Originally Posted by SnappleofDiscord

Ugh sorry for your scapula pain!
I didn't break my scapula like you (which must have been s special dose of misery), but I too have some severe scapula winging with possible LTN injury.
Waiting hasn't helped, and my symptoms have only gotten worse. PT hasn't gone far, as most scapular stabilizing exercises further irritate the secondary problems Caused by it in my neck. I'm still searching for a doctor too.

I wouldn't wish this chase on everyone. I think you're right that most doctors are unfamiliar with this type of injury and scapula winging in general outside of a text book. I am endlessly frustrated by doctors telling me "they've never seen anything like it", and then referring me to a friend.


It's my understanding that basic EMG will only pick up a pronounced issue (i also had to do a chase to find someone willing to perform the EMG), and that it's a positive result is not always needed to diagnose LTN injury since it is so very easy to miss the nerve altogether.
I've got a negative results on my LTN EMG, but no matter what the print out says I still have a scapula you could rest a drink on and other symptoms of serratus dysfunction like trouble expanding my chest, fasiculations, shoulder instability, pain, etc.
I've been told nerve dysfunction and symptoms can happen from compression and chronic irritation/inflammation as well, and an EMG is testing for total compression, impingement, lesions, or severed nerves.
My symptoms seem to vary positionally and on how bad my compensating muscles are spasming. I can make the symptoms stop sometimes if I hold very still in a certain pose and never move, however, EMG isn't conducts in a comparison basis.

There's also some literature that I've found that puts together what seems like a fairly medically obvious case for scapular winging and LTN dysfunction without loss of nerve signal, in that the altered position and rhythm of the scapula compresses the brachial plexus, narrows the thoracic outlet, and grinds on muscles, tendons, and nerves it shouldn't be able to.
I'm too new in the forum to be allowed to post links in my comments, but I can message you some links to articles on this.

In your case there may be issues with the LTN being irritated by your scapular bursa (which may be remedied by some cortisone shots), scar tissue, or even bone spurs and change of shape from the original break. Even an inflamed irritated nerve from when the scapula was broken and untreated..

Being mostly confined to my house or bed because of the associated symptoms, I spend a lot of time researching how to Escape this hell cycle. I've turned to looking up doctors cited in medical literature..
Here's a few resources I'm looking in to chasing down myself as soon as this next round of doctors invariably bounces me...
Dr Nath- Houston
Dellon Institue- Baltimore and some others too
Washington University in St. Louis seems to have some winged scapula expertise as well.

I hope this helps you some.

Originally Posted by SnappleofDiscord

Wrote a big reply which may or may not show up due to Login time out. oy.
Booklover and Jkl626, I am still too new to send PM of links. Perhaps if you PM me first?
this is board is surprisingly strict for a support forum.

Key notes in rant that may or may not exist any longer.
-3 types of neurogenic TOS. Costoclavicular Syndrome, Scanlenus Anrtiuc Syndrome ("classic" neurogenic TOS) and Pectoralis Minor Syndrome.
-Costoclavicular TOS, the google term you want lacking direct links, is the compression of brachial plexus between first rib and clavicle, often seen in rolled shoulder, dislocated shoulder, and disrupted shoulder rhythm due to winged scapula.
-Disfigurement of shoulder structure through injury or break allowing it to slump forward compresses and/or irritates the nerves that allow you to protract the shoulder. It's a vicious cycle of pain and it likes to involve the neighbors such as the neck.

Originally Posted by SnappleofDiscord

I am still too new to send PM of links. Perhaps if you PM me first?
this is board is surprisingly strict for a support forum.