ROUND EARTH PUBLISHING
Mouth Wraparound Test
Infraspinatus DBAL
Middle Deltoid SBAL
Subscapularis DBAL
Posterior Deltoid SBAL
Supraspinatus
Teres Major SFAL
Latissimus Dorsi SFAL/BFL
Levator Scapula DBAL
Splenius Cervicis SL
Teres Minor DBAL
Coracobrachialis
Backrub Test
Coracobrachialis
Anterior Deltoid SBAL
Hand to Shoulder
Blade Test
Infraspinatus DBAL
Anterior Deltoid SBAL
Supraspinatus
Subscapularis DBAL
Supinator
Pectoralis Major FF, SFAL
Latissimus Dorsi SFAL, BFL
Teres Minor DBAL
http://www.round-earth.com/RotatorCuffTests.html[10/1/2008 3:17:20 PM]
This is the single most important test for shoulder girdle
dysfunction. Combine with Backrub Test , below.
1. Position patient’s head at 45 o to shoulders.
2. Patient reaches arm around back of head to mouth.
Substitution: Increasing head angle to reach hand. Maintain
proper posture.
A. No restriction: Short upper arms should reach corner of mouth;
Normal arms: center of mouth; Hypermobile arms: opposite side
of mouth.
B. Restriction: Primarily middle deltoid/infraspinatus with other
possible involvement.If patient is:
Unable to reach back of neck: subscapularis.
Able to reach to ear only: infraspinatus.
Able to reach over head but not behind it: posterior deltoid,
coracobrachialis.
Unable to hold arm in abduction: supraspinatus.
Unable to rotate head to 45 o for this test. See Cervical
Rotation Test.
1. Patient reaches across lower back to opposite side.
2. Note distance achieved and difference between one side
and the other.
3. Press at elbow, pushing arm downward and slightly to the
rear (away from the body).
A. No restriction: Knuckles of palm extend beyond spine.
B. Restriction: Knuckles reach only to midline. Restriction rare in
persons of normal weight.
Failure, or pain or weakness on resistance: severe
restriction in coracobrachialis, or a severely injured anterior
deltoid; see Arm Abduction Test.
Unable to reach behind back: supinator; see Supinator
Test.
1. Patient reaches open hand behind back, wrist straight.
2. Observe hand level relative to spine of scapula.
3. Measure any side-to-side variation.
Substitution: Bending wrist to reach higher up back. A. No
restriction: Fingertips reach spine of scapula. B. Restriction:
Fingertips cannot reach spine of scapula. If patient:
Can barely reach hip pocket: infraspinatus (primary) and
anterior deltoid (secondary). See Arm Abduction Test.
Supraspinatus usually involved with infraspinatus (see
Mouth Wraparound Test) or upper trapezius (see Cervical
Lateral Flexion Test).
ROUND EARTH PUBLISHING

Is slightly restricted after treating infraspinatus: teres minor.

Can overcome shortening and weakness through passive
motion (such as walking fingers or wrist up back:
subscapularis.
Has restriction with pain in supinator reference area of
thumb; difficulty bending elbow to reach behind back. See
Supination Test.
Still has restriction after working the above: pectoralis
major (see Shoulder Drop Test), latissimus dorsi (see
Overhead Reach Test).

Overhead Reach Test 1. Patient brings arms together over top of head as if clapping
hands.
Triceps DBAL 2. Determine whether patient can bring arms in to touch ears,
Teres Major SFAL palms together, fingers level.
Latissimus Dorsi SFAL, BFL
Substitution: Tilting arms away from short side to equalize reach.

A. No restriction: Can touch ears with insides of arms, arms reach

same height, fingertips aligned.

B. Restriction:

With severely shortened triceps or teres major, one arm or

(or both) will be bent, and it may be difficult or painful to
press arms to ears.
If not possible to move arm behind ears, teres major (see
Mouthwrap Test), coracobrachialis (see Backrub
Test), and latissimus dorsi may also be involved.

Over Shoulder Reach 1. Raise arm to shoulder level, arm out, palm up.
2. Flex elbow to place palm on same-side shoulder, palm
Triceps DBAL down.
3. Slide palm down back, pointing elbow to ceiling.

Substitution: Dropping head forward to bring ear forward of arm.

Shifting arm out to side to relieve tightness in triceps. Keep and
elbow perpendicular to body.

A. No restriction: Elbow vertical or beyond ear.

B. Restriction: Cannot point elbow to ceiling.

Note: The photo from which this sketch was made was not a
staged shot. It was actual Before & After range of motion.
Compare active triceps trigger points in B with improved range of
motion immediately after treatment (A).

http://www.round-earth.com/RotatorCuffTests.html[10/1/2008 3:17:20 PM]