How to Do the Shoulder Flexibility Test

A Simple Test Used for Sports Training and Rehab

man stretching shoulders
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The shoulder flexibility test is a simple evaluative measurement of the flexibility and mobility of your shoulder joint. Also known as the reach test or the Apley back scratch test, it is used to assess the range of motion (ROM) of your shoulder, including flexion and extension.

The goal of the shoulder flexibility test is to prevent the hyperextension of the joint, which can lead to acute and chronic injury of the rotator cuff muscle group (which includes supraspinatus, infraspinatus, teres minor, and subscapularis).

Sports injuries involving the rotator cuff are usually the result of repetitive movements, such as those involved with swimming, tennis, volleyball, racquetball, or any sport that requires throwing or catching.

Goals of Testing

The restriction of shoulder movement is often interrelated to the stiffness and tension experienced in the upper back and neck. If these muscles become rigid or foreshortened due to injury or inactivity, your ability to rotate your shoulder outward, upward, and backward will be impeded.

If this happens, you will be less able to extend your arm up and behind your head or to reach sideways across your head. Similarly, if you build bulky muscles in the upper back (trapezius), neck (sternocleidomastoid), shoulder (deltoid), or lower back (latissimus dorsi) without retaining flexibility through routine stretching, the connective tissues can also foreshorten 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 then repeated every several weeks to determine what progress you have made.

How to Perform the Test

The shoulder flexibility test is best performed without any bulky clothing and in a comfortable (rather than cold) room. The only equipment needed is a measuring tape or ruler. To begin the test:

  • Raise your right arm straight overhead.
  • Bend your right elbow and let your right palm rest on the back of your neck, palm down.
  • With your left hand, reach behind your back and rest your hand on your spine, palm up.
  • Now, without moving excessively, slide your right hand down your neck and your left hand up your spine toward each other.
  • Once you have reached as far as you can, the examiner will measure the distance between your fingers.

If your fingers touch, the examiner would record that as zero ("0 inches"). If the fingers overlap, he or she would record that as a negative figure (for example "-1 inch").

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

Test Results

The shoulder flexibility test, while basic, can give the therapist a pretty good idea of your functional ROM. For general health purposes, your ROM would be described as follows:

  • Excellent: fingers overlap
  • Good: fingers touch
  • Average: fingers are less than two inches apart
  • Poor: fingers are more than two 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 between winning or losing.

Other Shoulder Flexibility Tests

The shoulder flexibility test does have its limitations, namely in people whose arms are of different lengths. To this end, other tests may be used to evaluate injuries or impairment of the rotator cuff. They include:

If an injury of any sort is identified, additional evaluations would be recommended. These may include an ultrasound or magnetic resonance imaging (MRI), both of which are better at imaging soft tissue than an X-ray. MRIs are also effective in determining whether a rotator cuff injury is new or old.

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Article Sources

  • 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.
  • Aumiller, W. and 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.