Manual Muscle Testing: Shoulder Flexion

Shoulder Flexion to 90 Degrees Muscles Involved:

Deltoid (anterior)


Patient Positioning

  • Grades 3 to 5 - Patient is seated with arms at sides with elbows slightly flexed with forearm in pronation
  • Grades 0 to 2 - Patient is in side lying with the knee flexed to 90 degrees and supported by the therapist ('gravity minimal' position)

Therapist Position

  • Therapist to stand on test side
  • Palpation shoulder flexors

To Test

  • Patient to actively flex the shoulder to 90 degrees
  • For grades 4 to 5 apply resistance over distal humerus just above the elbow in the direction opposite to shoulder flexion.[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.