Ideal

Posterior View

• Medial borders are same distance from spine (5 cm, Kendall)
• Medial borders are parallel to spine
• Scapula is held firmly to the rib cage
• Scapula is rotated 30° anteriorly to the frontal plane

Lateral View

• Middle of the acromion process is on the plumb line
• Scapula is held firmly to the rib cage

You See

• Inferior angle of the scapula is noticeably lifted off the rib cage
• Arm is medially rotated
• More of back of hands visible in anterior view

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 for flexion of forearm in lateral view)
• Short subscapularis