Latissimus Dorsi Muscle Length Test (Lat Length Test)

Latissimus Dorsi Muscle Length Test (Lat Length Test)


This is Brent of the Brookbush
Institute, bringing you another muscle length test. In this video we’re going to
do the lat length test. Now the lat length test we use to
determine if the latissimus dorsi is one of the muscles restricting shoulder
flexion. I’m then going to show you some of the if-then scenarios, that will help
you determine whether the lats, the shorter internal rotators of the
shoulder, or both are involved. I’m going to have my friend Melissa come out, she’s
gonna help me demonstrate. So what the lat length test really is, is a shoulder
flexion test. It’s just a very quick shoulder flexion test, just like shoulder
flexion goniometry. Alright so what I’m gonna have you do, sorry start here,
laying flat. I’m going to have you try to bring this part of your forearm back to
the table in front of you. Alright there you go, so you guys see. We know
that normal shoulder flexion is between 100 and 185 degrees, so she’s missing
some shoulder flexion right. The lat length test part comes in and it
goes, if you really push it, can you push it, just go all the way down to the
table, go for it. Alright she pushes her arms down and does this, did you guys
see all this lumbar extension. I have to start thinking to myself all right
the muscles that could restrict shoulder flexion, I got the teres major,
subscapularis, the latissimus dorsi pectoralis major probably not likely in
this position. Of those muscles, which one crosses the lumbar spine, well the lattisimus dorsi crosses the lumbar spine. Not only does it cross the lumbar
spine, but it will cause lumbar extension, which is exactly what I saw. So when I
told Melissa to go ahead and push it, or I could even add a little overpressure,
obviously you wouldn’t want to do that to a painful shoulder. But if you added a little
overpressure and it pulled her into lumbar extension, I know that she ran out
of room from her lats, and had to shorten it somewhere else. So this would be a
positive lat length test. I know that the lats are one of the structures that
could be restricting her shoulder flexion.
There’s another way to go about this, we’ll start over.
This time we’ll put her in a hook lying position. Now hook lying position posteriorly tilts the pelvis a little bit, flattens up the lumbar spine and it kind
of anchors the pelvis a little bit, so that lumbar extension is
not as easy to get in this position. Now I have her go ahead and pull this way,
and usually what you’ll have is in that same individual, somebody will actually
look like they’re even more restricted and shoulder flexion. I could test to see
how much the lats are contributing to this by going okay, let’s go ahead and
bring your legs up, push you into a posterior tilt, and you guys see how when
I pushed her into a posterior tilt her arms came up a little bit. That’s a
pretty good sign that her lats are contributing to the restriction on her
shoulders. So that’s all the lat length test does. Is the lat one of the muscles
restricting shoulder flexion, the problem with that is, is it doesn’t do all that
much for us from a practical application standpoint. I still don’t know if it’s
subscapularis and teres major contributing to this. So how would I
figure that out? Well I could go back to my goniometry, if you guys remember
shoulder external rotation is done here. Alright, why shoulder external rotation?
Well subscapularis, teres major, latissimus dorsi are all internal
rotators. But if i go and put the arm back in ninety degrees of shoulder
abduction, i just shortened the lats a little bit right. It’s like halfway through a
lat pulldown. So these structures that are more likely to restrict this range
of motion in this position are the shorter external rotators. So if I had
positive lat length tests, and then I did external rotation and she had full 95
degrees, I might be able to deduce that it’s the lats restricting her shoulder
flexion, and the short internal rotators, teres
major and subscapularis. If I had a positive lat length test and she only
had 85 or 80 degrees of shoulder external rotation, then I know it’s
probably teres major, subscapularis and latissimus dorsi. If I had a
negative lat length test right, so that’s I did those lat length tests,
she had restricted shoulder flexion but pulling you into a posterior pelvic tilt,
or laying your legs flat didn’t change anything. So pulling your legs this way
didn’t cause your arms to come up, laying your legs flat didn’t cause your lumbar
spine to go into extension right, that’s a negative lat length test. But I came
over here and she was still restricted in internal rotation, then I know it’s
not my latissimus dorsi but my short internal rotators that are causing a
restriction in shoulder flexion. You guys catch all that. So let me review
this a little bit. If I had positive lat length test, negative shoulder external
rotation. So somebody had normal external rotation, then it’s probably just the
lats. If I had positive lat length test, and somebody had reduced shoulder external
rotation, they had a limit in external rotation, then it’s probably not only the
latissimus dorsi, but the subscapularis and teres major. If I didn’t get a
positive lat length test, but I have a restriction in external rotation, then
it’s probably the subscapularis and teres major, and not the lats. Now on a side
note, if we take this back to movement impairment,
generally speaking the only time I find that the lats are tight without the
subscapularis and teres major coming along for the ride, is when latissimus dorsi
over activity is not stemming from upper body dysfunction, but from lumbo-pelvic
hip dysfunction. In other words somebody has an anterior
pelvic tilt maybe with some low back pain, and you notice limited shoulder
flexion, however that limited shoulder flexion is caused from over activity of
the latissimus dorsi as a lumbar extensor, and your intervention, your
corrective exercise, your physical therapy, your therapeutic modalities
should be focused on trying to fix an anterior pelvic tilt, not this. I’m
willing to bet that if it’s upper-body dysfunction that’s causing the limit in
shoulder flexion, but not only will your lats be tight, but so will your teres
major, and your subscapularis along with potentially your anterior tippers of
your scapula. Now if you guys want to know how to differentiate between
lumbo-pelvic hip complex and upper body dysfunction, go check out the videos on
the overhead squat assessment, particularly the overhead squat
assessment sign clusters. You’ll see one for upper body dysfunction, one for
lumbo-pelvic hip dysfunction, one for lower leg dysfunctional, one for
asymmetrical weight shift. Go over the ones for upper body and lumbo-pelvic hip.
I think you’ll be able to differentiate those two dysfunctions, go back and start
thinking about the lat length test versus external rotation goniometry, and
think about how those play out positive or a negative lat length test, restricted
or normal external rotation. I think before you know it you’ll have a shorter
list of muscles that could be restricting this motion. Which means less
release techniques, less lengthening techniques, and less mobilization
techniques that you’ll need, which means a more refined program, a more effective
program, a more efficient program and hopefully better results. I’ll talk with
you guys soon.

39 Replies to “Latissimus Dorsi Muscle Length Test (Lat Length Test)”

  1. how to fix the problem Winged Scapula plus i have a shoulder pain in the same arm also my shoulder is very weak compared to my other hand

  2. Another great, short educational video that we can understand without having to work on a cadaver. I also love how you give applicable info! Keep up the great work.

  3. Good day Dr.B2… I have blowback pain directly to my lumbar area and i found out i have hamstring tightness…by stretching my hams daily will help to resolve my problem? I found out i have latissimus doors tightness too  but by doing the head to knee chest prayer positioning to stretch my latissimus doors triggers my back pain.. can i still continue stretching or do some strengthening first? my low back pain is just acute … I still have left thoracolumbar scoliosis too
    …Thanks a lot Dr.B2 ..God bless you for your great help 😀

  4. Love this lat length test. I passed with flying colors. Yay. I need a test for every muscle in my back and rotator cuff. Please & thanks. 🙂

  5. Hi Brent, I have a question about this test. What is the role of a tight m. rhomboideus in this test? Thanks in advance for your reply.
    Beatrijs

  6. Freaking great video!! Plays right into what I'm working on with one of my clients right now with frozen shoulder. He lats are bound up beyond anyone's business but so is his Teres major and sub scap so I'm mobilizing it all but now I can test and see if the mobility is helping one muscle and not the other. Great info it blows my mind very well laid out and understandable!! Thanks again B2B

  7. So, what is your favorite way to help clients with shortened lats, lacking external rotation on ONE side (usually opposite throwing arm) Tender Subscap, and teres. I was reading Brian Reddy's stuff (b-reddy.org) and he reccommends avoiding pressing, and pulling. Specifically hes not a fan of the serratus push up. He advocates regaining overhead motion.

    Is the first step in your opinion releasing lat then subscap then teres? What exercises would you use for a swimmer who has these symptoms, resulting in neck and shoulder tightness.

    Lots of questions in there lol

  8. What should I be doing with my scapulae while I perform this test? I noticed that if I keep them retracted then I don't get the full range of motion, but if I allow them to open up then I can pass the test

  9. Hi Brent, Great stuff bud! How can you make the call of the inferior latissimus being the indicated tightness as opposed to superior proximal latissimus in the end range of knee and hip flexion? The spine will flex in this position increase flexion in the thoracic spine as well which with the shoulder in end range will raise the arms. In other words if they don't touch the table in lat length test position 1 they will lift in position 2 not necessarily indicating additional tightness but shoulder flexion being at end range and spinal flexion increasing arm lift. Regards. 🙂

  10. hi Brent! i have internally rotated my left shoulder and i dont know how to deal with it. i tried everything( stretching, strenghtening rotator cuff) for 2 years but i havent noticed any improvement, when i tried your lats test i couldnt do full range of motion and had pain in that left shoulder. Do you think that lats stretching could help my wholelife problem? thx for any help or reply.

  11. sadly in my high school they (i mean teachers) dont talk what muscle contributed with what and that video is highly valuable. Thx man.

  12. Another great video! Thanks for taking the time to keep us sharp. I learn something new every time I tune in 👌

  13. Hi, can we grade tightness ( mild, moderate and severe tightness depending on outer, middle and inner range) ?

  14. I noticed that when at the end range of shoulder flexion if you internally rotate your arms a bit you achieve full 180 degrees of shoulder flexion. Also when doing scapula pulls on a bar I noticed that externally rotating at the beginning helps to activate the lats and to depress the scapula. Why is that? Maybe because of the Teres Minor? I'm kind of confused.

  15. This was a fantastic video! Its strange, but i can put my left arm behind my back and reach up my left arm can reach a lot higher and rotate a lot better than my right arm. What would you assess to be the issue?

  16. Hi Brent,

    I have restricted shoulder flexion, and test positive on both the lat length and external rotation tests. This is harmful as I'm an athlete in an overhead sport (rock climbing). Despite this, I have significantly under-active lats that I can't feel fire on nearly anything, especially a pull-up, (after a set of pull ups, I feel sore under the chest, in what I think is the pec minor).

    Do you have any stretching/exercise/release recommendations for getting appropriate shoulder flexion AND getting the lats going? Thank you, John

  17. I have suffered from ATP and chronic (associated?) (thoracic) back pain for longer that I can remember.

    Tried every hip flexor stretch, tried floor and wall posterior pelvic tilts, tried glutes and hamstring exercises, and got somewhat better… painwise only.

    When standing APT was still very noticiable. When standing for long periods of time I would get pain symptoms again.

    Eventually I reached the point where I tested pretty much negative in Thomas (psoas) / Ely (rectus femoris / Ober (TFL) tests. And yet still remarkable APT when standing.

    Yesterday I was lucky enough to come across this and guess what… ¡TESTED POSITIVE ON THIS ONE!.

    Lying on the floor with neutral lumbar spine, then trying to flex shoulders over my head proved to be impossible without lumbar lordosis compensation.

    I spent yesterday's whole afternoon trying to actively flex my shoulders while keeping neutral pelvis (which gives me a very intense stretch feeling in the armpit…)

    Today I've woken up with unrecognizable loose back. Both APT and Kyphosis reduced drastically. This amazing. It's like a miracle
    .

    I can't thank you enough for this info Brent.

    This is something that I feel it's not well spread…everyone (but you :D) just keep talking just about the psoas, quads, glutes and so on..

    If you have chronic back pain, please check for tight lats. I feel like you have a very high chance of getting relief by actively streching them and recovering pure shoulder flexion range of motion.

    Thanks again Brent… and good luck backpain
    sufferers!

  18. Wish you were my physio. I've been to dozens of them and none have a clue what they are doing. Can you recommend anyone in Canada who analyzes problems like this?

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