Ideal

Anterior View

• Sternal notch is on plumb line
• Xiphoid process is on plumb line

Posterior View

• SPs are on plumb line

You See

Anterior View

• Sternal notch AND xiphoid process are off plumb line

Posterior View

• SPs are off but relatively parallel to plumb line

Likely Cause

• SS short spine rotators and/or OS long spine rotators (consider same side and opposite side rotators)
• SS leg is medially rotated and/or OS leg is laterally rotated