Standing, sitting, or lying 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.
Posterior to the patient.
May I place my fingers just above your shoulder blade? (or point to the demonstrated area).
Place your hand behind your back (or demonstrate). Now gently shrug your shoulder.
(If palpation is not clear, ask the person to lift the hand away from the back, which produces
additional scapular downward rotation).
With the patient relaxed, ask the patient to place his/her hand on his/her lumbar spine area. Place your fingers just superior to the superior angle of the scapula. Ask the patient to gently shrug his/her shoulder. The tendon of the levator scapulae can be palpated near the attachment to the superior angle. Move the fingers superiorly and medially to palpate the muscle belly.
VH - close up of the posterior scapula without skin.