Winging of the shoulder blade is also quite common among younger females, but rarely a painful sign or symptom. It is more frequent among patients who are very flexible (hypermobile) and people with a curvature of the spine. Poor posture can make this appear worse. Certain muscles are responsible for the bottom of the shoulder blade sticking out and others for the inside border of the blade. It is thought poor stability between the shoulder blade and the back has a knock-on effect in weakening the shoulder/arm during activity.
Another symptom associated with winging and the shoulder blade is clicking. Sometimes referred to as scapular-thoracic instability or clicking scapulae. In our experience this is less likely to be associated with pain and more the sensation of clicking or crunching at the back of their shoulder. The cause is generally due to the shape or curvature of your mid back (thoracic spine), rib cage shape, posture and over activity of some of the larger muscles around the shoulder such as your pectorals or latissimus dorsi. A ‘Clicking’ shoulder blade seems to be more prevalent in younger females.
Again, physiotherapy is the front-line treatment for both of the above presentations and will look closely at muscle length, posture re-education, muscle strength around the shoulder and muscle imbalances.
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