Execution
- 1Position the patient standing.
- 2Elevate the patient's arms in the scapular plane to approximately 160°.
- 3Ask the patient to internally rotate and extend the arm downward as if climbing a ladder.
- 4Apply resistance against the downward extension/internal-rotation movement.
- 5Compare strength, pain, and substitution with the opposite side.
Positive outcome
Pain, weakness, or inability to internally rotate and extend the arm downward against resistance is abnormal. The finding suggests latissimus dorsi weakness but is not specific for one diagnosis.
CommentMagee presents this as a muscle weakness test, not a diagnostic-accuracy test. Latissimus testing can be affected by shoulder pain, thoracolumbar compensation, posterior deltoid, teres major, and patient effort. Use it as an impairment finding within the shoulder-girdle examination.