- Present with varying degrees of shoulder pain, loss of motion, weakness, and scapular deformity
- Electromyography (EMG) is the definitive study to evaluate for scapular winging originating from muscular or neurologic abnormalities
- Primary winging : medial(long thoracic nerve injury) or lateral(spinal accessory nerve injury)
- secondary winging : intrinsic glenohumeral conditions (e.g., rotator cuff pathology and glenohumeral instability) that disrupt scapular motion and positioning.
- Strengthening exercises to overcome the specific muscle weakness.
- Spinal accessory nerve – it can be treated with nerve exploration and repair if surgery is performed soon after the injury
- Surgical management of primary conditions involves dynamic muscle transfers to compensate for muscle weakness
- Medial winging due to serratus anterior palsy is effectively treated with pectoralis major muscle transfer.