muscles would have to be contracting to move the scapula into place. Keep in mind, normally, when your standing relaxed, those muscles are relaxed.
But, again, pictures end this debate.
No they don’t have the tools to correct minor scapular winging because minor scapular winging is just normal asymmetry. There’s nothing to correct. People are not perfectly symmetrical.
There’s plenty of ligaments in addition to musculature holding the scapula in place. Besides, the shape of the scapula bone its self can be slightly different from side to side.
You say those pictures are easy to find. Lets see them. I just did a quick look and only found before and after surgery. No before and after therapy.
Finally, I do have a winging scapula and have had dysfunction in the area. I still have scapular winging but the dysfunction has long been taken care of.
Push-ups are fine, but I would recommend push-ups on an unstable surface, such as:
- Medicine ball (under one hand and switch)
- Bosu Ball upside down and do push-ups
- Regular exercise ball
- If one side is worse it is good to stick the ball in a corner and make it a unilateral exercise. Just do an extra set on the weaker side.
Along with a good balanced routine to strengthen everything around your shoulder would be a good idea as well.
I have had winged scapula a couple times and it takes time to get them back to normal (I’m actually currently doing everything I just typed for shoulder impingement, but I also have winging scapula).
I have been getting better and highly recommend the unilateral push-ups on a ball. It is best to just follow a consistent program to help your problem.
[quote]bushidobadboy wrote:
No, minor scapular winging has nothing to do with symmetry or lack thereof. It is a condition in which (as I have described), the medial or inferomedial border of the scapula ‘breaks away’ from its anatomically correct position against the posterior ribcage.
It can do this in a normal resting position, or only under heavy load or under repeated load.
It is, to be precise, a dysfunction of the scapulothoracic joint.
You assert that “There’s plenty of ligaments in addition to musculature holding the scapula in place.” Please name them or provide links to anatomy sites that can, since I have never heard of them, and their purpose would be questionable in a pseudojoint that is as mobile as the scapulothoracic.
I assert that it is chiefly to do with strength (or lack thereof) and co-ordination of the muscles that control scapular retraction and depression, i.e. the S.Ant; Rhomboid major/minor; middle and inferior trapezius.
You are pretty far off base my friend. Please provide references for your theories on scapular winging. In the meantime, you might want to check out any good manual therapy book, to see what the worlds leading experts have to say on the matter.
Bushy[/quote]
A Google search of “Scapula Ligaments” yielded this site right off the bat; http://boneandspine.com/musculoskeletal-anatomy/anatomy-scapulamuscles-ligaments/
Are you seriously asking me to reference my self for my own theories?
I know what the worlds leading experts have to say. History is full of people who disagreed with “the worlds leading experts” and over time were proven to be right.
I understand you are in training to be a Chiropractor. I would assume you will be looking at a lot of backs over the next few years. I hope you will look closely at the healthy backs and note how often you see asymmetry from side to side.
This is not really a debate that one of us can win with words. You will need years to start seeing it my way and I will need convincing photos to see it your way.
Bushy, I don’t agree the burden of proof is on me. The fitness/rehab industry claims that this type of winging can be corrected via therapy yet there appears to be no photographic evidence, despite your claim that pictures are widely available. You are clearly correct; we are talking at cross purposes here. I keep asking for proof and you keep talking about experts and manuals but you don’t bring any facts with you or even anecdotal evidence. How about someone coming foreward any saying “yeah my scap used to wing, I did these exercises, now it doesn’t”.
Of course an idea can stand alone. That’s silly, and no it doesn’t have to be some outrageous claim that is clearly crazy. My idea stems from me trying to manually manipulate my left Scapula into a position matching the right side. From this it was clear it would take very strong contractions to accomplish such a task. Way beond what you described as “passive activity” or “active to some degree” or something to that effect.
From this experimentation I’ve concluded my left scapula is in it’s normal position. Regardless of the simplicity, this is stand alone work requiring no references. The only accompanying premise is that people are not perfectly symmetrical and this is widely known, not requiring references.
Symmetry aside, scapular winging is a movement impairment disorder. If it’s bad enough that it is causing issues, fix it. If not, then you may still want to work on it. “Minor” scapular winging can get worse, or it can get better, just like “major” scapular winging.
As far as it not being able to be corrected, you’re an idiot. Common knowledge doesn’t have to be referenced, and it’s common knowledge in the field of physical therapy that most scapular winging can be solved in a matter of weeks. People don’t bother proving what is common knowledge.
If you still aren’t convinced, pick up any physical therapy text book (I’d recommend Sahrmann’s Diagnosis and Treatment of Movement Impairment Disorders) and look for the case studies.
[quote]bushidobadboy wrote:
on edge wrote:
Bushy, I don’t agree the burden of proof is on me. The fitness/rehab industry claims that this type of winging can be corrected via therapy yet there appears to be no photographic evidence, despite your claim that pictures are widely available. You are clearly correct; we are talking at cross purposes here. I keep asking for proof and you keep talking about experts and manuals but you don’t bring any facts with you or even anecdotal evidence. How about someone coming foreward any saying “yeah my scap used to wing, I did these exercises, now it doesn’t”.
Of course an idea can stand alone. That’s silly, and no it doesn’t have to be some outrageous claim that is clearly crazy. My idea stems from me trying to manually manipulate my left Scapula into a position matching the right side. From this it was clear it would take very strong contractions to accomplish such a task. Way beond what you described as “passive activity” or “active to some degree” or something to that effect.
From this experimentation I’ve concluded my left scapula is in it’s normal position. Regardless of the simplicity, this is stand alone work requiring no references. The only accompanying premise is that people are not perfectly symmetrical and this is widely known, not requiring references.
So you come up with your own ‘unique’ idea, yet the burden of proof isn’t on you?
O brutha.
Bushy[/quote]
Tell what I could possibly do or say to persuade you? Do you expect me to pursue a PhD in Kinesiology and do my thesis on the scapula to collect my proof.
I’ve already acknowledged it will take years for you to see it my way. Hopefully the seed is planted and your mind is open enough that you will go forth looking at a lot of backs. Those with dysfunction around the scapula as well as those with no dysfunction. Take note if one group shows more winging than the other. Maybe you will find you were right all along, maybe you will see it my way. Either way, it’s not going to be settled here.
[quote]threewhitelights wrote:
As far as it not being able to be corrected, you’re an idiot. Common knowledge doesn’t have to be referenced, and it’s common knowledge in the field of physical therapy that most scapular winging can be solved in a matter of weeks. People don’t bother proving what is common knowledge.
If you still aren’t convinced, pick up any physical therapy text book (I’d recommend Sahrmann’s Diagnosis and Treatment of Movement Impairment Disorders) and look for the case studies. [/quote]
Are you seriously coming in here thumping a text book with out opening it up and presenting the information that shows I’m wrong. This has been covered.
BTW, I’m the one who taught you that common knowledge doesn’t need to be referenced. Remember, a long time ago, about one post up? Stay out of here with your weak shit.
On Edge is such an asshole. Stevko, take a before and after and shut that prick up.
Wow, you really like to fight, don’t you?
I’ve come in here with a different point of view based on my experience and you’re on the attack like I’m some kind of child molester. You must have some kind of intense need to be the final authority.
Since you love to fight so much here’s a summary of our exchange;
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I asked for photographic evidence, you couldn’t provide any despite your claim of wide availability.
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You claimed no Scapular Ligaments, I immediately provided a source naming the two major scapular Ligaments. I didn’t bother going into all the fine fascia that would also be involved. Who is accusing who of poor anatomical knowledge? Just to be clear, I claim no anatomical expertise.
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You claimed (and still do) that I need references in order to have a original idea. (Your running out of angles of attack, pal) This is all over an idea that is not so far fetched that it would require detailed research. It’s entirely plausible that therapist identifies scapular irregularities in a patient with pain in the region and incorrectly attributes the pain to the irregularity. It may very well be that most people wing on one side more than the other but no one pays attention if there is no pain. THIS IDEA IS NOT SUCH A BIG DEAL THAT YOU HAVE TO FUSS SO MUCH OVER IT. IT’S JUST A FRIGGIN IDEA I’M GETTING OUT THERE.
Oh yeah, I wasn’t inconsistent with my statement in the previous post, your comprehension is poor. No need to tell me you are a Chiropractor. I already stated in a previous post that I knew you to be in training to be a Chiro. Congratulations on graduating. Now start paying better attention.
[quote]on edge wrote:
Your comprehension is poor.
[/quote]
Then why can’t you comprehend that everyone that has ever taken a single class on the biomechanics of the shoulder understands something that you will need “years to see”.
Here’s your reference:
Orthopaedic Examination, Evaluation, and Intervention
By Mark Dutton
Page 433
Disorders of the Shoulder: Diagnosis & Management
By Joseph P. Iannotti, Gerald R. Williams
Page 1299
Those are the only 2 I brought with me to Virginia.
Scapular winging is one of the most commonly treated deformities of the shoulder. To say that it can’t be treated, is retarded.
The causes of scapular winging are also well known, and yes, it is often treated even when the patient does not present with pain. The way we know this, is that when there is scapular winging, and we fix what we think the cause is, the scapular winging goes away (as does any pain that may or may not have presented).
Your idea is simple, but wrong.
I’ll go ahead and go through a full explanation.
There are 3 types of scapular winging. Primary, secondary, and voluntary. Primary is usually due to injury, secondary is due to biomechanical issues, voluntary is not caused by anatomic issues.
The original poster is most likely talking about secondary scapular winging. Primary is usually treated with surgery, while secondary is often treated through physical therapy. In many cases, secondary scapular winging can present with pain. In fact, this is most cases, since most people don’t see a PT without some pain presenting.
The therapy designed to treat the underlying pathologies behind the winging (ie the issues causing the pain, since winging is a symptom and not a cause) also in many cases corrects the winging.
However, in cases where it does not, the most common explanation is the short duration of the therapy (this is what happened to you). Pain often resides before the winging fully corrects, since usually there is a good deal of winging prior to the presentation of pain. As a result, many patients stop their therapeutic regimen as soon as the pain subsies, and NOT when the winging is corrected, since it is possible to have a small degree of winging and not experience other symptoms.
Pain often subsides in a matter of weeks, whereas it would require a matter of months in order to fully correct the scapular winging itself. However, even in patients that do not follow the regimen for the full time, STILL SHOW SMALL IMPROVEMENTS in the winging, despite the fact that the time they do the exercises is small compared to what would be required.
Make sense?