College of Massage Therapists of British Columbia (CMTBC) Practice Exam

A patient stands facing the wall and performs a wall push-up during assessment. The therapist observes the medial border of the patient's left scapula lift off the thorax. What does this indicate in the assessment?

1. Hypertoned subscapularis

2. Weakness of the subscapularis

3. Hypertoned serratus anterior

4. Weakness of the serratus anterior

The correct answer is: Weakness of the serratus anterior

The situation described indicates that the medial border of the patient's left scapula is lifting away from the thorax while performing a wall push-up. This specific observation suggests a problem with the muscles responsible for stabilizing the scapula, particularly the serratus anterior. The serratus anterior is crucial for anchoring the scapula to the thoracic wall and ensuring that it remains stable during movements of the upper extremities. When this muscle is weak or not functioning optimally, it cannot effectively keep the scapula in place, leading to the winging or lifting of the medial border off the thorax, which is what the therapist observed. In this context, weakness of the serratus anterior is a significant factor contributing to the condition observed during the push-up. Strengthening this muscle would typically be an important focus in rehabilitation for improving scapular stability and overall shoulder function.