Manual Muscle Testing: Shoulder Internal Rotation

Original Editor - Kakshya Rupakheti Top Contributors - Kakshya Rupakheti

Muscle Involved

Subscapularis

Patient Position

Grade 3 to 5: Prone position, head turn towards the test side, Shoulder abducted to 90° and folded towel placed under the distal arm and forearm hanging vertically from the edge of the bed.

Grade 2 and 1 : Prone position, head turn towards the test side, Patient at the edge of the bed so that the entire arm hangs freely from the edge of the bed. Arm is Placed in the neutral position (palm facing the table).

Therapist Position

Grade 3 to 5: Stand at the test side. For resistance place the hand on the volar side of the forearm just above the wrist and the other hand provides counterforce at the elbow. The resistance hand applies resistance in the downward and forward direction. The counterforce is applied backward and slightly upward.

Grade 2,1 and 0: Stand or sit on a low table on the test side. The therapist should stabilize the test arm at the shoulder.

To Test

Instruction to the patient should be given in the language they are comfortable with.

The Patient moves the arm in the available range of internal rotation (backward and upward).

Complete available range of motion and hold maximum resistance for grade 5. Complete available range of motion and hold moderate to minimum resistance for grade 4. Complete available range of motion without resistance.For grade 2 Instruct the patient to rotate shoulder internally in the given position.

For grade 1 palpate the subscapularis tendon deep in the central area of the axilla. Palpation contraction is present for grade 1 and No palpable or visible contraction is occur for grade 0.[1]

[2]

References

  1. Hislop HJ.Daniels and Worthingham's Muscle testing: techniques of Manual Examination. St.Louis,Missouri. Saunders Elsevier,8th edition.
  2. EducatedPT. Shoulder Internal Rotation MMT. https://www.youtube.com/watch?v=obfI4UAmd4I [last accessed 08/11/2020]