Which of the following is an alignment anomaly of the shoulders?

• A. Winging Scapula
• B. Protracted Scapula
• C. Winging Scapula and Elevated Scapula
• D. Elevated Scapula

Answer: (C)

In shoulder alignment, how the scapula sits on the rib cage and how it moves reveals common alignment issues. Winging scapula is when the medial edge of the scapula protrudes toward the back, often with the lower angle sticking out, usually due to weakness or timing problems in the serratus anterior. Elevated scapula means the shoulder girdle sits higher than normal, typically from overactivity of the upper trapezius and related muscles, which can create neck tension and limit shoulder motion. Protracted scapula describes a forward shift of the scapula, contributing to rounded shoulders.

Choosing the description that includes both winging and elevated scapula best captures multiple simultaneous deviations in shoulder alignment, which is why it’s the correct answer. The other options describe only one type of deviation, not the combined pattern that can occur in altered shoulder alignment.