Ideal

• Scapula is held firmly to the rib cage
• Scapula is rotated 30° anteriorly to the frontal plane

You See

• Inferior angle of the scapula is noticeably lifted off rib cage – scapula is tilted anteriorly

Likely Cause

• Short pectoralis minor
• Short pectoralis major (indirect)
• Short serratus anterior (upper fibers) and/or long serratus anterior (lower fibers)
• Long scapular retractors (check for hypertrophied rhomboids and mid trapezius)
• Short biceps brachii, check whether there is flexion of forearm (lateral view)
• Short subscapularis