Standing, sitting, or prone
For women, a gown over the non-examined side with the examined area exposed or a halter top is recommended.
For men, removal of the shirt is requested.
Anterior to the patient.
Please put your hand behind your back. May I place my fingers on the upper border of your
shoulder blade?
With the patient relaxed and with the patientÃs hand on the lumbar spine, place the pad surface of the tips of fingers 2 and 3 or the tip of your thumb on the corner of the superior surface and vertebral border of the scapula.
Rationale for hand placement: Placing the hand on the lumbar spine downwardly rotates the scapula. This position relaxes the upper trapezius, which is a scapular upward rotator and which is superficial to the levator scapulae. The position also makes the superior angle prominent.
VH - close up of the posterior skeleton showing the scapula.