In brief Winging of the scapula most brief commonly results when trauma or overuse injures the long thoracic nerve. However, as these two case studies illustrate, the diagnosis might not be initially obvious, and the etiology can be overlooked. Scapular winging may have an unusual cause. Thus, when the mechanism of injury is not clear, a careful workup is particularly critical. Although most cases of long thoracic neuropathy resolve with conservative treatment, surgery is sometimes needed. Most active individuals can return to full activity.