How to Perform the Apley Scratch Test

Assess Range of Motion in Your Shoulders

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Also Known As: Shoulder flexibility test, reach test, back scratch test, shoulder reach test

Targets: Shoulder

Equipment Needed: None

Level: Beginner

The Apley scratch test is a shoulder flexibility test used to evaluate the flexibility and mobility of your shoulder joint. The test can also be used to assess the range of motion (ROM) of your shoulder, including flexion and extension.

You perform the Apley back scratch test by touching your palm to the opposite shoulder blade by bending your elbow above or below your shoulder. It can be a helpful test and stretch to perform before any upper-body sport workout or strength-training workout that includes throwing, catching, or any shoulder movement.

Benefits

The Apley back scratch specifically tests the mobility of your shoulders. The goal of the shoulder flexibility test is to prevent hyperextension of the joint.

Hyperextension (the extension of the joint beyond its normal limits) can lead to an acute or chronic injury of the rotator cuff muscle group, including supraspinatus, infraspinatus, teres minor, and subscapularis. These rotator cuff injuries can be caused by repetitive movements, such as those involved with swimming, tennis, volleyball, racquetball, or any sport that requires throwing or catching.

Restricted shoulder movement is often related to stiffness and tension in the upper back and neck. If these muscles become rigid or foreshortened because of an injury or inactivity, it will limit your ability to:

  • Extend your arm up and behind your head
  • Reach sideways across your head
  • Rotate your shoulder outward, upward, and backward

If you build bulky muscles without retaining flexibility through routine stretching—particularly in your upper back (trapezius), neck (sternocleidomastoid), shoulder (deltoid), or lower back (latissimus dorsi)—the connective tissues can become tight and limit your ROM.

The shoulder flexibility test is used by exercise physiologists and physical therapists to assess baseline flexibility before starting an exercise or rehab program. The test is repeated every few weeks to determine progress.

Step-by-Step Instructions

The shoulder flexibility test is best performed when you are not wearing bulky clothing. It is also recommended that the temperature of the room you are in is comfortable (rather than cold). The only equipment needed is a measuring tape or ruler.

Stand evenly on both feet and relax your shoulders and arms.

To begin the test:

  1. Raise your right arm straight up over your head.
  2. Bend your right elbow. Let your right palm rest on the back of your neck with your fingers pointing down toward your feet.
  3. Using your left hand, reach down behind your back and rest the back of your hand on your spine (your palm should be facing away from your body).
  4. Without straining, slide your right hand down your neck and your left hand up your spine (your hands should be moving toward each other).
  5. Once you have reached as far as you can, the examiner will measure the distance between your fingers.
  6. Release your grasp by reversing the stretch and returning to the starting position.

If your fingers touched, the examiner will record your score as zero ("0 inches"). If your fingers overlapped, the results will be recorded as a negative figure (e.g., "-1 inch").

You would then switch hands to perform the test on the opposite shoulder.

Test Results

The shoulder flexibility test is a basic test that can give your therapist a good idea of your functional ROM. The functional range of motion gives you and the therapist an idea of how well your joint will function in activities of daily living.

For general health purposes, your ROM test results would be described as follows:

  • Excellent: Fingers overlap
  • Good: Fingers touch
  • Average: Fingers are less than 2 inches apart
  • Poor: Fingers are more than 2 inches apart

For training purposes, the physiologist would be more concerned about the exact measurement, especially in sports like swimming or gymnastics where shoulder flexibility can make the difference in performance.

If your score is below average, your physical therapist will work with you to develop a treatment plan that may include therapeutic modalities and stretching exercises to improve your flexibility and ROM.

Common Mistakes

The test must be completed without any straining or arching in your back. When extending your fingertips toward each other, make sure you are not arching your back to force contact. Stand relaxed with your back straight for the most accurate result.

Variations and Modifications

Variations

While the above instructions show using both arms in the exercise, the Apley test can also be performed separately with each arm, measuring the external rotation and internal rotation of the shoulder independently.

The test can be done by extending one arm above and behind the back and toward the opposite scapula (shoulder blade). Then, taking the same arm, reach under behind your back toward the lower part of the opposite shoulder blade.

Need a Modification?

The Brockport Physical Fitness Test, used to test fitness in children with disabilities, modifies the Apley test by instructing the student to touch their back using one hand, reaching for the opposite scapula.

Safety and Precautions

If you have existing back discomfort or pain, do not attempt the stretch test. Consult a physical therapist or sports medicine doctor to diagnose any pain.

When performing a stretch, a bit of tightness or mild discomfort is normal. However, if you feel pain, stop immediately.

Shoulder Conditions

If you have been diagnosed with certain shoulder conditions, your Apley scratch test score may be poor or average. Conditions including injury, frozen shoulder, tendonitis, arthritis, or any shoulder pain can prohibit full ROM.

Improving Range of Motion

To improve your shoulder mobility and score higher on the Apley scratch test, you can improve the range of motion in your shoulder using stretches and at-home exercises.

Consider these helpful shoulder stretches to improve your shoulder flexibility:

  • Towel shoulder rotation stretch: Using a towel, hold one end in each hand and perform a modified Apley test, pulling the towel up with your top hand and feeling the stretch in your shoulder blade.
  • Thread the needle: While on all fours, lift your right arm in the air, opening up for a chest stretch. Take your right palm, moving it under your left shoulder, and dropping your right shoulder to the floor. Hold the pose for a few seconds and feel the stretch as you press against the mat.
  • Anterior shoulder stretch: Clasp your palms together behind your back, and slowly lift them toward the sky. You'll feel this move in your shoulder blades, and always make sure to stop raising your palms when you feel discomfort.

A Word From Verywell

When stretching or performing any physical activity, always listen to your body. If you feel any pain or severe discomfort, stop immediately and consult a physical therapist or physician.

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4 Sources
Verywell Fit uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Academy of Orthopedic Surgeons. Rotator Cuff Tears.

  2. Gates DH, Walters LS, Cowley J, Wilken JM, Resnik L. Range of motion requirements for upper-limb activities of daily living. Am J Occup Ther. 2016;70(1). doi:10.5014/ajot.2016.015487

  3. Woodward TW, Best TM. The painful shoulder: part i. Clinical evaluation. AFP. 2000;61(10):3079-3088.

  4. The College of Brockport: State University of New York. Test Items and Standards Related to Aerobic Functioning on the Brockport Physical Fitness Test.

Additional Reading
  • Aumiller W, Kleuser T. Diagnosis and treatment of cuff tear arthropathy. J Am Acad PA. 2015;28(8):33–8. doi:10.1097/01.JAA.0000469435.44701.ce.

  • American College of Sports Medicine. (2013) ACSM's Guidelines for Exercise Testing and Prescription (9th Edition). Philadelphia, Pennsylvania: Lippincott Williams and Wilkins. ISBN: 978-1-6091-3955-1.