Equipment: Firm table; unpadded.
Starting Position: Supine, with the arms at the sides, elbows extended, knees bent, and low back flat on the table.
Test Movement: Subject raises both arms in flexion overhead, keeping the arms close to the head and bringing them down toward the table (maintaining a flat low back).
Normal Length: The ability to bring the arms down to table level, keeping them close to the head.
Shortness: Indicated by the inability to get the arms to table level. Record measurements as slight, moderate, or marked; measure the angle between the table and humerus to determine the number of degrees of limitation; or measure the number of inches between the table and the lateral epicondyle.
Note: Tightness of the upper abdominals will depress the chest and tend to pull the shoulder forward, interfering with the test. Likewise, a kyphosis of the upper back will make it impossible to get the shoulder down on the table.
A contractedpectoralis minor tilts the scapula anteriorly, pulling the shoulder girdle downward and forward. With the change in alignment of the shoulder girdle, flexion of the glenohumeral joint will appear to be limited even if the range is actually normal, because the arm cannot be brought down to touch the table.
Tightness of the pectoralis minor is an important factor in many cases of arm pain. With attachment of the pectoralis minor on the coracoid process, tightness of this muscle depresses the cora-coid anteriorly, causing pressure and impingement on the cords of the brachial plexus and the axillary blood vessels that lie between the coracoid and the rib cage. (See pp. 342, 343.)
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