Manual Muscle Testing

Front 1

abductor pollicis brevis

Back 1

sitting or supine, stabilize hand, thumb vertically abducted push against proximal phalanx in the direction of adducation

Front 2

opponens pollicis

Back 2

sitting, stabilize hand, thumb flexed + abducted+ slight medial rotation, push on metacarpal in direction of extension and adduction

Front 3

flexor pollicis longus

Back 3

sitting, hand on table, stabilize metacarpal and proximal phalanx of thumb, thumb extended, push on palmar surface of distal phalanx in direction of extension

Front 4

flexor pollicis brevis

Back 4

sitting, stabilizing the hand, flex MCP of thumb but not IP, push on palmar surface of proximal phalanx in direction of extension

Front 5

extensor pollicis longus

Back 5

sitting, stabilize hand and have thumb extended , push on dorsal surface of distal phalanx in direction of flexion

Front 6

extensor pollicis brevis

Back 6

sitting, stabillize wrist, extend at MCP joint of thumb, push on proximal phalanx of dorsal side of thumb

Front 7

abductor pollicis longus

Back 7

sitting, stabilize wrist and have thumb flexed at MCP and IP, push on lateral surface of distal end of first metacarpal

Front 8

opponens digiti minimi

Back 8

sitting, stabilize hand and hold first metacarpal firmly, push on palmar surface of 5th metacarpal

Front 9

abductor digiti minimi

Back 9

sitting, stabilize hand, have pinky abducted and push on ulnar side of pinky

Front 10

flexor digiti minimi

Back 10

sitting, stabilize hand, flex MCP of pink and push on palmar side

Front 11

dorsal interossei

Back 11

sitting, test each finger individually, have finger abducted and apply pressure toward middle finger for index, toward ring then index for middle, toward middle for ring (don't test pinky)

Front 12

palmar interossei

Back 12

sitting, begin in adduction and pull toward abduction for all fingers but middle

Front 13

lumbricals and interossei

Back 13

extend PIP and DIP, Flex MCP (lumbrical grip), push first on dorsal surface of middle and distal phalanges in the direction of flexion, then push on palmar surface of proximal phalanges in direction of extension

TWO STAGE

Front 14

palmaris longus

Back 14

fully supinated with forearm on table, strongly cup the palm of the hand, apply pressure on thenar and hypothenar eminence in direction of extending the wrist

Front 15

extensor digitorum

Back 15

stabilize wrist, wrist in partial extension, extend MCP, flex DIP and PIP, apply pressure on dorsal surfaces of proximal phalanges in direction of flexion

Front 16

flexor digitorum superficialis

Back 16

forearm on table supinated, stabilize MCP joint, PIP flexed, DIP extended, pressure on palmar surface of middle phalanx in direction of extension

Front 17

flexor digitorum profundus

Back 17

supinated forearm on table, stabilize middle and proximal phalanx, DIP flexed, push on palmar side of distal phalanx in the direction of extension

Front 18

flexor cari radialis

Back 18

forearm is slightly less than fully supinated, stabilize forearm, wrist is flexed, push on thenar eminence in direction of extension on ulnar side

Front 19

flexor carpi ulnaris

Back 19

full supination, stabilize forearm, flex wrist, pressure is on hypothenar eminence in the direction of extension toward radial side

Front 20

extensor carpi radialis longus and brevis

Back 20

sitting with elbow 30 deg from full extension supported on table fully pronated, wrist extended toward radial side, push on dorsal side of hand on 2nd and 3rd metacarpal in direction of flexion toward ulnar side

Front 21

extensor carpi radialis brevis

Back 21

same as longus and brevis except elbow is fully flexed

Front 22

extensor carpi ulnaris

Back 22

forearm is fully pronated and wrist is extended toward ulnar side, push down on 5th metacarpal bone in direction of flexion on radial side

Front 23

pronator teres

Back 23

supine or sitting, hold elbow against pt. side,full pronation, elbow partially flexed, push on lower forearm in the direction of supination

Front 24

pronator quadratus

Back 24

sitting or supine, hold elbow against pt. side, pronation with elbow completely flexed, apply pressure at the lover forearm in the direction of supination

Front 25

supinator

Back 25

supine, hold elbow against pt. body, elbow flexed to 90 with full supination, apply pressure in direction of pronation

Front 26

biceps and brachialis

Back 26

sitting, hold elbow, elbow 45 deg from extension, in full supination or pull pronation pull in direction of extension

Front 27

triceps and anconeus

Back 27

prone, shoulder at 90 deg abduction w/ no rotation, support upper arm, extended elbow, push forearm in direction of flexion

Front 28

brachioradialis

Back 28

sitting, hold elbow, neutral sup/pro, MUST SEE AND FEEL BELLY, pull in direction of extension

Front 29

coracobrachialis

Back 29

sitting, stabilize trunk, shoulder flexed and laterally rotated, elbow completely flexed and supinated, push on upper arm in direction of shoulder extension an slight abduction

Front 30

supraspinatus

Back 30

does not have grade only is working or not

sitting, neck laterally flexed and shoulder abducted to 90 deg, elbow at 90 deg

Front 31

deltoid middle

Back 31

sitting, stabilize shoulder, shoulder abducted to 90 with no rotation, elbow flexed to 90, push on upper arm in direction of adduction

Front 32

anterior deltoid

Back 32

shoulder abducted with slight flexion and slight lateral rotation, stabilize shoulder, push in direction of adduction and slight extension

Front 33

posterior deltoid

Back 33

sitting, shoulder abducted in slight extension and medial rotation, stabilize shoulder, push in direction of adduction and slight flexion

Front 34

pec major upper

Back 34

supine, elbow extended and shoulder in 90 deg flexion and slight medial rotation and humerus horizontally adducted, stabilize opposite shoulder, push against forearm in direction of horizontal abduction

Front 35

pec major lower

Back 35

supine, elbow extended, shoulder in flexion and slight medial rotation, adduct the arm obliquely across chest, stabilize opposite hip, push in forearm laterally and superiorly

Front 36

pec minor

Back 36

supine, stabilize rib cage, pt. forward thrust shoulder with arm at side and push shoulder back toward table

Front 37

infraspinatus

Back 37

prone, humerus supported by table, head facing away, stabilize arm near elbow, humerus laterally rotated with elbow at right angle, push down on forearm in direction of medial rotation

Front 38

teres minor

Back 38

supine, stabilize distal end of humerus medial side, humerus laterally rotated, elbow at right angle, apply pressure in direction of medial rotation

Front 39

teres major

Back 39

prone, hand behind back and have them hold it off body and push down

Front 40

subscapularis

Back 40

tested with teres major

Front 41

latissimus dorsi

Back 41

prone, stabilize pelvis, palm facing body, elbow extended and shoulder extended, apply pressure on forearm in direction of abduction and slight flexion

Front 42

rhomboids

Back 42

prone, elbow extended and arm abducted to 90 deg, thumb pointing down and push arm down

Front 43

middle trap

Back 43

stabilize scapula, prone, shoulder abducted to 90 deg, elbow extended, thumb facing upward, push arm down

Front 44

lower trap

Back 44

stabilize scapula, prone, shoulder abducted above 90 deg, elbow extended, thumb up and push down

Front 45

upper trap

Back 45

sitting, raise shoulder toward head and head toward shoudler and try and pry apart

Front 46

serratus anterior

Back 46

sitting, stabilize scapula, arm flexed to 120 deg, elbow extended, pull scapula back while simultaneously pushing arm down