Execution
- 1Position the patient standing.
- 2Ask the patient to forward flex the arm to 90°.
- 3Apply a backward force to the arm.
- 4Observe the medial border and inferior angle of the scapula.
- 5Repeat with a wall or floor push-up to confirm scapular winging.
Positive outcome
Medial border winging of the scapula during resisted forward flexion is positive for serratus anterior weakness or paralysis. Magee notes that the patient may also have difficulty abducting or forward flexing above 90°, although lower trapezius compensation may still allow some elevation.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Brunnstrom (1941) | NA | NA | NA | NA | NA |
CommentThis test is most useful for scapular winging and long thoracic nerve-related dysfunction, not cuff-tear diagnosis. Magee notes that posterior instability can mimic serratus dysfunction and suggests checking whether winging changes when the arm is externally rotated before elevation. Treat it as an impairment and differential screen.