In MMT for scapular adduction/downward rotation in anti-gravity, what is the test position?

• A. Supine with arm at 90 degrees
• B. Prone with tested UE behind the back with hand on the lumbar spine and head rotated to the opposite side
• C. Standing with arm abducted 90
• D. Seated with arm in front

Answer: (B)

Testing scapular adduction with downward rotation against gravity is best done by positioning the patient prone with the arm placed behind the back, the hand resting on the lumbar region, and the head turned away from the tested side. This setup places the scapula in a position where the retractors (primarily rhomboids, and to some extent middle trapezius) must actively pull the scapula toward the spine and rotate it downward. Turning the head to the opposite side helps prevent compensation from neck or shoulder muscles, ensuring the test targets the scapular muscles. Other positions either place the shoulder complex in a different plane or recruit other muscles (like serratus anterior with protraction or trapezius with shoulder elevation), so they don’t isolate scapular adduction and downward rotation.