What Is Scapular Dyskinesis?

Medically Reviewed by Sabrina Felson, MD on May 29, 2023
3 min read

When your shoulder blades aren’t stable, you may experience a shoulder disorder called scapular dyskinesis. It is characterized as losing a normal range of motion in your shoulder blades. In some cases, it is a condition of its own. Other times, scapular dyskinesis is a symptom of another health condition or injury.

Your shoulder blade is important for movement and range of motion in your shoulders. Also called the scapula, your shoulder blades provide stability to your rotator cuff. If you sustain an injury to your soft tissue, muscle, or bone around your shoulder, it may impact your shoulder blade too.

Scapular dyskinesis is easily identified because it causes your shoulder blades to stick out abnormally either during rest or activity. Scapular dyskinesis is also called winging because your shoulder blades stick out like wings on your back. Although the condition itself may not be painful, it can leave you at a greater risk of injury.

There are six factors that may contribute to scapular dyskinesis:

  • Damage to your nerves
  • Loss of flexibility
  • Damage to your muscles
  • Weakness in your core, hips, or legs
  • Weak bones or bone fractures‌
  • Damage to your joints

Your scapula has a normal rotation pattern of:

  • External rotation
  • Posterior tilt
  • Upward rotation‌
  • Medial translation

Damage may hinder a piece within this movement sequence. Playing sports increases your risk of the condition because more than 90% of unidirectional cases result from a dislocation injury. Sports with the highest likelihood of leading to scapular dyskinesis include:

  • Gymnastics
  • Swimming
  • Volleyball‌
  • Baseball, primarily pitchers

Men between the ages of 18 and 25 are most likely to be diagnosed with scapular dyskinesis.

Common symptoms of scapular dyskinesis include:

  • Pain or tenderness around your shoulder blade, especially when you raise your arms overhead or lift something heavy
  • Feeling a snap or pop that occurs with shoulder movement
  • Losing strength in your affected arm and shoulder
  • Changes in your posture, usually one side sagging down so that your shoulders appear asymmetrical
  • Shoulder blades sticking out and looking like wings
  • Feeling like your shoulder blade is out of place ‌

‌Your injury may be made worse by:

  • Chronic inflammation
  • Injury to your rotator cuff muscles
  • Shoulder stiffness‌
  • Poor technique when throwing or lifting 

Scapular dyskinesis may not be obvious at first. You may feel pain or discomfort without obvious physical symptoms. Alternately, your shoulder blades may stick out with no accompanying pain or discomfort.‌

If you think something is wrong, talk to your doctor immediately. Allowing the condition to go on without treatment may leave you at greater risk for additional damage, including:

  • Weakness
  • Muscle imbalance
  • Nerve damage‌
  • Damage to your rotator cuff or surrounding cartilage

Usually, an x-ray or MRI isn’t necessary for diagnosis. Instead, your doctor may look for physical signs of other related injuries leading to your shoulder dysfunction. Occasionally a specialized nerve test is used to evaluate the extent of your damage to help determine what treatment is best.  

‌If you notice that specific movement makes your pain or discomfort worse, be sure to share that. Include details about what happened when you first experienced a loss of motion or noticed a change in your shoulder blades.  

Most of the time scapular dyskinesis is improved through physical therapy or rehabilitation with a qualified physical therapist or athletic trainer. Therapy usually lasts 4 to 8 weeks, depending on how bad your injury is. It includes exercises to help you gently restore range of motion and strengthen the surrounding muscles. 

Keep in mind that physical therapy only helps if you also cease the activity or motion that caused the injury in the first place. While you may be able to continue the activity in the future, it is important to allow your body the chance to heal. ‌

Your physical therapy or rehabilitation is often accompanied by pain or anti-inflammatory medication to address your symptoms as you heal. Your doctor may also suggest using heat or ice to address pain.‌

Call your doctor right away if:

  • Your condition worsens despite treatment
  • You have sudden numbness or tingling in your arms or shoulders
  • You have signs of allergic reaction to a prescribed medication
  • Your fingernails begin turning blue or gray
  • New symptoms appear that are otherwise unexplained

You can prevent scapular dyskinesis by: 

  • Stretching and warming up before throwing or completing any overhead activities
  • If you’re in a sport, following age and league pitch count guidelines
  • Paying attention to correct ways to throw, especially important for children entering sports‌
  • Not forcing a range of motion when lifting, especially overhead