The top of the shoulder blade (scapula) should sit roughly at the second or third thoracic vertebra. I often see scapulae that are sitting lower than this. When this displacement occurs, the upper trapezius is typically too long and/or too weak to hold up the scapula.
I see this problem in nearly everyone with neck pain. Depressed shoulder blades -- shoulder blades (scapulae) that sit too low on the trunk -- can increase tension on the muscles connecting the scapulae to the neck, specifically the levator scapulae, and can lead to neck pain and headaches. It also sets the stage for inadequate elevation of the scapulae during overhead motions, further compromising those muscles and tissues.
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