Scapula Alata is caused by an affection of the nerve Thoracicus Longus, resulting in a reduced function of the muscle Serratus Anterior. Serratus Anterior is responsible for keeping the shoulder blade (Scapula) stabile and in the right movement. With a reduced function in the Serratus muscle, the shoulder blade will raise into a winging position and move towards the spine, opposite as it is supposed to. The patient will experience different kinds of difficulties. It can be all from tiredness in the arm to disabling pains, reduced strength, restriction of movement and radiating symptoms.

The cause of the nerve affection can be various. The nerve, Thoracicus Longus can be damaged by trauma or surgery, it can be infected by an infection in the body or a spontaneously arisen Neuritis without further explanation.

In most cases, the nerve regenerates on its own, and it can take up to two years. But even if the nerve is back to normal, it does not mean that the muscles retrieve neither their normal position of rest nor their function, on their own.  Unfortunately, due to the inappropriate position of scapula and thereby overstretched muscles, it may turn out that the condition gets worse over time.