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Glossary of Muscle testing

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Created by shearerpt

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Upper Trapezius

Patient positioning:
• Sitting
• Elevation of shoulder, posterolateral extension of neck
Therapist:
• Against the shoulder in direction of depression and against the head in the direction of flexion anterolaterally







Lower Trapezius

Patient positioning:
• Prone
• Arm abducted (diagonally over head) with lateral rotation (thumb up)
Therapist:
• Place one hand below the scapula on the opposite side for support. Apply pressure against forearm in a downward direction







Latissimus Dorsi

Patient positioning:
• Prone
• Arm adducted with extension and medial rotation
Therapist:
• Can apply counter pressure latterally on pelvis. Apply pressure against the forearm in direction of abduction and slight flexion





Middle Trapezius

Patient positioning:
• Prone
• Arm 90° abducted with lateral rotation (thumb up)
Therapist:
• Place one hand below the scapula on the opposite side for support. Apply pressure against forearm in a downward direction





Serratus Anterior

Patient positioning:
• Sitting, hold onto table with other arm
• Arm in 120° to 130° of flexion
Therapist:
• Apply pressure against the dorsal surface of the arm between shoulder and elbow downward. Place thumb on lateral boarder of scapula to trace the direction.







Rhomboids (alternate)

Patient positioning:
• Sitting
• Elbow flexed, humerus adducted in slight extension and slight lateral rotation
Therapist:
• Apply pressure with one hand against the patient’s arm in the direction of abducting and rotating medially. Other hand applies pressure in direction of depression.







Rhomboids
Patient positioning:
• Prone
• Arm 90° abducted with medial rotation (thumb down)
Therapist:
• Place one hand below the scapula on the opposite side for support. Apply pressure against forearm in a downward direction





Pectoralis Major (Upper)

Patient positioning:
• Supine
• Elbow extended and the shoulder in 90° of flexion and slight medial rotation with arm in horizital adduction
Therapist:
• Hold opposite shoulder firmly on table. Apply pressure against forearm in direction of horizontal abduction





Pectoralis Major (Lower)

Patient positioning:
• Supine
• Elbow extended and the shoulder in flexion and slight medial rotation with arm adducted obliquely toward the opposite iliac crest
Therapist:
• Place one hand on opposite iliac crest. Apply pressure against forearm in direction of oblique abduction





Pectoralis Minor

Patient positioning:
• Supine
• Arm at side with elbow and hand raised off table to prevent downward pressure
Therapist:
• Apply pressure against the anterior aspect of shoulder downward towards table







Deltoid (Middle)

Patient positioning:
• Sitting
• Elbow flexed 90° and the shoulder in 90° of abduction
Therapist:
• Apply downward pressure against anterior distal humerus







Deltoid (Anterior)

Patient positioning:
• Sitting
• Elbow flexed 90° and the shoulder in 90° of abduction and slight flexion and lateral rotation
Therapist:
• Apply pressure against anterior distal humerus in direction of adduction and slight extension







Deltoid (Posterior)

Patient positioning:
• Sitting
• Elbow flexed 90° and the shoulder in 90° of abduction and slight extension and medial rotation
Therapist:
• Apply pressure against posterior distal humerus in direction of adduction and slight flexion





Supraspinatus
Patient positioning:
• Sitting or standing
• Arm at side head turned to opposite side
Therapist:
• Apply pressure against forearm in direction of adduction







Triceps
Patient positioning:
• Prone
• Shoulder in 90° of abduction, extension of elbow (slightly less the full)
Therapist:
• Arm should be supported between the shoulder and the elbow by table and the examiner palces one hand under elbow for cusioning. Apply pressure against forearm in direction of flexion





Triceps (alternate)
Patient positioning:
• Supine
• Shoulder in 90° of flexion, extension of elbow (slightly less the full)
Therapist:
• Apply pressure against forearm in direction of flexion place one hand on biceps for stabilisation



Biceps Brachii and Brachialis

Patient positioning:
• Sitting or Supine
• Flexion of elbow slightly less then or at right angle with forearm in supination
Therapist:
• Place one hand under the elbow and apply pressure with other hand to forearm in direction of extension







Brachioradialis

Patient positioning:
• Sitting or Supine
• Flexion of elbow slightly less then or at right angle with forearm in neutral
Therapist:
• Place one hand under the elbow and apply pressure with other hand to forearm in direction of extension. Must see or feel brachioradialis



Ext. Carpi Ulnaris

Patient positioning:
• Sitting or Supine
• Forearm in full pronation and extension of wrist toward ulnar side
Therapist:
• Forearm rests on table or is suppourted by examiner. Apply pressure against dorsum of hand along the fith metacarpal in direction of flexion toward the radial side







Ext. Carpi Radialis Longus and Brevis

Patient positioning:
• Sitting with elbow about 30° from full extension
• Forearm in slightly less than full pronation and extension of wrist toward radial side (allow fingers to flex)
Therapist:
• Forearm rests on table or is suppourted by examiner. Apply pressure against dorsum of hand along the second and third metacarpal in direction of flexion toward the ulnar side





Ext. Carpi Radialis Brevis

Patient positioning:
• Sitting with elbow fully flexed (have subject lean forward to fully flex)
• Forearm in slightly less than full pronation and extension of wrist toward radial side (allow fingers to flex)
Therapist:
• Forearm rests on table or is suppourted by examiner. Apply pressure against dorsum of hand along the second and third metacarpal in direction of flexion toward the ulnar side





Flexor Carpi Ulnaris

Patient positioning:
• Sitting or supine
• Forearm in full supination and flexion of wrist toward ulnar side
Therapist:
• Forearm rests on table or is suppourted by examiner. Apply pressure against hypothenar eminence in direction of extension toward the radial side
*Note* normally fingers will be relaxed. If fingers actively flex the finger flexors are trying to substitute for wrist flexors






Flexor Carpi Radialis

Patient positioning:
• Sitting or supine
• Forearm in slightly less than full supination, flexion of wrist toward radial side
Therapist:
• Forearm rests on table or is suppourted by examiner. Apply pressure against thenar eminence in direction of extension toward the ulnar side
*Note* normally fingers will be relaxed. If fingers actively flex the finger flexors are trying to substitute for wrist flexors, can’t rule out palmaris longus








Flexor Digitorum Superficialis
Patient positioning:
• Sitting or supine
• Wrist in neutral or slight extension. Flexion of proximal interphalangeal joint with distal interphalangeal joints extended
Therapist:
• Stabilize the metacarpophalangeal joint. Apply pressure against the middle phalanx in direction of extension (do fingers 2,3,4 individualy)







Flexor Digitorum Profundus

Patient positioning:
• Sitting or supine
• Wrist in neutral or slight extension. Flexion of distal interphalangeal joint
Therapist:
• Stabilize the proximal and middle phalanges. Apply pressure against the palmar surface of proximal phalanx in direction of extension (do fingers 2,3,4 individualy)







Extensor Digitorum

Patient positioning:
• Sitting or supine
• Wrist in neutral or slight extension. extension of metacarpophalangeal joints of the second through fifth digits with interphalangeal joints relaxed
Therapist:
• Stabilize the wrist to prevent full extension. Apply pressure against the dorsal surface of proximal phalanx in direction of flexion







Tibialis Anterior

Patient positioning:
• Supine or sitting (knee flexed if gastrocnemius is tight).
• Dorsiflexion of ankle joint and inversion of foot
Therapist:
• Supports leg just above ankle joint adding pressure to the medial side, dorsal surface of foot trying to push the patient into plantar flexion and eversion







Tibialis Posterior

Patient positioning:
• Supine with leg in lateral rotation
• Foot plantar flexed and inverted
Therapist:
• Supports leg above ankle joint applies pressure against medial plantar surface in direction of dorsiflexion and eversion.



Peroneus Longus and Brevis

Patient positioning:
• Supine with leg in medial rotation (or side lying on opposite side)
• Foot everted and plantar flexed
Therapist:
• Supports leg above ankle joint applies pressure against lateral border and sole of foot in direction of inversion and dorsiflexion.







Soleus
Patient positioning:
• Prone with knee flexed at least 90° (eliminates action of gastrocnemius)
• Plantar flexion of ankle with no inversion or eversion
Therapist:
• Supports leg above ankle joint applies pressure trying to force foot into dorsiflexion. (push up on heal and down on sole)







Gastrocnemius
Patient positioning:
• Prone with knee extended and foot projecting over the table
• Plantar flexion of ankle with no inversion or eversion
Therapist: (weight of extremity supplies fixation)
• Supports leg above ankle joint applies pressure trying to force foot into dorsiflexion. (push up on heal and down on sole)

*note* this test does not isolate the gastrocnemius action from the other plantar flexors but presence or absence of the muscle can be determined through careful observation.









Medial Hamstrings

Patient positioning:
• Prone
• flexion of the knee between 50° and 70° with the thigh in medial rotation
Therapist:
• Hold thigh down firmly on table apply pressure against the leg proximal to ankle in direction of knee extension (no not apply pressure against rotation component)







Lateral Hamstrings

Patient positioning:
• Prone
• flexion of the knee between 50° and 70° with the thigh in slight lateral rotation
Therapist:
• Hold thigh down firmly on table apply pressure against the leg proximal to ankle in direction of knee extension (no not apply pressure against rotation component)







Iliopsoas with psoas major

Patient positioning:
• Supine
• Hip flexion with slight abduction and lateral rotation
Therapist:
• Stabilize the opposite iliac crest, apply pressure to leg in direction of extension and slight abduction





Iliopsoas
Patient positioning:
• Sitting with knees bent over side of table, holding onto table
• Full hip flexion with knee bent
Therapist:
• One hand on anterior shoulder and the other applies pressure against the thigh in direction of hip extension.





Hip flexors as a group

Patient positioning:
• Sitting with knees bent over side of table, holding onto table
• Slight hip flexion with knee bent
Therapist:
• One hand on anterior shoulder and the other applies pressure against the thigh in direction of hip extension.





Tensor Fasia Lata

Patient positioning:
• Supine, patient may hold the table
• Abduction, flexion and medial rotation of hip with the knee extended
Therapist:
• Apply pressure against leg in direction of extension and adduction (support opposite pelvis if necessary) (no not apply pressure against rotation component)







Gluteus Medius

Patient positioning:
• Side lying with underneath leg flexed at hip and knee
• Pelvis rotated slightly forward (creates anti gravity position)
• Abduction of hip with slight extension and external rotation, with the knee extended
Therapist:
• Stabilize the pelvis and apply pressure against the leg near ankle in the direction of adduction and flexion (no not apply pressure against rotation component)








Gluteus Maximus

Patient positioning:
• Prone
• Hip extension with knee flexed 90° or more
Therapist:
• Stabilize pelvis and apply pressure against the lower part of the posterior thigh in direction of flexion (no not apply pressure against rotation component)



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