The Shoulder: MMT Flashcards
Grades 5-0
5- Hold with Max resistance 4- Hold with Mod resistance 3- Completes test range with NO resistance 2- Completes partial ROM 1- Feel contraction of muscle 0- No activity
Shoulder FLEXION
Grades 5, 4, 3, 2
(Anterior Deltoid & Coracobrachialis)
Patient Position:
Short sitting with arms at rest
Elbows slightly flexed
Forearm Pronated
Therapist Position:
Stand at test side
Give resistance over distal humerus
Stabilization:
Shoulder
Test:
Patient flexes to 90*
Instructions:
“Raise your arm forward to shoulder height. Hold it. Don’t let me push it down.”
Shoulder EXTENSION
Grades 5, 4, 3, 2
(Latissimus Dorsi, Posterior Deltoid & Teres Major)
Patient Position:
Prone with arms at side
Shoulder IR
Therapist Position:
Stand at test side
Resistance over distal humerus
Test:
Patients raises arm off table, keeping elbow extended
Instructions:
“Lift your arm as high as you can. Hold it. Don’t let me push you down.”
Shoulder EXTENSION
Grades 1, 0
Patient Position:
Prone with arms at sides
Shoulders IR
Therapist Positions:
Stand at test side
Palpation:
- Latissimus Dorsi: side of thoracic wall below and lateral to inferior angle of scapula.
- Post. Deltoid: posterior shoulder superior to axilla.
- Teres Major: lateral border of scapula just below axilla.
Test:
Patient attempts to lift arm from table
Shoulder SCAPTION
Grades 5, 4, 3, 2, 1, 0
(Anterior, Middle Deltoid & Supraspinatous)
Patient Position:
Short sitting
Therapist Position:
In front of and slightly to test side
Give resistance over arm proximal to elbow
Test:
Patient elevates arms in plane btw Sagittal and Frontal
Instructions:
“Raise your arm to shoulder height halfway btw straight ahead and out to the side. Hold it. Don’t let me push you down.”
Shoulder ABD
Grades 5, 4, 3, 2
(Middle Deltoid & Supraspinatous)
Patient Position:
Short sitting arms at sides
Elbows slightly flexed
Therapist Position:
Stand behind patient
Resistance over arm proximal to elbow
Test:
Patient ABD’s arm to 90*
Instructions:
“Raise your arm out to the side and to shoulder level. Hold it. Don’t let me push you down.”
Shoulder ABD
Grades 1, 0
Patient Position:
Short sitting with arms at side
Elbow slightly flexed
Therapist Position:
Stand behind patient
Support at elbow
Palpation:
- Middle Deltoid: lateral to Acromion process on superior aspect of shoulder
- Supraspinatous: Not easy to palpte
Test:
Patient tries to maintain arm in 90* of ABD
Instructions: “Try to hold your arm in this position.”
Shoulder HORIZONTAL ABD
Grades 5, 4, 3
(Posterior Deltoid)
Patient Position:
Prone
Shoulder ABD 90*
Forearm off table with elbow flexed
Therapist Position:
Stand at test side
Resistance over posterior arm proximal to elbow
Test:
Patient horizontally ABD’s shoulder
Instructions:
“Lift your elbow up towards the ceiling. Hold it. Don’t let me push you down.”
*Shoulder HORIZONTAL ABD
Grades 2, 1, 0
Patient Position:
Short sitting
Therapist Position:
Stand at test side
Support arm under distal surface
Palpation:
-Post. Deltoid: over posterior surface of shoulder just superior to axilla
Test:
Patient tries to move arm into horizontal ABD
Instructions:
“Try to move your arm backwards.”
Shoulder HORIZONTAL ADD
Grades 5, 4, 3
(Pectoralis Major)
Patient Position: -Whole Muscle: Supine Shoulder ABD 90* Elbow flex 90* -Clavicular Head: Shoulder ABD 60* -Sternal Head: Shoulder ABD 120*
Therapist Position:
Stand on test side
Resistance over forearm just proximal to wrist
Test:
-Whole muscle:
Patient horizontally ADD shoulder through available range
-Clavicular head: start in 60* ADD and move up and in
-Sternal head: start in 120* ADD and move down and in
Instructions:
- Whole muscle: “Move your arm across your chest. Hold it. Don’t let me pull back.”
- Clavicular head: “Move your arm up and in.”
- Sternal head: “Move your arm down and in.”
Shoulder HORIZONTAL ADD
Grades 2, 1, 0
Patient Position:
Supine
Arm supported in 90* of ABD and elbow flexed to 90*
Therapist Position:
Stand at test side
Palpation:
-Pectoralis Major on anterior aspect of chest medial to shoulder joint
Test:
Patient attempts to horizontally ADD shoulder
Instructions:
“Try to move your arm across your chest.”
Shoulder EXTERNAL ROTATION
Grades 5, 4, 3
(2 Fingers Resistance)
(Infraspinatous & Teres Minor)
Patient Position: Prone Head toward test side Shoulder ABD 90* (fully supported on table) Forearm off table with elbow flexed Place towel under arm
Therapist Position:
Stand at test side at level of wrist
2 fingers give resistance at wrist
Other hand gives support at elbow
Test:
Patient moves forearm upward through range of ER.
Instructions:
“Raise your arm to the level of the table. Hold it. Don’t let me push you down.”
Shoulder EXTERNAL ROTATION
Grades 2, 1, 0
Patient Position: Short sitting Elbow flexed to 90* Forearm in neutral rotation Hand facing forward
Therapist Position:
Sit at test side at level
Stabilize outside of elbow
Palpation:
- Infraspinatous: over body of scapula below spine
- Teres Minor: on inferior margin of axilla and along Axillary border of scapula.
Test:
Patient attempts to externally rotate shoulder
Instructions:
“Try to push your forearm away from your stomach.”
Shoulder INTERNAL ROTATION
Grades 5, 4, 3
(2 Fingers Resistance)
(Subscapularis)
Patient Position: Prone Head toward test side Shoulder ABD 90* (arm fully supported on table) Forearm off edge of table Elbow flexed Place towel under arm
Therapist Position:
Sit at test side eye level to wrist
2 finger resistance to inner side of forearm proximal to wrist, other hand supports elbow
Test:
Patient moves forearm upward through ROM
Instructions: “Raise your arm up and back. Hold it. Don’t let me push you down.”
Shoulder INTERNAL ROTATION
Grades 2, 1, 0
Patient Position: Short sitting Elbow flexed to 90* Forearm in neutral Hand facing forward
Therapist Position:
Sit at eye level
Palpation:
-Supraspinatous: deep in central area of the axilla
Test:
Patient attempts to IR shoulder
Instructions:
“Try to pull your forearm toward your stomach.”
