How To check Shoulder Mobility with Apley’s Scratch Test

In this Article, you can check How To check Shoulder Mobility with Apley’s Scratch Test. Apley’s scratch test Involves multiple and simultaneous movements of the scapulothoracic and glenohumeral Joints in all three planes. Thus represents a challenge m evaluating shoulder movement and Identifying movement Ilmntatlons. To Identify the source of the mutation. you can first perform various Isolated movements In single planes to locate potentially problematic movements. Consequently. the scratch test is completed in Conjunction With:

  1. The shoulder flexion-extension test
  2. An internal-external rotation test of the humerus

Shoulder Flexion And Extention

How To check Shoulder Mobility with Apley's scratch Test

How To check Shoulder Mobility with Apley’s Scratch Test

Objective: To assess the degree of shoulder flexion and extension. This test should be performed in conjunction with Apley’s scratch test to determine if the limitation occurs with shoulder flexion or extension.

Equipment:

  • Exercise Mat
  • pillow(optional)

Instructions:  Explain the purpose of the test.

Shoulder flexion:

  1. Instruct the person to lie supine on a mat, with the back flat and a bent-knee position (knees and second toe aligned With the ASIS). and with the arms at the sides.
  2. Have the client engage the abdominal muscles to hold a neutral spine without raising the hips from the mat.
  3. Instruct the client to raise both arms simultaneously into shoulder flexion, moving them overhead, keeping them close to the sides of the head, and banging them down to touch the floor or as close to the floor as possible
  • The client must maintain extended elbows and neutral wrist position (the arms will naturally rotate internally during this movement)
  • Have the client avoid any arching in the low back during the movement.
  • Have the client avoid any depression of the rib cage, which may pull the shoulders off the mat.

 Shoulder extension:

  1. Instruct the client to lie prone, extending both legs, with arms at the sides, and resting the forehead gently on a pillow or the mat.
  2. Ask the client to slowly raise both arms simultaneously into extension, lifting them off the mat while keeping the arms close to the sides (the arms will naturally rotate internally during this movement).
  •  A small amount of extension in the thoracic spine is acceptable during the movement.
  • The client should avoid any arching in the low back or any rotation of the torso during the movement.
  • The client should avoid any attempts to lift the chest or head off the mat during the movement. Observations: 0 Measure the degree of movement in each direction.
  • Note any bilateral differences between the left and right arms in performing both movements.

General interpretations:

° Use the information provided in Table to determine the limitations in these shoulder flexibility tests.

Interpretation of the Shoulder Flexion and Extension Test

Limitations /MovementsShoulder mobility
Ability to flex the shoulders to 170-180 degrees (hand touching/nearby touching floor)good shoulder mobility
inability to flex the shoulder to 170 degrees or discrepancies between the limbspotential tightness in the pectoralis major and minor, latissimus dorsi, teres major, rhomboids, and subscapularis.
1. Tightness in the latissimus dorsi force to the low back to arch.
2. tightness of the pectoralis minor may tilt the scapulae forward(anterior tilt) and prevent the arm from touching the floor.
3. tight abdominals may depress the rib cage, tilting the scapulae forward(anterior tilt), and prevent the arms from touching the floor.
4. thoracic kyposis may round the thoracic spine and prevent the arm from touching the floor

Ability to extend the shoulders to 50-60 degrees off the floorgood shoulder mobility
inability to extend the shoulder to 50 degrees or discrepancies between the limbspotential tightness in pectoralis major, abdominals, subscapularis, certain shoulder flexors(anterior deltoid),coracobrachialis, and bicep brachii
1. tightness in the abdominals may prevent normal extention of the thoracic spine and rib cage.
2. tightness in the bicep brachii may prevent adequate shoulder extention with an extended elbow(but may permit extention with a bent elbow).

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Internal and External Rotation Of Humerus at the Shoulder

How To check Shoulder Mobility with Apley's scratch Test

How To check Shoulder Mobility with Apley’s Scratch Test

Objective. To assess the internal (medial) and external (lateral) rotation of the humerus at the shoulder joint. This test should be performed in conjunction with Apley’s scratch test to determine if the limitation occurs with internal or external rotation of the humerus

Equipment

  • Mat

Instructions:

  • Explain the purpose of the test. 0 Instruct the client to lie supine, with his or her back flat on a mat in a bent
  • knee position (knees and second toe aligned with the ASIS).
  • Ask the client to abduct the arms to 90 degrees, with a 90-degree bend at the elbows and the forearms perpendicular to the mat (i.e.. pointing up toward the ceiling).
  1.  The upper arms must remain aligned with the shoulders throughout the test.
  2. The backs of the upper arms should rest against the mat throughout the test.
  •  External (lateral) rotation to evaluate medial rotators. Ask the client to slowly rotate his or her forearms backward toward the mat, aiming to rest the forearms and the backs of the hands on the mat adjacent to the head, while maintaining the 90-degree bend at the elbows.
  1. The client should engage the abdominals to avoid arching the low back and avoid flexing the spine forward.
  2. The client should maintain a neutral wrist position throughout the movement.
  •  Internal (medial) rotation to evaluate lateral rotators. 1.  Have the client return to the starting position (forearms perpendicular to the mat). 2. Ask the client to slowly rotate the forearms forward toward the mat, turning the palms downward while maintaining the 90-degree bend at the elbows.
  •  The client should avoid raising the shoulders off the table or flexing the spine forward.
  • The client must maintain a neutral wrist position throughout the movement.

Observations:

  • Measure the degree of movement in each direction.
  • Note any bilateral differences between the left and right arms in performing both movements.

General interpretation: 

Use the information provided in Table to determine the limitation(s) in this flexibility test.

Interpretation of the Internal and External Rotation Test

Movement/Limitations-External/Lateral RotationShoulder Mobility
Ability to externally rotate the forearms 90 degrees to touch the mat. Good mobility in the internal(medial) rotators, allowing the joint to move through the full range.
inability to reach the floor or discrepancies between the limbsPotential tightness in the internal rotators, of the arm (i.e., subscapularis)
The joint capsule and ligaments may also be tight and limit rotation.
Movements/Limitation- Internal/Medial RotationShoulder Mobility
Ability to internally rotate the forearm 70 degree toward the mat.(i.e., forearm are 20 degrees of the mat)Good mobility in the external(lateral) rotators, allowing the joint to move through the full range.
Inability to internally rotate the forearm 70 degrees, or discrepancies between the limbsPotential tightness in the external rotators of the arm (i.e., infraspinatus and teres minor)
The joint capsule and ligaments may also be tight and limit rotation.

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Apley’s Scratch Test for Shoulder Mobility.

How To check Shoulder Mobility with Apley's scratch Test

How To check Shoulder Mobility with Apley’s Scratch Test

Objective: To assess the simultaneous movements of the shoulder girdle (primarily the scapulothoracic and glenohumeral joints).

Movements Include:

  • Shoulder extension and flexion
  • Internal and external rotation of the humerus at the shoulder
  • Scapular abduction and adduction

Instructions:

  • Explain the purpose of the test and allow a warm-up (e.g., forward and rearward arm circles).
  • Shoulder flexion. external rotation, and scapular abduction
  1. From a sitting or standing position, the client raises one arm overhead, bending the elbow and rotating the arm outward while reaching behind the head with the palm facing inward to touch the medial border of the contralateral scapula or to reach down the spine (touching vertebrae) as far as possible.
  2. The client should avoid any excessive arching in the low back or rotation of the torso during the movement.
  3. Have the client repeat the test with the opposite arm.
  • Shoulder extension, internal rotation, and scapular adduction
  1. From a sitting or standing position, the client reaches one arm behind the back. bending the elbow and rotating the arm inward with the palm facing outward to touch the inferior angle of the contralateral scapula or to reach up to the spine (touching vertebrae) as far as possible.
  2. The client should avoid any excessive arching in the low back or rotation of the torso during the movement.
  3. Have the client repeat the test with the opposite arm.

observations:

  • Note the client’s ability to touch the medial border of the contralateral scapula or how far down the spine he or she can reach with shoulder flexion and external rotation.
  • Note the client’s ability to touch the opposite inferior angle of the scapula or how far up the spine he or she can reach with shoulder extension and internal rotation.
  • Observe any bilateral differences between the left and right arms in performing both movements.

General interpretations: Use the information provided in the TABLE to determine the limitations of this flexibility test.

interpretation of Apley's scratch Test

Movement/LimitationsShoulder Mobility
Ability to touch specific landmarksGood shoulder mobility
Inability to reach or touch the specific landmarks or discrepancies between the limbsRequire further evaluation to determine the source of the limitation(i.e., which of the movements is problematic)
1. shoulder flexion and extension
2. scapular abduction and adduction

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