Misalignment progression sequence
A posterior misalignment scapula (winging scapula) cause the muscle groups to compensates and become hypertonic and weak (Serratus anterior compromised) affecting the scapulothoracic rhythm and changing the orientation of the shoulder joint and casing the humerus to misalign anterior and inferior leading to the fixed forward position.
In my clinical experience, this is a common postural presentation seen among my patients, this pattern of dysfunction is one of the main predisposing factors for several shoulder injuries.
Clinical evaluation of the shoulder girdle as well as visualizing the pattern of compensation presence on the upper extremity.
Anterior – Posterior (AP) shoulder view is essential to evaluate the degree of misalignment involved in this deformity.
Specific adjustments to the shoulder complex
Stretching and strengthening of specific shoulder muscle groups
Depending on the level of deformity and chronicity, minimum 6 weeks of care is advisable to resolve this condition.