Back Scratch Test: How to Perform, Interpret, and Improve Shoulder Mobility

How do you do a back scratch test?

The back scratch test is a simple, effective field assessment used to measure shoulder girdle flexibility, specifically the ability to reach behind your back with both hands. It involves attempting to touch the fingertips of one hand over the shoulder and the other hand up the back.

What is the Back Scratch Test?

The back scratch test is a widely recognized component of functional fitness assessments, often included in batteries like the Senior Fitness Test. It evaluates the combined range of motion in the shoulder joint, specifically focusing on internal rotation, adduction, and extension of one arm, and external rotation, abduction, and flexion of the other. Essentially, it gauges the functional mobility required for many daily activities, such as dressing, reaching for objects, and maintaining personal hygiene.

Why is the Back Scratch Test Important?

Assessing shoulder mobility is crucial for several reasons:

• Functional Independence: Adequate shoulder flexibility is essential for performing everyday tasks without limitation or pain. Restricted range of motion can significantly impact quality of life.
• Injury Prevention: Poor shoulder mobility can lead to compensatory movements, increasing the risk of impingement, rotator cuff injuries, and other musculoskeletal issues in the shoulder and upper back.
• Posture and Biomechanics: Restricted shoulder movement can contribute to poor posture, affecting the entire kinetic chain from the cervical spine to the thoracic spine.
• Performance Enhancement: For athletes and active individuals, optimal shoulder mobility is foundational for efficient movement patterns and injury-free performance in sports and exercise.

Step-by-Step Guide to Performing the Back Scratch Test

To ensure accurate and consistent results, follow these instructions carefully. It's often helpful to have a partner assist with measurement, but it can also be self-administered with a ruler or tape measure and careful observation.

Preparation

• Warm-up: Perform a light warm-up that includes arm circles, shoulder rolls, and gentle stretches to prepare the muscles and joints.
• Attire: Wear comfortable clothing that does not restrict movement.
• Positioning: Stand upright with your feet shoulder-width apart, arms relaxed at your sides. Maintain a neutral spine and avoid hunching or arching your back excessively.

Execution (Dominant Arm Over the Shoulder)

1. Raise Dominant Arm: Extend your dominant arm straight up overhead, then bend your elbow, reaching down your back as far as possible, with your palm facing inward and fingers extended.
2. Reach Up with Non-Dominant Arm: Bring your non-dominant arm behind your back, palm facing outward, and reach upwards as far as possible, attempting to touch or overlap the fingers of your dominant hand.
3. Hold Position: Once you've reached your maximum extent, hold the position briefly without straining.

Execution (Non-Dominant Arm Over the Shoulder)

1. Repeat on Opposite Side: Switch arm positions. Extend your non-dominant arm straight up overhead, bend your elbow, and reach down your back.
2. Reach Up with Dominant Arm: Bring your dominant arm behind your back, palm facing outward, and reach upwards as far as possible, attempting to touch or overlap the fingers of your non-dominant hand.
3. Hold Position: Hold the position briefly.

Measurement

• Fingertip Overlap: If your fingertips overlap, measure the distance of the overlap to the nearest centimeter or half-inch. This is recorded as a positive score.
• Fingertip Gap: If your fingertips do not touch, measure the shortest distance between them. This is recorded as a negative score.
• Touching: If your fingertips just barely touch, the score is zero.
• Record Both Sides: Always record the score for both the right and left sides, as asymmetry is common and important to note.

Interpreting Your Results

Scores are typically compared to age and sex-specific normative data, which can be found in various fitness assessment guides. Generally:

• Positive Score (Overlap): Indicates good to excellent shoulder flexibility. The greater the overlap, the better the mobility.
• Zero Score (Touching): Suggests adequate functional mobility.
• Negative Score (Gap): Suggests limited shoulder flexibility. A larger gap indicates poorer mobility.

Key considerations for interpretation:

• Asymmetry: Significant differences between your right and left sides (e.g., more than 2-3 inches or 5-7.5 cm) can indicate muscular imbalances or underlying issues that warrant attention.
• Age-Related Decline: It's normal for flexibility to decrease with age, but consistent mobility work can mitigate this decline.
• Activity Level: Active individuals, especially those who regularly perform upper body mobility work, typically score better.

Factors Affecting Your Score

Several factors can influence your back scratch test performance:

• Muscle Tightness: Tightness in the latissimus dorsi, pectoralis major/minor, teres major, and subscapularis can restrict overhead reach and internal rotation.
• Joint Capsule Stiffness: Over time, the shoulder joint capsule can become stiff, limiting range of motion.
• Thoracic Spine Mobility: Restricted mobility in the upper back (thoracic spine) can significantly impede shoulder movement, particularly overhead reach.
• Rotator Cuff Health: Weakness or injury to the rotator cuff muscles can affect the stability and mobility required for the test.
• Posture: A rounded shoulder posture (kyphosis) can limit the ability to reach behind the back effectively.
• Previous Injuries: History of shoulder injuries, surgeries, or conditions like "frozen shoulder" (adhesive capsulitis) will severely impact results.

Improving Your Shoulder Mobility

If your scores indicate limited mobility, incorporating targeted flexibility and mobility exercises can be highly beneficial:

• Static Stretches:
  • Doorway Pec Stretch: To open the chest and stretch the pectorals.
  • Lat Stretch: Using an overhead bar or the edge of a wall to lengthen the lats.
  • Triceps Stretch: Reaching behind the head.
• Dynamic Mobility Drills:
  • Arm Circles: Forward and backward.
  • Shoulder Passes: Using a PVC pipe or resistance band held wide.
  • Thread the Needle: For thoracic spine rotation and shoulder mobility.
• Foam Rolling: Targeting the upper back, lats, and pectorals can help release muscle tension.
• Resistance Training: Incorporating exercises that promote full range of motion, such as overhead presses (with good form), pull-aparts, and face pulls, can strengthen the muscles that support healthy shoulder mechanics.

Consistency is key. Regular, gentle stretching and mobility work can gradually improve your range of motion and functional capacity.

When to Seek Professional Guidance

While the back scratch test is a simple self-assessment, it's not a diagnostic tool. If you experience any of the following, consult a healthcare professional, physical therapist, or certified exercise physiologist:

• Pain during the test: Flexibility should be challenged, but not painful.
• Significant asymmetry: A large difference between sides without a clear explanation.
• Inability to perform the test at all: Suggests severe restriction.
• Persistent stiffness or loss of range of motion: Especially if it's new or worsening.
• Concerns about underlying medical conditions: Such as arthritis, rotator cuff tears, or nerve impingement.

An expert can provide a comprehensive assessment, identify the root cause of any limitations, and develop a personalized plan for improvement.