This document discusses techniques for measuring the length of several muscles in the upper extremity, including the latissimus dorsi, pectoralis major, pectoralis minor, triceps, and biceps. Passive techniques using a goniometer or tape measure are described to measure the length of each muscle. Normal ranges of motion are provided as well as signs of muscle shortness. Accompanying diagrams demonstrate patient positioning and landmarks for each test.

1. by
Ahmed Assem
Lecturer of physical therapy
Basic Science Department
TECHNIQUES FOR TESTING
MUSCLE LENGTH

2. TECHNIQUES FOR TESTING MUSCLE LENGTH
Upper Extremity
The techniques for flexibility testing for the upper extremity that are included in this chapter.
These measurement techniques were chosen because they can be performed passively by the
clinician or actively by the patient, the tests do not require patient strength, and the
examination can be performed easily.
latissimus dorsi muscle length
FIG. 6-3 End ROM for latissimus dorsi muscle length. Bony landmarks for
goniometer alignment (lateral midline of trunk; shoulder, lateral to acromion;
lateral epicondyle of humerus) indicated by red line and dots.

3. FIG. 6-4 Patient position for measurement of latissimus dorsi muscle length using
goniometer.
FIG. 6-5 Patient position for measurement of latissimus dorsi muscle length using
tape measure.

4. pectoralis major muscle length
FIG. 6-6 Starting position for measurement of pectoralis major muscle length.
FIG. 6-7 Patient position for measurement of pectoralis major muscle length
using tape measure.

5. Upper (clavicular) part of pectoralis major:
Position: Supine with the knees bent and the low back flat on the table. Test:
The examiner places the subjects arm in horizontal abduction, with the elbow
extended and the shoulder in lateral rotation (palm upward).
Normal length: Full horizontal abduction with lateral rotation, the arm flat on
the table without trunk rotation. In this position the tendon of pectoralis major
at the sternum should not be found to be unduly tense, even with maximum
abduction of the arm, unless the muscle is short.
Shortness: The extended arm does not drop down to table level. Limitations
may be recorded as slight, moderate or marked; measured in degrees using
goniometer or measured in inches using a ruler to record the number of
inches between the table and lateral epicondyle.

6. FIG. 6-12 Starting position for measurement of upper portion of pectoralis major
muscle length.
FIG. 6-13 Patient position for measurement of upper portion of pectoralis major muscle length
using goniometer. Goniometer aligned with bony landmarks (parallel to support surface, lateral
tip of acromion, midline of humerus toward lateral epicondyle).

7. FIG. 6-14 Patient position for measurement of upper portion of pectoralis major
muscle length using tape measure.
FIG. 6-15 Example of excessive length in upper portion of pectoralis major
muscle.

8. lower portion of pectoralis major muscle length
Lower (sternal) part of pectoralis major:
Position: Supine with the knees bent and the low back flat on the
table. Test: The examiner places the subjects arm in position of
approximately 135 degrees of abduction (in line with the lower
fibers), with the elbow extended. The shoulder will be in a lateral
rotation. Normal length: Arm drops to table level, with the low
back remaining flat on the table. Shortness: The extended arm
does not drop down to table level. Limitations may be recorded
as slight, moderate or marked; measured in degrees using
goniometer or measured in inches using a ruler to record the
number of inches between the table and lateral epicondyle.[2]

9. FIG. 6-8 Starting position for measurement of lower portion of pectoralis major
muscle length.
FIG. 6-9 Patient position for measurement of lower portion of pectoralis major muscle
length using goniometer. Goniometer aligned with bony landmarks (parallel to support
surface, lateral tip of acromion, midline of humerus toward lateral epicondyle).

10. FIG. 6-10 Patient position for measurement of lower portion of pectoralis major
muscle length using tape measure.
FIG. 6-11 Example of excessive length in lower portion of pectoralis major
muscle.

11. pectoralis minor muscle length
The pectoralis minor can become very tense when the
serratus anterior is weak. Likewise, shortening of
pectoralis minor may produce impingement on blood
vessels and nerves, causing shoulder impingement
and thoracic outlet syndrome. To assess for pectoralis
minor tightness, the patient is placed in a supine
position with both arms are the side. The arms should
be in anatomic position, i.e. shoulders externally
rotated, elbows extended, and forearms supinated. A
tape measure is used to measure the distance from the
posterior border of the acromion to the table. This
measure should be taken bilaterally. Asymmetry is
considered a positive test.

12.  pectoralis minor muscle length
FIG. 6-16 Starting position for measurement of pectoralis minor muscle length. Bony
landmark for goniometer alignment (posterior acromial border) for tape measure
alignment indicated by red dot.
FIG. 6-17 Patient position for measurement of pectoralis minor muscle length using tape
measure. Bony landmark (posterior acromial border) indicated by red dot.

13. Triceps muscle length
FIG. 6-18 Starting position for measurement of triceps muscle length. Bony
landmarks for goniometer alignment (humeral head, lateral epicondyle of humerus,
radial styloid process) indicated by red dots.

14. FIG. 6-19 End ROM of triceps muscle length. Bony landmarks for goniometer alignment
(humeral head, lateral epicondyle of humerus, radial styloid process) indicated by red dots.
FIG. 6-20 Patient position and goniometer
alignment at end of triceps muscle length.

15. biceps muscle length
FIG. 6-21 Starting position for measurement of biceps muscle length. Bony
landmarks for goniometer alignment (lateral midline of thorax, lateral
aspect of acromion process, lateral epicondyle of humerus) indicated by red
line and dots.

16.  than