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Continuing Education1 Credit

Manual Muscle Testing (MMT): Upper Body

Manual muscles tests (MMT) for the shoulder external rotators, lower trapezius, serratus anterior, and deep cervical flexors. The compensations, overactive synergists, and interventions for the common underactive muscles in the upper body. Manual muscle testing for neck, shoulder, elbow, and scapular pain, as well as arms fall, scapula elevates, head falls forward, upper body dysfunction, and cervical dysfunction.

Course Description: Manual Muscle Testing: Upper Body

Why Assessment?

All fitness, performance, and rehabilitation programs should start with an assessment. The goal of assessment is to refine technique selection, with the intent of improving client and patient outcomes. This course describes potential additions to a comprehensive movement assessment that are most commonly referred to as "manual muscle testing" (a.k.a. MMT, MMTs, muscle testing, strength testing, muscle strength testing, strength assessment, strength measures, manual resistance, etc.). The tests included in this course are intended for muscles prone to inhibition (e.g. underactive, hypotonic, phasic, exhibiting muscle weakness, etc.).

When to Use Manual Muscle Tests:

It is important that the intent of manual muscle tests, the length of a muscle group, the activity of a muscle group, and the testing position are considered prior to the their application. Any muscle that has adopted a compensatory change in length or activity (altered length/tension relationship) may test "weak", "with compensation", or "with pain". For example, if an individual presents with Arms Fall during an Overhead Squat Assessment , and goniometry confirms a loss of shoulder flexion extensibility, it is likely that manual resistance of shoulder extension (from 180 degrees of shoulder flexion) would result in a finding of "weakness" or "with compensation". If the intention of manual muscle testing is to address muscles assessed as "weak" or "with compensation" with strengthening exercises, then we might assume that we should strengthen the latissimus dorsi to address this weakness. But, this logic is flawed. Unfortunately, strengthening the latissimus dorsi may increase activity, further decrease shoulder flexion mobility (by contributing additional shortening), and may result in poor carry-over of results from session to session; even if strengthening the latissimus dorsi results in initial improvements in strength. Although counter-intuitive based on manual muscle testing alone, we may improve shoulder extension strength more by optimizing length-tension relationships with release and lengthening techniques for the latissimus dorsi . For these reasons, manual muscle tests are likely best applied to muscles that are implicated as inhibited by a dynamic movement assessment (e.g. the Overhead Squat Assessment ), and performed as pre/post tests to confirm the effectiveness of selected activation, strengthening, stability, integration, and/or conditioning techniques.

The Brookbush Institute recommends that these assessments are added to the repertoire of all sports medicine professionals (personal trainers, fitness instructors, physical therapists, massage therapists, chiropractors, occupational therapists, athletic trainers, etc.).

Additional Courses:

For a complete introduction to manual muscle testing (for an active population) including definitions of specific terminology, "why?" manual muscle testing, basic procedures, comparing traditional versus Brookbush Institute recommended scoring, amount of external resistance, what muscles should be tested, length/tension relationships, defining a “good assessment,” and best use check out:

For Upper Body Manual Muscle Tests

Manual Muscle Tests Covered in this Course:

Printable PDF of the Movement Assessment Template:


Deep Cervical Flexor Endurance Test

External Rotator Manual Muscle Test

Lower Trapezius Manual Muscle Test

Serratus Anterior Manual Muscle Test


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