Manual Muscle Testing: Shoulder Flexion

Original Editor - Claire Knott

Top Contributors - Claire Knott, Wanda van Niekerk, Joao Costa and Nikhil Benhur Abburi  

Shoulder Flexion to 90 Degrees Muscles Involved:[edit | edit source]

Patient Positioning[edit | edit source]

  • Grades 3 to 5 - Patient is seated with arms at sides with elbows slightly flexed with forearm in pronation
  • Grades 0 to 2 - Patient is in side lying with the knee flexed to 90 degrees and supported by the therapist ('gravity minimal' position)

Therapist Position[edit | edit source]

  • Therapist to stand on test side
  • Palpation shoulder flexors

To Test[edit | edit source]

  • Patient to actively flex the shoulder to 90 degrees
  • For grades 4 to 5 apply resistance over distal humerus just above the elbow in the direction opposite to shoulder flexion.[1]
  • To satisfy grade 5 'normal muscle' performance criteria, the patient must have the ability to move through complete range of motion (active resistance testing) OR maintain an end point range (break testing) against maximum resistance.


References[edit | edit source]

  1. Hislop H, Avers D, Brown M. Daniels and Worthingham's muscle Testing-E-Book: Techniques of manual examination and performance testing. Elsevier Health Sciences; 2013 Sep 27.
  2. EducatedPT. Shoulder Flexion MMT. Available from:[last accessed 31/7/2021]