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Can You Do the Apley Scratch Test?

Apley scratch Test

Apley Scratch Rotator Cuff

You most likely haven’t heard before of the Apley scratch test used for shoulder pain assessment. Your chiropractor or doctor may have had you perform the Apley scratch test during a physical examination. It is an orthopaedic test to see if there is a restriction or pain with your shoulder movement.

This orthopaedic shoulder test can be used both as a diagnostic tool and as a treatment tool for certain shoulder pain. I the following article I’ll give you a link to the doctor who the test is named after, show you a video of how to perform a Apley Scratch Test correctly and what I meant how it can be used both as a diagnostic aid and apart of a shoulder exercise treatment protocol.

The Apley Scratch Test for Shoulder Pain

Dr Alan Apley, an English orthopaedic surgeon, developed the Apley scratch test to look for shoulder pain and restriction of movement between the left and right shoulder in patients.

In the following video you’ll get to see how to perform the Apley scratch test correctly.

The Apley scratch test movement has two parts to it:

  1. Step one involves one arm abducting, and externally rotating with the fingers pointing down the spine reaching as far behind you as you can, like reaching to scratch your back.
  2. Step two involves the other arm adducting, and internally rotating with the fingers pointing up the spine, like reaching to put a bra strap on.

So What Does the Test Tell You?

1. Shoulder Diagnosis

As you can see from the above video it can be quite hard to reach back equally between the left and right shoulder. I have seen that some people cannot touch their fingers together on the one side, but can do it on the other.

This restriction of shoulder complex movement could be a sign of a tightness or injury in the rotator cuff muscles. An abnormal test could also be a sign of a problem inside the gleno-humeral joint like a labrum tear or an impingement syndrome at the acromio-clavicular joint.

This type of orthopaedic test helps differentiate between pathology localised in the shoulder complex versus a trapped nerve in the shoulder.

What I tend to find is that most people have a problem trying to reach up their backs with the bottom hand and not the top hand reaching down.

It is quite a common restriction of movement in people with a frozen shoulder (adhesive capsulitis) diagnosis. Also in those type of guys who like to do frequent heavy weight lifting at gym and end up with their chests muscles too tight causing a forward drawn posture described by Prof Janda. This usually shows up as another shoulder pain condition called impingement syndrome of the shoulder.

2. Shoulder Pain Treatment Tool

As I mentioned earlier, this type of shoulder examination protocol is used to help diagnose a shoulder complaint, but it can also be used as a shoulder treatment tool.

In the following video you will see how the Apley scratch movement can be used as a shoulder pain relief exercise.

As you would have seen above, you can place a towel behind your back to move the shoulder blades up and down. This will allow you to gently stretch any tightness around the shoulder joint and in the rotator cuff muscles and tendons. Be careful to do this if you have a shoulder pain and especially if you have a rotator cuff tear. That is why you shoulder consider the eBook by UK physiotherapist Tim Allardyce to help give you guidance for rotator cuff injuries.

How did you do with your Apley scratch test? Was one arm harder to turn and bend than the other? If your right handed was it more of a right shoulder problem? Let me know in a comment below.

  • Renee Fillers

    My right arm doesn’t go any high than the small of my back. : /

  • yuletak

    My right arm internal rotation is MUCH tighter than the left. I’d estimate I have at least a 3 inch gap. Externally, it’s not quite as flexible as left, but it’s off by maybe half an inch. What other exercises can I do. I’ve been doing the ball rolling. Also, I play badminton.