How to Quickly Evaluate a Shoulder Blade and Implications

The following is a picture that shows the four things I look for first when I'm looking at someone with mid back, shoulder or neck pain.  I've found that if any one of the four are uneven, most adjustments to the spine of the mid back and neck won't last very long.

The orange line is the medial border.  This should be vertical.  The green line is the horizontal border.  This should be even.  The blue line is the distance between the spine and the medial border.  This should be equal.  The grey arrow indicates that the shoulder blade should be sitting square on the thoracic rib cage.  Often you will find one tipped forward.

Only after all four indicators are level will an adjustment, in my opinion, hold its value so to speak.

I find the green line affected most by the latissimus dorsi.  The orange line by the rotator cuff muscles, the serratus anterior and levator scapulae.  The blue line by the rhomboid group.  The grey line by the pec minor.  Of course these are all generalizations.  But it's a great starting point to quickly gain a thought process in treatment.