The shoulderblade (scapula) often rotates abnormally, or becomes stressed, in a clockwise or counterclockwise direction. Another way to conceptualize this is to imagine the bottom angle of the scapula moving in direction toward, or away from, the spine.
Because of how the scapula articulates at the shoulder, these rotations can affect the upper extremity all the way down to the wrist.
In my Activator Chiropractic protocol, after I find a rotated scapula and correct it, I then check the humerus (the bone in the upper arm), the radius and ulna (the two bones in the forearm), and the carpals (bones in the wrist).
This is a good example of the thoroughness of Activator Method when assessing and adjusting the body.