Name: Shoulder External Rotator Manual Muscle Testing (MMT) for an Active Population
Uploaded: 2023-04-26T01:02:30.000Z
Duration: 7 min 49 s
Description: Master shoulder external rotator MMT with our video. Get practical demos, in-depth anatomy insights, and biomechanics understanding for active individuals.

English captions

https://stream.mux.com/hcET00dYdV2uu011MlkNqr01QFP00grqRxrX00xarxFbNqGM.m3u8

Master shoulder external rotator MMT with our video. Get practical demos, in-depth anatomy insights, and biomechanics understanding for active individuals.

Introduction to Manual Muscle Testing for Shoulder External Rotators

Traditional Kendall Test for Infraspinatus and Teres Minor

Active vs Passive Range of Motion Evaluation

Alternative Testing Technique: Comparison and Compensation Observation

Assessment Insights and Interventions for Weak External Rotators

Shoulder External Rotator Manual Muscle Testing (MMT) for an Active Population

This is Brent of the Brookbush Institute, and in this video we're going to do shoulder external rotator manual muscle testing for an active population. So, since we're going to go ahead and test a more active population, we're going to get rid of that Kendall scale of the one through five of the pluses and minuses and replace it with a simpler scale of strong, weak, with compensation, or with pain. But, we're going to pay a little closer attention to the details, because we know in that more active population, who is putting a little bit more stress on their musculoskeletal system, it often doesn't take a very large change in muscle activity, length, or we'll say joint alignment to start showing signs of pain and dysfunction. I'm going to have my friend, Melissa, come out. She's going to help me demonstrate these tests. Now, the first test we're going to use for the infraspinatus and teres minor, which we know have a propensity to get long and underactive, is the very traditional Kendall style test. It is prone, facing away, with their humorous supported by a table, and you guys can use a little towel under their humorous so that they they keep in good alignment throughout their shoulder. Since their chest tissue will lift them up a little bit, we want them in neutral position. Now, in this position, I have a lot of control over her shoulder girdle, so I can help stabilize it. Or, I can put it back into good position and just have her hold that. I can also palpate her infraspinatus, just under the spine of her scapula, or I can use my thumb to palpate her teres minor. Now, the first thing I'm going to do with this test is I'm actually going to check her range of motion. We can see Melissa actually has pretty close to optimal range at 90 or 95 degrees of external rotation. If I have her do the same thing actively- now go ahead and do that for me- you guys will start to notice that she actually doesn't have the same range of motion actively. That's something I want to take note of. She has good passive range of motion, but her active range of motion is lacking. Now, if I have her go ahead and do that again and then I add some external resistance, what we notice with Melissa is she has a weak spot through here. and then she catches about here, at about 75 to 80 degrees of external rotation. Now, if you're asking me, I'm actually going to make a note of that. That's a week test to me. Although, she may test a five in this position, if she doesn't have optimal strength all the way to 90 degrees, the question I start asking myself are will she keep that 90 degrees of external rotation. If she's not stable and strong in a range of motion, there is a chance that she could lose that range of motion. So note: weak maybe week last 15 degrees and whatever you guys want to add as far as detail, but this would be a weak test to me. I'm going to go ahead and have Melissa sit up. Now, the test I use more commonly is not the traditional Kendall test, but it's the one I see a lot of people use in clinic, because it's convenient and has some advantages. It's not quite as strict as that test, but if I have Melissa just sit up here, put both her arms out, and I'm going to go ahead and make sure she's in a slightly flexed position, so maybe elbows lined up with the anterior side of a rib cage here. Once she's lined up this way, I have posterior delt a little bit inhibited, I'm making sure I get as much infraspinatus and teres minor as I can, and I can go ahead and push both arms at once. The advantage to pushing both arms at once is I can compare her two sides. With all manual muscle testing, there's a little bit of practice that you guys need to do. You have to start comparing individuals. It takes a little bit of time to kind of determine what is strong versus what is weak. I can't just tell you guys on camera that a strong result would give you X percentage, or X pounds, or she should be able to hold, because I can tell you right now that Melissa's infraspinatus and teres minor are not as strong as my pecs. Right? Those are much smaller muscles. But, I don't have to necessarily be able to rate her infraspinatus and teres minor versus my pecs if I can compare sides, especially she's coming to see somebody like me to correct some shoulder pain on her right side. I can do that test and immediately compare her left side to the right side, and now I have presumably a good side and a symptomatic side to compare to. The other thing that this position is really nice for is I can easily address or see compensation. Remember, that's that test result with compensation that we talk about a lot when it comes to using these tests for helping us determine postural dysfunction and intervention. If I come behind her, which isn't how I would do this test, but just so you guys can see on camera, if I push her into internal rotation, you can see her start to abduct at the shoulder and her elbows are actually starting to flare out a little bit. Her infraspinatus and teres minor definitely don't do abduction, so she's starting to try to use her overactive synergists, which in the case of the external rotators is posterior delt and supraspinatus, to try to abduct her shoulders to resist me rather than do pure external rotation. That's with compensation. If I know her compensation's abduction, maybe I'm thinking in the back of my head already that maybe one of the interventions I want to give her is supraspinatus release, or posterior deltoid release along with her external rotator activation. Now, I do want to show you guys one more view from the side. I would make sure Melissa's sitting up nice and tall so that I don't have her starting in a compensated position. I'm once again going to line her arms up so that her elbows are at her anterior rib cage, just to try to inhibit her posterior delt a little bit. We don't want that taking over from the get-go. And then, all I'm going to do is use my pecs to go ahead and push in and see if she can maintain that perfect posture. Melissa, as we could tell from the other test, does have, in my opinion, fairly weak external rotators. From this view, they're even and unless I'm cueing her to do so, she actually doesn't compensate. So, maybe in Melissa's case, since she doesn't compensate, I could get away with not doing supraspinatus release, not doing posterior delt release, which is two less releases I have to do. Maybe I don't have to do any posterior capsule stretching, which is one less stretch I have to do. But, I am going to go ahead and do some external rotator isolated activation and integration to try to get her shoulders a little stronger. I hope you guys enjoyed this video. I hope you guys enjoyed seeing my take on the external rotators, or infraspinatus and teres minor manual muscle test for an active population. you

Home

Videos

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.

Shoulder External Rotator Manual Muscle Testing (MMT) for an Active Population

Single Leg Alternating Horizontal Abduction with External Rotation

Combined Deep Cervical Flexor and External Rotator Activation

Infraspinatus and Teres Minor Static Manual Release (Soft Tissue Mobilization)

Shoulder Special Test: Infraspinatus and Internal Rotation Resistance Strength Test (IRRST) Tests

Shoulder External Rotator Activation Taping

PNF Carry Away

Prone Floor Cobra (after chest-out/thumbs out)

External Rotator Reactive Activation

Shoulder External Rotator Activation Progression

Shoulder External Rotator Isolated Activation

Comments

Guest