Why your shoulder blades stick out — and why it's an upper-back problem
If your shoulder blades stick out from your back, the cause almost never sits at the scapulas themselves. The wing is a downstream signal that your upper back — the thoracic spine — has lost the ability to extend and rotate.
When the upper back stays rounded forward, the shoulder blade can't glide along the rib cage the way it's supposed to. It tilts, rotates, and “wings out” — which is what you see when you look in the mirror or notice in a photo.
Strengthening exercises, scapular squeezes and pulling the shoulders back rarely fix this. The shoulder blade follows the rib cage. If the rib cage stays compressed and the upper back can't extend, the scapula has nowhere correct to sit. The fix has to come from changing how the upper back moves — not from working the shoulder blade in isolation.
Below is what the research shows, and what we work on at Functional Patterns Brisbane to actually change the picture. If you want our full treatment approach, see our winged scapulas page.
Functional Patterns Brisbane Scapular Wing Correction Using Movement
The drills that change a winged scapula focus on getting the upper back to extend and rotate again — especially during walking, where most of the day's load is delivered. Once the upper back recovers that movement, the shoulder blade has somewhere correct to sit. The wing reduces because it no longer has to.
It is the opposite approach to what most people are given. Pulling the shoulders back, scapular retraction sets, and band pull-aparts treat the shoulder blade as the problem. They work the symptom site without changing what is producing it. The wing returns the moment the band is put down.
More Studies Showing The Importance Of Posture & Thoracic Spine Engagement For CoRRecting Scapular Winging
A study conducted by Kebaetse et al. (2019) looked at how the way we sit and hold our upper body, specifically our thoracic spine (the upper part of our back), can affect the movement of our shoulder blades and the strength of our shoulder muscles.
They had a group of people sit in two different ways: sitting up straight and sitting in a slouched position. They used special tools to measure how the shoulder blades moved when the participants raised their arms, both at their sides and out to the side. They also tested how strong the shoulder muscles were in these positions.
What they found was that when people slouched, their shoulder blades moved differently when they raised their arms. They also had less movement in their shoulders and their shoulder muscles weren't as strong compared to when they sat up straight.
This means that having a healthy and engaged upper back (thoracic spine) is really important for how our shoulder blades move and how strong our shoulder muscles are. When we slouch, it can affect the way our shoulders work and make our muscles weaker. So, it's a good reminder to sit up straight to keep our upper back in good shape and help our shoulders move and stay strong!
Functional Patterns Brisbane Scapular Winging Correction Using Movement
A further study by Mihata et al. (2012) aimed to understand how the positioning of the shoulder blade (scapula) during throwing motions affects the shoulder joint and potential injuries. The researchers used frozen cadaver shoulders to mimic the action of throwing, analysing the effects of different scapular orientations.
They found that when the shoulder blade was rotated inwards (internal rotation), it increased the pressure and impingement (pinching) in the back part of the shoulder joint. In contrast, when the shoulder blade was rotated upwards (upward rotation), it decreased the impingement area. Essentially, incorrect scapular positioning, particularly internal rotation, can lead to higher pressure on the shoulder joint and increase the risk of injuries.
This study highlights the importance of maintaining correct scapular positioning, especially during activities like throwing, to prevent shoulder injuries. Good posture and proper engagement of the thoracic spine are crucial to ensure that the shoulder blade is in the right position, reducing the risk of pressure and impingement on the shoulder joint during movements like throwing. This information underscores the significance of proper body mechanics and positioning in sports and daily activities to keep the shoulder joint healthy and prevent injuries.
(Kebaetse et al., 1999; Mihata et al., 2012)