Upper Extremity MMT

Question 1

SHOULDER FLEXION

Answer 1

SHOULDER FLEXION

Question 2

What is the primary mover in shoulder flexion?

What assist this muscle?

Answer 2

• Anterior deltiod

- Coracobrachialis and supraspinatus

Question 3

Common Substitutions:

• Arm position is important, if patient externally rotates arm they can use ______ to flex the arm.
• What is shoulder hiking?
• Patient may try to lean trunk ________ in an attempt to elevate the shoulder.
• If examiner observes horizontal adduction, this indicates recruitment of ___________ (can only occur up to 70°)

Answer 3

• biceps
• elevation caused by upper traps
• backward
• pectoral muscles

Question 4

TESTING SHOULDER FLEXION: ______________

• What is the normal ROM?
• Difference between a grade 3-5 test vs a grade 0-2?

Answer 4

• Primarily Anterior Deltoid
• 180°
• In a grade 3-5 test, the patient will be short sitting with their arm pronatedand at 90°. Pressure is applied proximal to the elbow. In a 0-2 test, the patient will be side lying for a gravity minimized test.

Question 5

TESTING SHOULDER EXTENSION: _____________

• What is the normal ROM?
• What muscle also assists with this movement?
• Difference between a grade 3-5 test vs a grade 0-2?

Answer 5

• Posterior Deltoid, Latissimus, Teres Major
• 0-60°
• Long head of triceps brachii
• In a grade 3-5 test, the patient will be prone with palm facing upward. The patient will raise their arm as high as they can and pressure will be applied proximal to the elbow. In a grade 0-2 test, the patients arm will be supported while in side lying.

Question 6

TESTING SHOULDER ABDUCTION: _______________

• What is the normal ROM?
• For this test do not allow lateral __________ or elevation of the _________
• Difference between a grade 3-5 test vs a grade 0-2?

Answer 6

• Middle Deltoid, Supraspinatus
• 0-180°
• trunk flexion, shoulder
• In a grade 3-5 test, the patient will be short sitting with their arm at 90° flexion. Pressure will be applied to the proximal elbow. In a grade 0-2, the patient will be lying supine and instructed to abduct their arm while being supported by the PT (no help).

Question 7

TESTING SHOULDER EXTERNAL ROTATION: _____________

• What is the normal ROM?
• Difference between a grade 3-5 test vs a grade 0-2?
• Keep in mind the force applied will be at the _________________ in supine due to the largest gravitational moment occuring at the start of external rotation.

What is an alternative to this that is often used in the clinic?

Answer 7

• Infraspinatus, Teres Minor
• 0-90°
• In a grade 3-5 test, the patient will be lying prone at the edge of the table with a towel under their proximal elbow. The patient will be instructed to raise their arm to 90° and pressure will be applied towards the floor. In a grade 0-2 test the patient will be moved to the very edge of the bed so their arm is completely off. They will then be instructed to turn their palm out (supinate).
• beginning of the motion

Patient is in short sitting with arm internally rotated. They are then instructed to push their forearm away from their stomach. It is difficult to isolate external rotators here.

Question 8

TESTING SHOULDER INTERNAL ROTATION: ________________

• What is the normal ROM?
• What are some other assisting muscles?
• Difference between a grade 3-5 test vs a grade 0-2?

Answer 8

• Subscapularis, Teres Major
• 70-80°
• Pec major, Latissimus dorsi, Anterior Deltoid
• For a grade 3-5 test, the patient will be lying prone at the edge of the table with a towel under their proximal elbow. The patient will be instructed to bring their arm back as far as they can and pressure will be applied towards the floor. In a grade 0-2 test, the patient will be moved to the very edge of the bed so their arm is completely off. They will then be instructed to turn their arm inward (pronate).