Rhomboid Manual Muscle Test
Learn how to detect Rhomboid muscle weakness by conducting the Rhomboid Manual Muscle Test!
Fact Checked by Nate Lacson.
What are rhomboid muscles?
The rhomboids are two muscles in the upper back (the rhomboid major and the rhomboid minor), specifically between the shoulder blades. Their primary role is to stabilize the scapula and help allow the smooth movement of the shoulder blades.
When the rhomboids contract, they aid the scapula in retracting and elevating. Whenever the scapula retracts and elevates, the shoulder blades can be moved close together and back. This allows people to perform upper-body movements like pulling, stretching, rowing, and more. They also help us maintain a good posture.
Just like any muscle, the rhomboids can get strained or injured. The rhomboid major and rhomboid minor can weaken or become inflamed if they get strained or injured. When these muscles weaken, it can lead to unwanted problems such as the following:
- Pain and discomfort in the upper back
- Lead us to have poor posture
- Cause shoulder instability, which makes us prone to injuries and dislocations
- Scapular Dyskinesis, which can lead to shoulder impingement and rotator cuff issues
- Lower our upper body strength, making it harder for us to perform certain activities
Printable Rhomboid Manual Muscle Test PDF
Check out our free Rhomboid Manual Muscle Test PDF here
How to conduct the Rhomboid Manual Muscle Test:
When a patient presents themselves to a healthcare professional, specifically one that specializes in handling problems related to the musculoskeletal system, and they discuss pain and discomfort in their upper back, one of the tests that the professional can conduct is the Rhomboid Manual Muscle Test, sometimes referred to as the Rhomboid Weakness Test.
It’s a physical examination that involves passive movements through the manipulation of the arms by the professional. It involves two specific movements: adduction (moving the limb toward the body's midline or another part) and downward rotation. Here’s how it goes:
- First, the patient will lie down in a prone position (face down) on an examination table/bed
- The patient must put the back of their hand on the small of their back. The hand they must use will depend on which side the professional is at
- Once the hand is on the small of the back, the professional will instruct the patient to lift the hand off their back
- The professional will then apply force to the hand in a downward and outward direction at the distal humerus
- While doing this, the professional will instruct the patient to exert resistance against the force being applied to their hand
- The professional will exert maximum force at first (Grade 5) and then strong/moderate force (Grade 4)
- After that, the professional will palpate the muscles along the scapula’s medial border
- While palpating the muscles, the patient must try to reach their full range of motion by lifting their hand (Grade 3)
- Next, the patient will sit down while keeping their hand at the small of their back
- The professional will palpate the rhomboid muscles and scapula while instructing the patient to complete the test of motion by lifting the arm of their back in a backward, rising motion (Grade 2 to 0)
How to interpret the findings of the Rhomboid Manual Muscle Test
You’ve probably noticed the Grades 5 to 0 mentioned above. Those are what will determine the results of the Rhomboid Manual Muscle Test.
Here’s how to interpret the results:
- Grade 5 means they completed the range of motion and exhibited maximum resistance to maximum downward force. This means their rhomboid muscles are at normal strength. The professional's fingers will pop out when the rhomboids contract.
- Grade 4 means they completed the range of motion but only exhibited maximum resistance to strong/moderate downward force. This means their muscle strength is good. The professional’s fingers will usually pop out when the rhomboids contract
- Grade 3 means they can complete the range of motion but can’t tolerate the downward force exerted on their hand. This means their muscle strength is far
- Grade 2 means they can complete the scapula’s range of motion. This means their muscle strength is poor.
- Grade 1 means that contractile activity was detected despite having no movement. This means there is a trace of contraction.
- Grade 0 means there is no trace of contraction at all.
The weaker their muscles are, the higher the possibility of the patient having a subscapular muscle tear or lesion, especially if they can’t lift their hand from the small of their back. If the test indicates poor to no muscle strength, it would be best to further test the patient with other physical examinations and imaging tests to confirm the problem and address it accordingly.
Rhomboid Manual Muscle Test example:
Now that you know what rhomboid muscles are and how the Rhomboid Manual Muscle Test is conducted, it’s time to acquaint you with our Rhomboid Manual Muscle Test template.
Usually, these physical examinations don’t come with results sheets. If you’re a physical therapist who knows how to conduct the Rhomboid Manual Muscle Test but doesn’t have a sheet to record results, look at our template!
Our template contains instructions on conducting the test in case you have a mental block and temporarily forget parts of it. It also has checkboxes so you can tick the patient's grade after the test.
Download our Rhomboid Manual Muscle Test PDF
If you like what you see and believe this is a good way to record Rhomboid Manual Muscle Test results, feel free to download our free Rhomboid Manual Muscle Test PDF template!
When is it best to conduct the Rhomboid Manual Muscle Test?
When a patient discusses shoulder or upper back discomfort and pain
As mentioned earlier, the Rhomboid Manual Muscle Test is one possible test you can offer to conduct when a patient discusses shoulder or upper back pain and discomfort during an appointment with you. If they agree to go through this test, you can do so. It’s best to explain what it’s for and how it can help determine the problem causing the pain, discomfort, and perhaps weakness in the upper back and shoulders.
During rehabilitation or physical therapy sessions
Suppose a patient was confirmed to have weak rhomboid muscles during the initial testing and diagnosis, and they’re currently undergoing rehab to regain strength in their rhomboids. You can routinely conduct this test during rehabilitation or physical therapy sessions to see if their rhomboids are regaining strength.
When assessing athletes
Coaches and trainers can employ physical examination techniques to assess their players. They can conduct this test as part of an overall athlete assessment to see if the athlete being assessed is in tip-top shape and condition. If the test results show otherwise, they can adjust the training plan to ensure they reach peak conditioning to take on competition and more difficult types of training.
How can Carepatron help with physical therapy?
Thanks for reading this guide! This is an excellent introduction or refresher to the Rhomboid Manual Muscle Test. If you decide to use our template, we hope it helps you record your patient’s results and monitor their progress as they work to rehabilitate and strengthen their rhomboid muscles.
While we still have you, we’d like to ask you for your time to check more of the Carepatron platform. We have a lot of nifty features, and we’re confident they’re cool and helpful enough to convince you to consider us your number-one clinical documentation and physical therapy practice management software. We won’t get into those features here, but we’d like to discuss one related to this guide: our resource library.
Our resource library is one of the features we’re most proud of. It also happens to be one of our most popular features! It houses a massive collection of clinical resources that cover numerous healthcare fields, topics, and practices, especially physical therapy.
We have numerous templates for different types of physical examinations. We have other templates for shoulder-related tests like the Crank Test, Neer’s Test, Speed’s Test, and the Empty Can Test, to mention a few. What’s great about these templates is that they’re free, so download as much as you want and need!
Commonly asked questions
It’s possible for patients to feel pain and discomfort while this test is being conducted. However, this will be due to an existing problem. The pain and discomfort will point to a possible problem that can be determined through other tests.
Physicians, physical therapists, rehabilitation specialists, and other similar professionals specialize in treating musculoskeletal problems.
No. It is considered a diagnostic test, but it’s best not to rely on it as the only test to diagnose a person with a shoulder-related problem. It’s best to add this as part of a comprehensive examination.
