How to Do a Shoulder Flexibility Test

In This Article

The shoulder flexibility test is a simple evaluation 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 hyperextension of the joint. Hyperextension—the extension of the joint beyond its normal limits—can lead to acute and chronic injury of the rotator cuff muscle group, including 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.

The Goal of Testing

The restriction of shoulder movement is often related to 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 limited.

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 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 then repeated every several weeks to determine what progress you have made.

How to Perform the Shoulder Flexibility Test

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

  1. Raise your right arm straight overhead.
  2. Bend your right elbow and let your right palm resting on the back of your neck, with fingers pointing down towards your feet.
  3. With your left hand, reach down and behind your back and rest the back of your hand on your spine (so that the palm faces away from your body).
  4. Now, without straining, slide your right hand down your neck and your left hand up your spine toward each other.
  5. Once you have reached as far as you can, the examiner will measure the distance between your fingers.

If your fingers touch, the examiner will record your score as zero ("0 inches"). If the fingers overlap, they will 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 is a basic test that can give the 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 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.

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.

Other Shoulder Flexibility Tests

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

  • AC joint compression test (to diagnose shoulder separation)
  • Apprehension and relocation test (to identify a shoulder tear)
  • Neer's test (to diagnose shoulder impingement)
  • Sulcus test (to evaluate shoulder instability)
  • Empty can test (to confirm a rotator cuff tear)
  • Frozen shoulder tests (to diagnose a rotator cuff adhesion)

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
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  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):7001350010p1-7001350010p10. doi:10.5014/ajot.2016.015487

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.