Shoulder Mobility screening and scoring
Setup and purpose
The Shoulder Mobility pattern tests bilateral shoulder flexion, extension, internal and external rotation, and scapular control. Measure hand length from the distal wrist crease to the tip of the middle finger. The patient stands with feet together and makes fists with thumbs inside. In one motion, one hand reaches over the shoulder and the other reaches up the back. The examiner measures the distance between the closest points of the fists. Both sides are tested. The test is not a strength test; it reflects mobility and scapular control.
Scoring criteria
- 3: Distance is within one hand length.
- 2: Distance is within one and a half hand lengths.
- 1: Distance is greater than one and a half hand lengths.
- 0: Pain during the movement or with the shoulder impingement clearing test. The shoulder impingement clearing test is performed after the reach: place the hand on the opposite shoulder and raise the elbow. Pain is a 0.
Worked example
Hand length is 18 cm. On the left, the fists are 12 cm apart. 12 cm is less than 18 cm, so the score is 3. On the right, the fists are 24 cm apart. 24 cm is greater than 18 cm but less than 27 cm, so the score is 2. The asymmetry is flagged, and the total uses 2. If the right reach is pain-free but the clearing test reproduces shoulder pain, the score is 0, not 2.
Traps
- Measuring from the fingertips instead of the wrist crease.
- Not keeping the fists closed or the thumbs inside.
- Forgetting the clearing test.
- Scoring 1 for pain; pain is always 0.
- Not testing both sides or not measuring the distance. Record the distance in centimeters or hand lengths.