Manual Muscle Testing: Scapula Elevation

Muscles Involved:

Trapezius (upper)

Levator scapulae

Patient Positioning

Seated with arms relaxed in lap, patient to have head turned away from test-side For grades 0-2 gravity eliminated, patient in prone.

Therapist Position

Therapist to stand behind the patient

  • Palpation over scapular elevators
  • For grades 4 and 5: provide resistance downward at the top of the shoulder

To Test

  • Patient actively elevates scapula
  • For grades 4 and 5: therapist to give resistance downwards in the direction opposite to elevation. [1]
  • Note: as with all resisted testing of vertebroscapular muscles, the preferred resistance point is that which constitutes the longest lever as this more closely reflects the functional demands of the limb. To satisfy grade 5 'normal muscle' performance criteria, the patient must have the ability to move through complete range of motion (active resistance testing) OR maintain an end point range (break testing) against maximum resistance.

References

  1. Hislop H, Avers D, Brown M. Daniels and Worthingham's muscle Testing-E-Book: Techniques of manual examination and performance testing. Elsevier Health Sciences; 2013 Sep 27.