Shoulder Case 9 History/Physical Exam

Winged Scapula

Patients complain of inability to fully raise the arm overhead or do a push up. Women tend to notice scapular prominence when wearing tight fitting clothes or putting on a bra. Injury can occur during simple daily tasks like carrying heavy objects with straps, such as purses or backpacks, or during certain surgeries such as thoracic outlet repair or cardiac surgery. Weakness of the muscle with functional impairment will be the primary complaint, with minimal sensory or pain complaints.

To evaluate for this injury, patients should stand facing a wall and do a push-up type maneuver against the wall. Winging of the affected scapula will be obvious by the asymmetry.