Manual Muscle Testing: Wrist Extension

Original Editor - Claire Knott

Top Contributors - Claire Knott, Nikhil Benhur Abburi and Wanda van Niekerk  

Muscles Involved:

• Extensor carpi radialis longus
• Extensor carpi radialis brevis
• Extensor carpi ulnaris

Patient Positioning

• Patient is seated with palmar surface of forearm supported in pronation on table, wrist is neutral

Therapist Position

• Therapist is seated to access test-side
• Palpation of wrist extensors

To Test

• Patient actively extends the wrist through range.
• For grades 4 to 5 apply resistance through dorsal aspect of hand in a direction opposite to extension.
• 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.

Biasing Muscles/ Muscle Groups

• To bias extensor carpi radialis longus & brevis: preposition the wrist in slight extension and radial deviation and instruct the patient to extend the wrist leading with the thumb side. Resistance is applied over the 2nd metacarpal (radial side) in the direction of flexion and ulnar deviation.
• To bias extensor carpi ulnaris: preposition the wrist in slight extension and ulnar deviation and instruct the patient to extend the wrist leading with the 5th digit ("pinky") side. Resistance is applied over the dorsal surface of the 5th metacarpal (ulna side) in the direction of flexion and radial deviation.