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1. 1st thing is screening exam: Individual places hand on opposite shoulder and then attempts to point the elbow upward - if there is pain this results in a 0 score - do it bilaterally 2. One hand over the top and the other hand reaching around back 3. I am watching for thoracic spine to extend /rotate to compensate 4. Grading: 1= fists are not within one and a half hand lengths 5. Grading 2 = Fists are 1 and 1/2 6 Grading 3 = Fists are 1 hand length

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