Manual Muscle Testing of the Scapulothoracic Region

Scapular Abduction	Patient is short sitting with hands on lap.  Examiner stands at test side with one hand giving resistance on the arm just above elbow.  The other hand uses thumb, index finger, and web space in between to palpate inferior angle of scapula.  Patient raises arm to about 130 degrees of flexion against resistance.  Scapula should abduct without winging.
Scapular Adduction	Patient is prone with shoulder at edge of table.  Shoulder is abducted to 90 degrees and externally rotated.  Elbow may be flexed to a right angle.  Examiner stands at test side and stabilizes the contralateral scapular area.  Resistance hand is placed over distal humerus.  Patient lifts elbow towards ceiling which adducts scapula.
Scapular Adduction and Downward Rotation	Patient is prone with shoulder internally rotated, elbow flexed, and arm adducted across the back.  Examiner stands at test side with resistance hand placed on humerus just above the elbow.  Resistance is given in a downward and outward direction.  Palpation hand is placed on vertebral border of scapula.  Patient lifts hand off the back against resistance which adducts scapula.
Scapular Elevation	Patient is short sitting with hands relaxed in lap.  Examiner stands behind patient and places hands over the top of both shoulders to give resistance in a downward direction.  Patient shrugs shoulders simultaneously against resistance.

Adapted from:

Hislop, Helen J. & Montgomery, Jaqueline with contributor Barbara Connelly.

      Daniels and Worthingham's muscle testing: techniques of manual examination., 6th edition, 1995.