Take a look at anyone’s resting shoulder blade position from behind the next time you are at the pool or at the beach. If you look closely, you may notice that many people’s shoulder blades, or scapulae, do not sit evenly. Two common observations to see are one shoulder blade sitting higher than the other or one shoulder blade carried further away from the spine than the other.
What are the implications of this?
To address the first observation, shoulder blade height is largely a function of hand dominance. A right-handed person will almost always have the right scapula sitting a tiny amount lower than the left side. You will notice with “lefties” the opposite is true.
The bottom line is the following: if you are right handed and your right shoulder blade sits a bit lower than your left shoulder blade, don’t worry about it. However, if you are a righty and your right shoulder blade rests significantly higher than your left shoulder blade, this may be problematic. You may have certain muscle groups that may be too weak, too tight, or less than functional on your right side. If you are having shoulder or neck pain, get it checked out by your doctor or therapist.
The second observation (scapular distance from the spine) in my opinion is more commonly associated with shoulder pain. There are differing opinions in the medical community as to what the “ideal” distance should be from the spine to the border of the shoulder blade. “Three finger widths” of distance between the spine and the border of the shoulder blade is a commonly used standard. It is very common to see rotator cuff tendonitis, impingements, and chronic neck pain in a person who has a shoulder blade that sits too far out to the side.
Shoulder blades can end up sitting too far out to the side because of prolonged forward posture. Using a computer mouse for hours daily can have the effect of pulling a shoulder blade outwards.
How do we combat this?
Work on training the muscles of the back to work in a shortened position. Below is a link to one simple exercise that trains the scapular muscles to work the shoulder blade in a more ideal position. It is also a great idea to incorporate scapular exercise into your gym routine. Far too many people over-train the frontal muscles (chest, biceps, deltoids) and under-train the back muscles (middle and lower trapezium). Do not neglect the muscles that you cannot see when you look in the mirror!
It is also a good idea to change any ergonomic issues with your computer to minimize the amount of reaching that is necessary to use your keyboard and mouse.
Really nice post and video.
I’m felling much pain on my shoulder blades these days. Gonna try that!
reason biomechanical of uneven shoulder
Hi. For awhile now I’ve been having pain in my left shoulder when I do certain motions. I’m right handed and my right shoulder blade sits higher that my left. I’ve been lifting for a year now and just noticed when I flex my lat muscles the left side of my body looks normal but on the right side my trap muscle goes up into a hump shape. I cannot get the 2 sides of my body to move the same way no matter how I try to
Nathan I would get it checked out by a PT or a doc. If you are right handed, we would normally expect the right shoulder blade to be a tiny bit lower than the left shoulder blade. Your situation could mean a few different things, nothing crazy or dangerous but I would have someone look at it.
Hi, I seem to have the same problem, but unlike the dominance issue i broke my left collar bone pretty badly and have just notice that my shoulders are not like they once was. my left shoulder blade is sticking out more then my right (I am right handed) and they were both even in distance out before the accident. Is this just because I have lost some muscle mass in my left side due to the fact that I couldnt use the arm for a week or two or is there something else happening.
For the details on the break. It broken in the middle of the bone forcing one side above the other.
Korey I agree with you. I think that there may be weakness that resulted from the break. This can contribute to asymmetry. The collar bone does connect with part of the shoulder blade, so there may be a difference in how the shoulder blade moves based on that fracture, especially if the fracture has created a difference in the angle of the collar bone.
It would not be a bad idea to see a physical therapist and see if the muscle strength in the shoulder blade can be improved if there are weak areas.
okay sweet thank you for replying I will find one as soon as I can
Hi! I hurt myself in my sleep 6 days ago, I woke up and suddenly moved my right arm and felt a pinch on my shoulder blade and I felt something was wrong. I tried doing stretching exercises but it just keeps getting worse and hurting more and now my shoulders are completely uneven and I can’t move my neck. I have been massaging using a tennis ball today but it’s so painful so I’ve been only doing it for a few minutes at a time. I had this before but a long time ago before I start working out regularly, I used to think it was lack of muscle on my back but I’m in good shape so not sure what to make of it. Any advice that can help me!
This is probably a pretty bad neck sprain. They usually go away in a matter of days. If it doesn’t, I would see your doc to get it looked at. Sometimes other factors can contribute to this, such as working at a desk where the keyboard and monitor are too far in front of you. In the mean time I would also avoid watching TV or reading when you are lying down. That can make it worse.
Hello doctor,
I am a right handed person and I am having uneven shoulder it’s looks very ugly when I walk and my postures are not so presentable due to my left shoulder always stays little upper side than the left shoulder and I will regularly or some time have to suffer from a acute pain and I am having this problem from last 6 years..
I need your suggestions please …!!
In our exercises on the website (media tab, password is “patient”), go to the shoulder exercises and try out the “shoulder shrugs”. You need to really emphasize the elevation of the right shoulder blade when you do this. I would maybe have someone watch you from behind and see if you are indeed elevating the right side effectively. You will probably have to do this for quite a while (many months) to start to see an effect. As always, get permission from your doc to do this please!
my right scapula is very uncomfortable and feels uneven when i am writing or doing exercieses. help me please
I would have the position of the shoulder blades assessed by a physical therapist. I cannot tell you what exercises to do because I would need to see what your alignment looks like.
I see no link. Has it been removed? I would be grateful if someone could provide me with the link :)
I just asked my web guy to put the link back up. Give it a few hours, sorry about that.
I have been experiencing sever pain in my left shoulder blades for about 9+ years now. I have a history of repeat left shoulder dislocations, my first dislocation was at the age of 12, I had my first arthroscopic procedure in 2010 and then had another open banker repair this past June for repeat instability. Due to my extensive history I have been to a couple of Drs. as well as several rounds of PT (currently doing PT) and voiced my constant and recurring shoulder blade pain over and over. All I am ever told is that it is either just a Triger point area that will go away as I recover from surgery (been told that twice now) or that it is due to posture and that fact that I am a student constantly sitting in class–but for some reason my bad posture doesn’t affect my right side. Iv also been told that numerous times that as soon as I regain strength it will go away and that it is due to weakness, however Iv been through multiple rounds of PT. Iv noticed that my shoulder blades are uneven, I am a righty but my left side is way lower and further to the side. My PT also noticed this which said could be a source of pain but has not given me a solution to fix it other than holding out till it gets stronger and that my left shoulder blade is probably overly compensating and taking more stress. Iv been told over and over that the pain will go away with no results! Every Dr or therapist I see brushes off the problem with out giving me any resolutions. I don’t know if this is something to be concerned about or if anything is medically wrong. However, I do know that I am only 22 and can’t take the pain any longer. Iv been experiencing this pain for at least 8 years on an almost daily basis and its starting to consume me, who should I be seeing/ what can I do to finally get some answers and see RESULTS!!!!
It sounds to me like the positioning of your shoulder blades are off. That left shoulder blade should not be protracted and depressed like that. Have any of the PT’s worked on elevation of the left shoulder blade? (Check out the exercise in our shoulder section labeled “shrugs”.) I obviously can’t make a diagnosis over the internet, but if you have not addressed the long and weak upper trapezium on the left side you ought to. I think that sometimes a long and weak upper trap is overlooked.
Depending on how extreme the positioning of the left shoulder blade is, you may also want to be checked to make sure that the spinal accessory nerve on the left side is okay. That nerve innervates the upper trap.
I have shoulder pain, aggravated by doing planks, lifting or sudden movement. Am right handed. Pain on right shoulder blade area sharp intense pain. Have difficulty holding pen comfortably to write, end up grabbing pen to write legibly, but writing a simple short letter hurts through arm, through to neck and sometimes head… Have this issue (more the writing) almost 20 years, GP referred me to Physio twice, diagnosed with carol tunnel/tennis elbow and recently (3yrs ago) focal dystonia.. Nobody has helped at all..
Forgot to mention. My right shoulder blade is almost invisible, looks like I only have one from behind…
This must have something to do with your shoulder blade positioning. If there is a lack of control through the shoulder blade, the rest of the arm can easily fall victim to the faulty alignment. Have you tried seeing an osteopath about this? I would get a good x-ray of the shoulder blades as well to see the actual positioning.
Okay i Think My shoulderblades are uneven. Its not a lot But noticeable. Im right-hended and My right shoulderblade is higher than The left. (I also noticed that They are Very pointy and The bottom like small wings, compared to my friends But idk if that matters). I do Archery so My right shoulder is used more But i Dont know if that makes Any difference. I Also do fitness so My right shoulder should be strong too. Should i get it checked Or? Is it Something i should fix Or is it just How Im built? Im not having Any pain i only know They are uneven Cause of What i (and others) see.
Two things to point out here.
1. It is a bit out of the ordinary for the right shoulder blade to be elevated compared to the left if you are right hand dominant. I would have it checked out to see if there is any weakness in the lower trapezium on that side.
2. I think that what you are describing is “winging” or “tipping” of your shoulder blades. This is usually an indication of specific weakness in a few of your muscles that support the shoulder blades. This is pretty common.
Getting an evaluation from a PT to get an idea of exercises to do is not a bad idea.
Hi Dan,
Good to find ur article.
9 months back my neck was injured due to traumatic neck (left side) and emotional injury.
I got PT for 3 months my neck is alot better after PT, but my left shoulder is still 2 inch higher than my right shoulder. (I am left handed) and my left side of cerical spine is winging.
Can you please suggest if 2 inch distance can be completely fixed?
Hmmm, that is strange. It sounds like your upper trapezium on the left side is still pulling the shoulder blade excessively upwards. I think that this is treatable, but you may want to try some different avenues. Dry needling or acupuncture might be options?
Help plz need something doing
Hi I’m right handed I have had chronic pain in left shoulder thourt it could be router coughs damage it’s bin like this for 5 years still in pain wen need to get something out a cubered or put on a jacket but apparently they can’t find any thing wrong consteley feel like my neck gonna click out ov place all the time and now I have noticed my right shoulder blade is an inch higher than the left what can I do
I would guess that something is not working correctly with the upper trapezium on the left side??? I would see a PT if there is one available.
Hi my left shoulder is a bit higher with slight pain and it makes a cracking noise when i stretch it or do lateral raises also there’s a bit of pain sometimes right under that left shoulder blade and I’m a lefty pls reply thank you.
I would guess that one or more of the muscles that control your shoulder blade from behind may need some specific strength training. The lower trapezium and the middle trapezium may be involved.
I have been having left shoulder pain on and off for about 8 years now. Sometimes it aches when I am not even moving. I had an xray about a year ago, it showed degenerative bone. The is getting worse.