Protruding Shoulder Blade: Causes and Concerns

Protrusion of the scapula?

Hello, a small bone protrusion was found on the right scapula, parallel to the shoulder, which is visible to the naked eye and quite noticeable when wearing clothes.
I went to see a doctor and had an X-ray, but the doctor said that there was no noticeable protrusion when comparing both shoulders.
What could be the cause of this? Thank you.

Kenny, 10~19 year old female. Ask Date: 2023/04/24

Dr. You Dianqi reply Orthopedics

Hello, it is recommended to consult a physician in person.
Thank you.

Reply Date: 2023/04/24

More Info

The protrusion of the shoulder blade, or scapula, can be a concerning symptom, especially when it is visibly noticeable and causes discomfort. There are several potential causes for this condition, and understanding them can help in addressing your concerns.

1. Scapular Winging: One of the most common reasons for a protruding shoulder blade is scapular winging. This occurs when the muscles that stabilize the scapula, particularly the serratus anterior or trapezius muscles, are weak or injured. This weakness can lead to the scapula moving away from the rib cage, creating a wing-like appearance. This condition can be caused by nerve injuries, such as long thoracic nerve palsy, or muscle imbalances.

2. Postural Issues: Poor posture, especially in individuals who spend long hours sitting or working at a desk, can lead to muscular imbalances that affect the position of the scapula. Rounded shoulders and forward head posture can contribute to the appearance of a protruding shoulder blade.

3. Injury or Trauma: Previous injuries to the shoulder area, including fractures or dislocations, can lead to changes in the anatomy of the shoulder blade. Even if X-rays do not show any fractures, soft tissue injuries or changes in muscle attachment can cause the scapula to protrude.

4. Structural Abnormalities: In some cases, structural abnormalities such as scoliosis or other spinal deformities can affect the alignment of the shoulder blades. These conditions may not always be visible on standard X-rays, and further imaging, such as MRI or CT scans, may be necessary for a comprehensive evaluation.

5. Muscle Imbalances: Overuse of certain muscle groups, particularly in athletes or individuals engaged in repetitive overhead activities, can lead to muscle imbalances that affect scapular positioning. Strengthening the weak muscles and stretching the tight ones can help restore proper alignment.

Concerns and Recommendations
If you are experiencing discomfort or pain associated with the protruding shoulder blade, it is essential to consult with a healthcare professional, such as an orthopedic specialist or a physical therapist. They can perform a thorough examination, including a physical assessment of your shoulder and scapular movement, to determine the underlying cause of the protrusion.

1. Physical Therapy: Engaging in a physical therapy program can be beneficial. A physical therapist can design a personalized exercise regimen focusing on strengthening the muscles around the scapula and improving overall shoulder stability. This may include exercises targeting the serratus anterior, trapezius, and rotator cuff muscles.

2. Postural Training: Learning proper posture and body mechanics can help alleviate the symptoms associated with scapular winging. Ergonomic adjustments to your workspace and regular breaks to stretch and move can also be beneficial.

3. Further Imaging: If the protrusion is accompanied by significant pain, weakness, or functional limitations, further imaging studies may be warranted to rule out any underlying structural issues that may not have been visible on initial X-rays.

4. Surgical Options: In rare cases, if conservative management fails and the condition significantly impacts your quality of life, surgical options may be considered. This typically involves addressing the underlying muscular or structural issues contributing to the scapular protrusion.

In conclusion, while a protruding shoulder blade can be concerning, understanding the potential causes and seeking appropriate evaluation and treatment can help manage the condition effectively. It is crucial to address any associated symptoms and work towards restoring normal function and comfort in your shoulder.

Similar Q&A

Understanding Shoulder Blade Pain: Causes and Prevention Tips

My mother often complains about pain in her scapula. She visited an orthopedic doctor who mentioned something about cartilage protrusion. Why does the cartilage in that area protrude, and how can it be prevented? Thank you for your response!

Dr. Chen Xianchang reply Rehabilitation
Hello, sir: Thank you for your inquiry. Here are my responses and recommendations: 1. The area near the scapula is governed by the nerve roots of the fifth and sixth cervical vertebrae. 2. A definitive diagnosis requires a CT scan and electromyography (EMG) examination. 3. Pay at...

Understanding Chronic Shoulder Blade Pain: Causes and Treatment Options

Hello Doctor, I would like to ask you about an issue I've been experiencing. Since around the fifth grade, I have had a persistent dull pain in the muscles around my scapula for many years. Whenever I maintain a position for about 10 minutes (whether standing, sitting, or sq...

Dr. Huang Yingzhe reply Neurology
ANSWER: It is not possible to draw a conclusion from your description. Please contact a neurologist or a rehabilitation physician for further evaluation.

Understanding Post-Surgery Issues with Bone Pins: Normal or Complications?

I am not entirely sure about the definition of a protruding screw, so I would like to ask. I fractured my scapula at the end of December. After surgery, I recently felt the shape of the screw when touching the area of the incision and stitches, but it doesn't hurt much; only...

Dr. Shi Guozheng reply Orthopedics
It is necessary to compare the front and back X-ray images to accurately determine if the nail is protruding. If the nail is significantly protruding and causing redness and swelling on the skin, it also indicates that it is indeed protruding.

Understanding Shoulder Blade Pain: Can Rehabilitation Help?

Hello Doctor: I have been experiencing severe pain in my left scapula due to overuse of my hands, and I also have pain in my upper arm and elbow joint. I consulted an orthopedic doctor who mentioned a condition I don't understand, called thoracic outlet syndrome. I am very a...

Dr. Su Hongci reply Rehabilitation
"Thoracic Outlet Syndrome" refers to a condition where vascular or neurological symptoms arise due to compression of the brachial plexus or subclavian artery and vein at the thoracic outlet. The pain typically radiates around the chest wall and scapula. The most common ...