How to Do a Shoulder Flexibility Test

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The shoulder flexibility test (also known as the reach test or the Apley back scratch test) 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.

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.

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

The Goal of Testing

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.

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 the temperature of the room you are in is comfortable (rather than cold). The only equipment needed is a measuring tape or ruler.

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.

If your fingers touch, the examiner will record your score as zero ("0 inches"). If your fingers overlap, the results will be recorded 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. Other tests can be used to evaluate injuries or impairment of the rotator cuff, including:

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

If an injury is identified, additional evaluations would be recommended. Ultrasound or magnetic resonance imaging (MRI) are better at imaging soft tissue than an X-ray. MRIs are also effective at 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.