Wing-shaped shoulder blades can appear in both adults and children. This condition occurs when the shoulder blades cease to fit snugly to the surface of the chest. In the absence of this violation, dilution is provided by the muscles. Outwardly, the scapula, when deviating from the norm, resembles wings in their form, whence came the name.
Causes of occurrence
In the correct position, the scapula is held by the dentate muscle. Near it is a superficial nerve, which is easy enough to damage. If injury occurs, then the scapula begins to protrude forward, namely its lower edge.
Also, the cause of the pterygoid scapula can be a rupture of the deltoid and anterior dentate muscle. It is very simple to see the development of the violation, it is enough to lean your back against a flat wall, and the protruding shoulder blade will immediately be visible.
Another factor influencing the development of this disorder is the transfer of poliomyelitis or progressive muscular dystrophy. The consequence of the displacement of the scapula in relation to the chest becomes the development of pterygoid scapula syndrome.
This pathology can be congenital. In this case, the violation develops in the process of fetal development and is detected immediately after childbirth.
A photo of the pterygoid scapula is presented in the article.
Features of development in children
The first signs of development in children of pterygoid scapulae often appear in front of the school. At this time, parents pay attention to the unnatural location of the shoulder blades in the child and consult a doctor.
In children attending school, the cause of the displacement of the shoulder blades can be not only injury, but also improper wearing of a heavy satchel. In this case, symptoms begin to appear that are absolutely no different from the signs of the disease of pterygoid scapula syndrome in adults.
Main symptoms
Often, pterygoid scapular disease affects men at a young age.
This disease manifests itself suddenly: early in the morning or at night. First of all, a person begins to feel severe pain, which can give to the limb. Because of these sensations, there is a significant limitation of active movements. Over time, the pain disappears, but after a month the mass of the muscles of the shoulder girdle is significantly reduced and weakness in the arm (or arms, if both shoulder blades are affected) increases.
Although rare, all the muscles of the shoulder, forearm, and hand can be involved during the pathological process.
Most often, damage occurs only on one side, but over time, the displacement of the second scapula also begins.
Diagnostics
The syndrome of pterygoid scapula is accompanied by constant pain in the shoulder blades or behind the chest, which are aching in nature. In addition, discomfort in the shoulders or upper limbs may be felt. Outwardly, the syndrome manifests itself in the unnatural position of the shoulder blades that protrude from the back.
In order to determine the presence or absence of damage to muscles and nerves, doctors use electroneuromyography. An x-ray examination of the shoulder blades is also mandatory to exclude congenital bone pathology. As additional diagnostic measures, a blood test is taken and antinuclear antibodies are determined. To confirm the diagnosis, the use of magnetic resonance imaging of the spine in the cervical spine, brachial plexus and spinal cord is sometimes required. However, this is used only in cases where there is a suspicion of the presence of neurological problems.
The most obvious sign of the development of pterygoid scapula syndrome is their position in relation to the inner edge of the chest. In the process of raising a hand, the shoulder blades only move further away from it. In addition, raising the shoulder to a horizontal position is quite difficult, and in some cases impossible. It is this symptomatology that allows you to accurately diagnose pterygoid scapula.
Treatment methods
To conduct effective therapy, it is necessary to know with precision what caused the displacement of the shoulder blades and why the dentate muscle stopped functioning normally. Often the cause of the development of the syndrome is damage to the superficial nerve, which can be caused by various factors (for example, squeezing by a tumor formation or nearby tissue).
Treatment of pterygoid scapulae can last a very long time, but never lead to a full recovery. First of all, the efforts of doctors are aimed at eliminating the causes of this pathology. In cases of signs of formation that presses on the nerve, surgery is performed to remove it. After the operation, you should refuse to carry weights or backpacks.
In order for the scapula to assume its natural position, special devices of orthopedic orientation can be used. They help stabilize the scapula and, by their action, affect its movement.
In cases of patient complaints of pain in the area of the shoulder blades, the doctor prescribes medications in the form of tablets, which are nonsteroidal anti-inflammatory drugs, as well as physiotherapeutic procedures. These include:
- application of cold and thermal applications;
- massage sessions;
- physiotherapy exercises.
In case of damage to the muscle or nerve, surgery is performed to restore them.
Treatment in children
The displacement of the shoulder blades in preschool children is treated with the help of long courses of massage, physiotherapy exercises, as well as the creation of an even posture. If these measures do not give results, then a surgical operation can be prescribed, which involves muscle plasty, or fixing the scapula to the ribs using special sutures.
The treatment of pterygoid scapulae in children attending school also involves passing a special massage course and performing exercises of physiotherapy exercises. During treatment, the child must be protected from carrying a heavy satchel or bags. If necessary, parents should independently carry the weight to school. Also, swimming, cycling, skating or skiing is recommended as therapy, since strengthening the spinal muscles accelerates the healing of the pterygoid scapula.
Surgical intervention
In cases where conservative treatment does not bring results, the patient is referred for surgery. There are two methods for doing it:
- The first method is based on the replacement of a paralyzed dentate muscle with a healthy one, by transplanting it from an unaffected area. This method is called functional.
- The second method involves fixing the scapula to the ribs. This method is called stabilizing. After such an operation, the shoulder blade no longer takes part in the movement of the shoulder girdle.
Therapeutic exercises
In the treatment of pterygoid scapulae, exercises and therapeutic exercises equally effectively affect both children and adults. Such measures are used not only as a treatment, but also to prevent the development of this pathology.
It is best to start the treatment of pterygoid scapulae with exercises that affect the dentate muscle. First of all, you should stand against the wall, leaning on it with one hand. When pressing the palm against the wall, tension of the muscles of the chest and back should be felt.
In addition, pulling with a "front grip" will help in correcting the defect. When performing this exercise, the arms should be wide apart with the palms in front. Instead of pulling up, girls are recommended to push up from the gymnastic bench. Their hands should also be spread wide with the fingers located outside.
Very useful is the lesson on the crossbar. Its essence is that it is necessary to raise both hands to grab it. Initially, you should tilt the body to the left, and then to the right. A correctly performed exercise stretches and contracts the dentate muscle, as well as the mass between the shoulder blades.
After the above exercises are completed, you need to take a pose, leaning on your knees and elbows. The purpose of the exercise is to bend the torso to reach the floor with the upper part of the sternum. At run time, elbows should be pulled apart.
After that, you need to start exercises that affect the front dentate, rhomboid muscle and stomach. To perform, you should be in the knee-wrist position, shifting body weight into the shoulder girdle. With an inhalation, the elbows should be closed, straining the muscles of the abdominal press and chest as much as possible.
To strengthen the clamps of the shoulder blades should lie on your back. Hands should be spread apart in different directions. With maximum relaxation of the upper muscle group, arms, chest, neck and head should be raised.
Possible complications and predictions
All complications with pterygoid scapula can be divided into two groups:
- The first, which includes damage to the shoulder due to its limited functionality.
- The second, associated with an error in the diagnosis, as a result of which the syndrome is not treated for a long time.
Timeliness of treatment and a correctly diagnosed diagnosis are the key to recovery in 90% of cases. An important condition is the absence of paresis in a person that cannot be restored.
Often, pain in the arm or shoulder lasts a fairly long time. In 5% of cases, a relapse of the disease occurs, which can occur both in the same place and on the other hand. In the vast majority of cases, relapses are less painful than the initial disease.