Scapular winging and how to work around it

[TheLizardWizard]

Hello Starting Strength team. I have scapular winging, and from browsing previous posts on this forum it is my understanding that this is due to a long thoracic nerve issue. I am inquiring today because I am determined to not let this ailment get in the way of my training, and am wondering what lifts if any should be avoided? For example when doing bench with the scapula retracted my upper back is not flat and the blades of by shoulder are like stilts holding me up. I fear that once I reach higher weights that this has the potential to injure me. I however have the mindset that if I quit lifting or working out then it is the same conclusion that I would have if I lifted, injured myself, and then was unable to work out. Thank you.

[Mark Rippetoe]

Both sides are winging?

[TheLizardWizard]

Correct. I would say right side is more severe than the left however

[Nick D'Agostino]

Hey LizardWizard, I have a few questions that will hopefully better help me with a recommendation.

How was this diagnosed?

What symptoms are you experiencing?

Have you started training yet?

Also, what's your height and weight?

[TheLizardWizard]

Hey LizardWizard, I have a few questions that will hopefully better help me with a recommendation.

How was this diagnosed?

What symptoms are you experiencing?

Have you started training yet?

Also, what's your height and weight?

1) I recently got into a motorcycle accident (about 4 months ago) and met with an orthopedic surgeon to have surgery on my broken ankle where they put 2 screws in. While I was there I brought up my winged scapula that was first brought to my attention during a personal trainer consult from my works gym. The orthopedic surgeon did a few x-rays and informed me that he doesn't believe that physical therapy is a good call because he personally had never seen anyone correct this postural issue. He did however mention that he fully encourages me to continue lifting, so that is what I am looking to do.

2) general shoulder instability (crunching, popping, grinding) during certain movements. This leads to what feels like joint inflammation, and is uncomfortable enough to scare me into not working out typically although lately I have just been ignoring it.

3) I have just recently started getting back into lifting due to the fact that my ankle and hand was broken from the motorcycle accident. In the past week I have been focusing on re-learning the proper form for the main compound lifts. I am mostly just looking to get some information about what issues can arise from doing the compound movements with a compromised serratus anterior in order to better educate myself about what I am potentially doing to my body. Surely this is an important muscle for many of the lifts, but is it absolutely necessary? Have you personally coached any lifters that have this and seen them make good progress?

4) I am 6'3 183 pounds

Thank you.

[Nick D'Agostino]

First, it sounds like you have found an excellent orthopedic surgeon that you should recommend to others. From what you have just told me I think it is very unlikely that your serratus anterior is compromised and that your winged scapula is anatomically normal for you. A true winged scapula is caused by a severe insult to the long thoracic nerve or the serratus anterior muscle. This is something that would stick out in your mind similariy to the broken ankle. You would know the moment it happened. I have coached many lifters who have scapulas that are not pretty to look at, but I have not coached someone with a true winged scapula. It is also important to note the scapula behaves differently when loaded. The load forces muscles to contract harder. I will not be surprised if load makes an immediate visual difference to how your scapula behaves as you go overhead. There is an excellent chance progressively loading your shoulder using the bench and press, getting stronger, and building muscle mass will improve or eliminate the visual scapular winging. Hopefully, this gives you peace of mind to start training.

[TheLizardWizard]

First, it sounds like you have found an excellent orthopedic surgeon that you should recommend to others. From what you have just told me I think it is very unlikely that your serratus anterior is compromised and that your winged scapula is anatomically normal for you. A true winged scapula is caused by a severe insult to the long thoracic nerve or the serratus anterior muscle. This is something that would stick out in your mind similariy to the broken ankle. You would know the moment it happened. I have coached many lifters who have scapulas that are not pretty to look at, but I have not coached someone with a true winged scapula. It is also important to note the scapula behaves differently when loaded. The load forces muscles to contract harder. I will not be surprised if load makes an immediate visual difference to how your scapula behaves as you go overhead. There is an excellent chance progressively loading your shoulder using the bench and press, getting stronger, and building muscle mass will improve or eliminate the visual scapular winging. Hopefully, this gives you peace of mind to start training.

Thank you very much Nick. Your advice and knowledge have definitely given me the peace of mind needed to continue. I will work on covering my ugly scapulas with muscle haha.

[Nick D'Agostino]

Thank you very much Nick. Your advice and knowledge have definitely given me the peace of mind needed to continue. I will work on covering my ugly scapulas with muscle haha.

Your welcome

[TheLizardWizard]

Your welcome

Hey Nick,

I have been successfully squatting and dead lifting since we last spoke, but as of two days ago I think I may have injured myself doing bench. Immediately after bench I felt some pretty intense pain in the area circled in the attached image. I figured this was just soreness from a good workout since I felt it in both arms. The next day however I woke up to bruising on both arms in the circled area. After some research I think this is maybe a muscle strain? I was wondering if you had any advice on what I may be doing wrong that has caused my arms to get hit so hard? It seems that every time I bench I feel it mainly in that circled area. I have been icing the area so that I can have as quick a recovery as possible. Thank you for your time. Hopefully one day I will be able to train without bumps in the road.
P.S. If a bench press form check is needed I can absolutely provide this once my arms feel more up to the task
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IMG_0569.jpg

[Nick D'Agostino]

A form check is needed. I also have a couple of questions. Have you added any additional exercises to the program? Does the area hurt at rest, or is it when you move it? It may be a muscle strain, but the fact that this happened in both arms simultaneously is very unusual. If it is some flavor of delayed onset muscle soreness or a muscle damage protective reaction, everything should feel back to 100% within a week. Next bench session starting with the bar, I would ramp higher reps (sets of 10-15) and see how you respond if things are getting worse as you go shut it down. If the pain starts to feel better as you go, keep adding weight until you get to something moderately hard. If the latter reaction occurs jump back on the program the following bench session starting 10lbs lighter than the weight the reaction occurred.