Does weak serratus anterior cause scapular winging?
Weakness of one particular muscle, the serratus anterior, is one of the leading causes for scapular winging. Interestingly, many health care providers will miss this condition all the time… Serratus Anterior, Long Thoracic Nerve,…
What muscles are weak in scapular winging?
The long thoracic nerve innervates the serratus anterior muscle (Figure 2). Injury to the this nerve in turn causes weakness of the serratus anterior muscle, which can manifest clinically as scapular winging.
What happens when serratus anterior is weak?
If the serratus is weak, then the shoulder blade literally can’t get out of the way of the arm, and that leads to pinching at the top of the shoulder, frequently known as subacromial impingement syndrome or subacromial bursitis. Over time, it can even lead to development of a rotator cuff tear.
Does the serratus anterior stabilize the scapula?
The serratus anterior is an important scapular stabilizing muscle. Due to the multiple attachment sites, the primary role of the serratus anterior is to stabilize the scapula during elevation and to pull the scapula forward and around on the thoracic cage.
How long does it take for serratus anterior to heal?
If the LTN is injured, the usual outcome is a winging scapula caused by serratus anterior dysfunction, which limits overhead movements and significantly reduces performance. Recovery is usually spontaneous and occurs on average nine months after diagnosis.
Is scapular winging serious?
Scapular winging is a rare, but potentially debilitating condition that can affect the ability to lift, pull, and push heavy objects, as well as to perform daily activities of living, such as brushing one’s hair and teeth and carrying grocery bags [1].
What can cause scapular winging?
Most lesions associated with winged scapula are the result of blunt trauma due to repetitive movements, as seen in athletics. The most common cause of scapular winging is paralysis of the serratus anterior muscle due to the injury of the long thoracic nerve.
How long does it take for thoracic nerve to heal?
With conservative treatment, most LTN injuries resolve on average within nine months, however, recovery can take anywhere from six to 24 months(1,7). Some patients may be left with some residual scapula weakness due to incomplete healing of the nerve(1,5).
How long does it take to fix scapular winging?
Recovering from scapular winging can take anywhere from a few months to several years, depending on the initial cause, treatment method, and nerves and muscles affected. Nonsurgical treatment options can start working almost immediately, while surgical treatment will likely take a few months to produce results.
Can a serratus anterior muscle injury cause winged scapula?
Injury to the serratus can result in a condition called a winged scapula. This manifests as a visual bump in your back where your shoulder blade resides. One common cause of a serratus anterior injury is a problem with the long thoracic nerve.
What can I do about my serratus anterior weakness?
The two main surgical options include (1) releasing scar tissue and freeing up the nerve (this is technically called neurolysis) or (2) transferring a healthy muscle to the shoulder blade. Transfer of half the pectoralis major has become our procedure of choice.
Which is the best treatment for scapular winging?
Nonoperative treatment is the most common for scapular winging, whether the cause be neurogenic, muscular, or both. Physical therapy should focus on range of motion and periscapular strengthening to correct scapular winging associated with serratus anterior, trapezius, rhomboid and/or levator scapulae imbalance .
What causes scapular winging in the right arm?
Scapular winging is almost always caused by damage to one of three nerves that control muscles in your arms, back, and neck: the long thoracic nerve, which controls the serratus anterior muscle.