The Scapula: MMT Flashcards
Scapula ABD & UPWARD ROTATION
Grade 2
Patient Position:
Short sitting
Arm flexed above 90*
Therapist Position:
Stand at test side
Hand supporting elbow
Other hand at edge of inferior angle of scapula
Test:
Monitor scapula motion by using light grasp on scapula at inferior angle (look for winging)
Instructions:
“Hold your arm in this position. Let it relax. Now hold your arm again. Let it relax.”
Scapula ABD & UPWARD ROTATION
Grades 5, 4, 3
(Serratus Anterior)
Patient Position:
Short sitting
Therapist Position:
Stand at test side
Resistance on arm proximal to elbow
Other hand at edge of inferior border of scapula
Test:
Patient raises arm to 130* flex with elbow ext
Instructions:
“Raise your arm forward over your head. Keep your elbow straight, hold to. Don’t let me push you down.”
Scapula ABD & UPWARD ROTATION
Grades 1, 0
Patient Position:
Short sitting
Arm flexed above 90*
Therapist Position:
Standing in front and slightly to the test side
Hand supporting arm at elbow
Other hand at edge of inferior angle of scapula
Palpations:
-Serrarus Anterior: tips of fingers just in front of the inferior angle along Axillary border
Test:
Patient attempts to hold the arm in test position
Instructions:
“Try to hold your arm in this position.”
Scapular ELEVATION
Grades 5, 4, 3
(Upper Trapezius)
Patient Position:
Short sitting
Hands relaxed in lap
Therapist Position:
Stand behind patient
Hands over both shoulders
Resistance in a downward direction
Test:
Patient elevates shoulders
Instructions:
“Shrug your shoulders. Hold it. Don’t let me push them down.”
Scapula ELEVATION
Grades 2, 1, 0
Patient Position:
Prone or supine
Therapist Position:
Stand on test side
Support shoulder with palm of one hand
Palpations:
-Upper Trapezius: just adjacent to cervical spine
Test:
Patient elevates shoulder to ear
Instructions:
“Raise your shoulders toward your ears.”
Scapula ADD
Grades 5, 4, 3
(Middle Trapezius & Rhomboid Major)
Patient Position:
Prone with shoulder at edge of table
Shoulder ABD to 90*
Elbow flexed to 90*
Therapist Position:
Stand at test side
-if post delt is grade 3 or better place resistance over distal humerus
-if grade 2 or less place resistance over shoulder joint
Stabilization:
Contralateral scapula area: to prevent trunk rotation
Test:
Patient horizontally ABD’s arm and ADD’s shoulder
Instructions:
“Lift your elbow toward the ceiling. Hold it. Don’t let me push you down.”
Scapula ADD
Grades 2, 1, 0
Patient Position:
Prone w/ shoulder at edge of table
Shoulder ABD to 90*
Elbow flexed to 90*
Therapist Position:
Stand at test side
One hand cradles shoulder/arm
Palpations:
Spine of scapula from Acromion to vertebral column
Test:
Patient horizontally ABD’s arm and ADD’s shoulder
Instructions:
“Lift your elbow toward ceiling.”
Scapula DEPRESSION & ADD
Grades 5, 4, 3
(Lower Trapezius)
Patient Position:
Prone with test arm over head to ab 140* ABD
Thumb pointing to ceiling
Therapist Position:
Stand at test side
Resistance over distal humerus
Test:
Patient raises arm from table to at least ear level
Instructions:
“Raise arm from table as high as possible. Hold it. Don’t let me push it down.”
Scapula DEPRESSION & ADD
Grades 2, 1, 0
Patient Position:
Prone with test arm over head to ab 145* ABD
Thumb pointing to ceiling
Therapist Position:
Stand at test side
Support patients arm under elbow
Palpation:
Triangular area btw root of spine and lower thoracic vertebrae
Test:
Patient attempts to raise arm from table
If unable then therapist lifts and supports wt. of arm
Instructions:
“Try to raise your arm from the table as high as you can.”
Scapula ADD & DOWNWARD ROTATION
Grades 5, 4, 3
(Rhomboid Major and Minor)
Patient Position: Prone Shoulder IR Arm ADD across back Elbow flexed Hand resting on back
Therapist Position:
Stand at test side
One hand under vertebral border of scapula
Other hand:
-if shoulder ext grade 3 or better: place resistance on distal humerus downward and outward
-if shoulder ext grade 2 or less: places resistance along Axillary border of scapula
Test:
Patient lifts hand off back as resistance is given
Instructions:
“Lift your hand. Hold it. Don’t let me push you down.”
Scapula ADD & DOWNWARD ROTATION
Grades 2, 1, 0
Patient Position:
Short sitting
Shoulder IR
Arm extended and ADD behind back
Therapist Position:
Stand at test side
Support arm by grasping the wrist
Palpations:
Muscle under the vertebral border of scapula
Test:
Patient attempts to move hand away from back
Instructions:
“Try to move hand away from back.”
Scapula DEPRESSION
Grades 5, 4
(Latissimus Dorsi)
Patient Position: Prone with head turned to test side Arms at sides Shoulders IR Test shoulder "hiked" to level of chin
Therapist Position:
Stand at test side
Grasp forearm above patients wrist with both hands
Test: patient depresses arm
Instructions:
“Reach your hand toward your feet. Hold it. Don’t let me push your arm upward toward your head.”
Scapula DEPRESSION
Grade 5
(If patient is very strong in the Lats)
Patient Position:
Short sitting
Hands flat on table adjacent to hips
Therapist Position:
Stand behind patient
Test:
Patient pushes down on hands and lifts buttocks from table
Instructions:
“Lift your bottom off the table.”
Grade 5 if able to lift buttock off the table
Scapula DEPRESSION
Grades 3, 2
Patient Position:
Prone with arms at sides
Shoulders IR
Therapist Position:
Stand at test side
Test:
Patient pushed arm towards feet
Instructions:
“Reach down towards your feet.”
