Manual Muscle Testing: Shoulder Extension

Muscles Involved:

Latissimus Dorsi

Deltoid (posterior)

Teres Major

Patient Positioning

  • Patient is in prone with elbow extended with arm free to move, palm directed up in direction of internal rotation
  • For grades 0-2 patient is in side lying ('gravity minimal' position) +/- low friction board

Therapist Position

  • Therapist stands on test-side
  • Palpation over shoulder extensors

To Test

  • Patient actively extends the shoulder through available range
  • For grades 4 to 5 apply resistance over posterior surface of distal humerus in a direction opposite to extension[1]
  • 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.


  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.