Scapular Winging

1. Primary

1.1. Muscle weakness (of scapular stabilizers)

2. Secondary

2.1. Pathology of GH joint

3. Dynamic

3.1. Long thoracic nerve injury

3.1.1. elevate scapula, move medial

3.1.2. effect: difficulty in elevating arm above 120 degree

3.2. Spinal accessory nerve injury

3.2.1. depress scapula

3.2.2. laterally rotated

3.2.3. before 90 degree abduction, winging appears

3.2.4. inability to shrug shoulder

4. Static

4.1. structural deformity of clavicle, spine, ribs