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Desk workers shoulders? Neck pain? Arm weakness? – Scap Winging

Desk workers shoulders? Neck pain? Arm weakness?

There are a variety of reasons one could have these complaints but less common reason involves a concept called ‘Scapula Dyskinesis’.

The scapula is joined to the rib cage at the scapulothoracic joint and as joints go it’s not really much of one. Where a knee or a hip has big broad stabilising ligaments and a even a shoulder joint has some retaining fibres the scapulothoracic joint is stabilised almost purely by its musculature. The scapula can glide up and down, side to side forward and back and even rotate around the rib cage with its degrees of freedom these muscles provide but it is constantly stabilised in every day life by a muscle called the Serratus Anterior.

Serratus anterior is the multi headed one most easily spotted on the side of the rib cage of a boxer and it spreads in a fan shape from the bottom of the scapula and down. It retains the scapula against the rib cage and gives the shoulder a strong base of support in arm movement. When the shoulder loses this support it becomes weak and other arm and neck muscles start to suffer. The scapula starts to move more than it should, past its normal range of motion. More muscle effort is required to stabilise the joint from the other muscles in the area and pain ensues. The scapular can even lift off and away from the rib cage and seem  to float away a little, a process called winging and, more broadly, scapula dyskenisis.

A case has recently been described in the UK medical literature where a computer gamer had complete paralysis of this muscle, a consequence of that person’s estimated 4 million mouse clicks in the last 4 months. Obviously this is a lot of clicks but the problem for this individual was easily solved with exercises to help the surrounding muscles and eventually, once the paralysis abated, strengthening of the serratus anterior itself.

If you feel like you’re approaching the 4 million click mark and need some advice on managing we’re not far away 🙂


Michael O’Doherty