The Shoulder ASH Test, also known as the Athletic Shoulder Test, measures how much force a client can produce through the shoulder and upper limb in long-lever prone positions. It is commonly used in sport, performance and shoulder strength profiling because it assesses force production in positions that are more demanding than short-lever shoulder rotation tests.
The ASH test is often performed in three positions: ASH 90, ASH 125 and ASH 180. These positions broadly represent the arm out to the side, diagonally overhead and fully overhead. This makes the test useful for overhead athletes, throwing athletes, contact sport athletes, swimmers, gym-based clients, workplace clients and people who need to produce force with the arm away from the body.
The Muscle Meter is a handheld dynamometry tool used to measure force output during push, pull and isometric strength assessments. When used on its own, the Muscle Meter primarily measures peak force, which is the highest force value produced during the test. When used with Measurz, Muscle Meter data can be recorded and analysed with a broader set of strength and force-time metrics, including peak force, impulse, torque, rate of torque development, rate of force development, time to peak and fatigue index.
For routine Shoulder ASH testing, peak force is usually the main metric. Force as a percentage of body weight is also useful because ASH results are commonly compared relative to body size. Rate of force development and time to peak may be useful when rapid shoulder force production matters, such as throwing, swimming, grappling, tackling, contact sport, overhead lifting or high-speed upper-limb tasks. Impulse may be useful if sustained force over a defined time window is intentionally analysed. Fatigue index is only relevant if repeated or sustained ASH efforts are part of the protocol.
The result can support assessment reasoning and progress tracking, but it does not diagnose shoulder injury, rotator cuff pathology, instability, nerve involvement, pain source, concussion risk, contact readiness, throwing readiness or work readiness on its own.
The Shoulder ASH Test is an isometric long-lever upper-limb strength test performed with the client prone and the arm positioned in different abduction angles. The client presses the hand or distal arm into the Muscle Meter, force plate or fixed dynamometry setup without visible movement.
Common ASH positions include:
ASH 90: arm abducted to approximately 90 degrees
ASH 125: arm positioned diagonally overhead, often around 125 degrees of abduction/elevation
ASH 180: arm positioned overhead, often around 180 degrees of shoulder elevation
These positions are sometimes described as T, Y and I positions. The exact naming should be recorded because different systems may label the positions slightly differently.
The test aims to measure the client’s ability to produce and transfer force through the shoulder, scapular region, trunk and upper limb in long-lever positions. It is not an isolated rotator cuff test. It reflects shoulder strength, scapular control, trunk stability, arm position tolerance, confidence and task familiarity.
Consistent setup matters because arm angle, body position, device placement, hand position, trunk stabilisation, scapular position, lever length, pressure direction and client intent can all affect the result.
Explain that the test measures how strongly they can press into the Muscle Meter while lying prone with the arm in different ASH positions. Record baseline symptoms, shoulder pain, neck symptoms, elbow or wrist symptoms, paraesthesia, fatigue, recent throwing, swimming, contact sport, overhead training, gym workload and confidence with maximal effort.
Use at least one submaximal practice trial in each position so the client understands the direction of force and learns to build force smoothly without trunk rotation, shoulder shrugging, elbow bending or breath holding.
Position the client prone on a table or floor-based setup. The tested arm is placed in the selected ASH position. The opposite arm may be positioned comfortably, but it should not assist the test.
Record:
Test side
ASH position: 90, 125 or 180
Whether positions are labelled T, Y or I
Shoulder angle
Elbow position
Forearm and hand position
Head and neck position
Trunk position
Scapular position if observed
Device contact point
Whether a strap, force plate, platform or handheld setup was used
Whether symptoms were present before testing
The arm should remain long unless a modified protocol is intentionally used. The client should avoid lifting the trunk, rotating the body, bending the elbow or using momentum.
For a Muscle Meter setup, place the device under the hand, wrist, distal forearm or chosen contact point, depending on the protocol. The device must be stable and aligned with the intended force direction.
If using a strap, platform, force plate or fixed setup, record:
Device type
Device orientation
Contact point
Arm angle
Table or floor setup
Whether the device moved
Whether any pre-tension was used
Whether the same setup can be repeated at retest
Handheld, force-plate, floor, table, strap-based and platform-based ASH results should be recorded separately unless the protocol supports direct comparison.
Place the Muscle Meter at the chosen hand or distal-arm contact point. Use the same contact point at retest. Avoid uncomfortable pressure over bony or sensitive areas.
The force direction should be clearly defined. In many ASH setups, the client presses downward into the device while lying prone. In modified setups, the force direction may differ, so it must be recorded.
Stabilise the body position by ensuring the client stays prone and still. The professional may monitor trunk rotation, shoulder hiking, elbow bending, wrist collapse and unwanted body movement.
The aim is controlled long-lever shoulder force in the selected ASH position.
Use consistent instructions such as:
“Press into the device as hard as you can and hold.”
“Build up smoothly, then push hard.”
“Keep your elbow straight.”
“Keep your body still.”
“Do not twist, shrug or lift your chest.”
“Keep breathing.”
“Tell me if you feel shoulder pain, neck pain, tingling, weakness, dizziness or anything unusual.”
Use the same wording at retest where possible.
Use 1–2 practice trials, then record 2–3 maximal trials in each ASH position. A common contraction duration is 3–5 seconds. If using an ASH protocol based on force-plate or HHD research, keep the contraction duration and rest periods consistent with that protocol.
Rest for 30–60 seconds between trials and longer between positions if fatigue, symptoms or apprehension occur. Record whether the final score uses the best trial or the average of recorded trials. Either approach may be used if applied consistently.
Repeat or mark a trial as invalid if:
The trunk rotates or lifts
The shoulder shrugs significantly
The elbow bends
The arm angle changes before or during the effort
The wrist collapses or changes the force direction
The device slips or moves
The client pushes with the body rather than the shoulder and upper limb
Pain, paraesthesia or neurological symptoms limit effort
The client starts before the device is ready
The client holds their breath excessively
The recording misses the peak effort
Record shoulder pain, neck symptoms, elbow symptoms, wrist symptoms, paraesthesia, clicking, apprehension, confidence and symptom response after testing. Do not repeatedly test through worsening symptoms, significant paraesthesia, strong apprehension or high pain.
For retesting, match the same body position, ASH position, arm angle, device placement, force direction, instructions, contraction duration, rest period, scoring method and symptom recording.
The Shoulder ASH Test is used to quantify long-lever upper-limb isometric force output in shoulder positions that are relevant to overhead and contact demands. It may be useful for:
Baseline shoulder strength profiling
Side-to-side comparison
Monitoring change over time
Comparing ASH 90, ASH 125 and ASH 180 positions
Supporting overhead sport assessment reasoning
Supporting contact sport and collision sport assessment reasoning
Supporting throwing, swimming, racquet sport, gymnastics, climbing and gym-based strength profiling
Supporting workplace assessment where overhead force, reaching, pushing or bracing are relevant
Tracking response to workload, training or fatigue
Client education
Fitness and performance progress tracking
The test should support assessment reasoning. It should not be used as a stand-alone diagnostic, performance-prediction, return-to-sport or clearance measure.
The test primarily measures isometric long-lever shoulder force output in selected ASH positions. It reflects the client’s ability to produce force through the upper limb while controlling the shoulder, scapula, trunk and arm position.
It may provide useful information about:
Peak force in ASH 90, ASH 125 and ASH 180
Side-to-side force difference
Position-to-position force profile
Force relative to body weight
Confidence producing force in overhead or long-lever positions
Symptom response during resisted long-lever shoulder loading
Change in force over time
Relationship between shoulder strength and related sport, work or daily-life tasks
It does not directly measure:
Cause of shoulder pain
Rotator cuff tissue status
Shoulder joint structure
Shoulder instability
Nerve function
Throwing readiness
Swimming performance
Contact sport readiness
Work readiness
A higher score may suggest greater long-lever shoulder force output in that specific ASH position. A lower score may suggest reduced force output, but the reason should be interpreted carefully.
Lower force may be influenced by pain, apprehension, poor familiarisation, fatigue, guarding, inconsistent arm angle, device movement, reduced confidence, neck symptoms, shoulder symptoms, scapular compensation, trunk rotation, elbow bending or poor understanding of the force direction.
One result should not be interpreted in isolation. Interpretation is strongest when the same setup is repeated over time and reviewed alongside symptoms, confidence, shoulder range of motion, shoulder rotation strength, abduction strength, flexion strength, scapular control, overhead workload, sport demands and work tasks.
Important influences include:
Shoulder pain
Neck symptoms
Apprehension
Poor familiarisation
Fatigue
Guarding
Arm angle
ASH position
Device placement
Contact point
Force direction
Elbow position
Wrist position
Trunk stability
Scapular control
Table or floor setup
Device stability
Client confidence
Breath holding
Published Muscle Meter-specific universal norms for the Shoulder ASH Test are limited. Most published ASH evidence uses force plates, hand-held dynamometry, Wii Fit Balance Board or other device-specific setups. Reference values should therefore be used as context only and not as direct targets unless the protocol is closely matched.
More user-friendly comparison data include:
The original ASH test reliability study tested 18 elite rugby players with an average age of 22.4 ± 4.6 years and average body mass of 95.5 ± 13.4 kg. This population is highly specific and should not be treated as a general adult norm.
That study reported excellent inter-day reliability across ASH positions, with ICC values of approximately 0.94–0.98. This supports ASH peak force as a useful monitoring metric when setup is standardised.
The same study reported minimal detectable change values of approximately 13.2–25.9 N, depending on the ASH position. Small changes below this range may reflect normal test variation rather than a true performance change.
A later ASH study comparing Wii Fit Balance Board and handheld dynamometry in healthy amateur rugby players found both devices could be used to assess ASH strength, but agreement depends on the device and setup. This supports recording the device type and avoiding direct comparison between different tools unless validated.
A Modified-Athletic Shoulder Test using handheld dynamometry has been reported to show strong concordance with ASH test values, with reported ICC 0.86–0.97 across positions. This suggests HHD-style ASH testing can be useful, but setup must be carefully standardised.
In practical monitoring, ASH force is often reviewed as peak force, side-to-side difference and force relative to body weight. Values around 10–15% of body weight are sometimes used as broad overhead-athlete context, but they should not be treated as universal targets or clearance criteria.
For side-to-side comparison, a difference of around 10% or more is often worth reviewing more closely, especially if it matches symptoms, previous injury, confidence changes, overhead exposure or functional limitations. This should not be used as a strict pass/fail cut-off.
Compare ASH 90, ASH 125 and ASH 180 separately. A client may perform well in one position but not another, especially if symptoms or confidence change as the arm moves overhead.
If force is recorded as a percentage of body weight in Measurz, use it mainly for baseline comparison, side-to-side comparison and repeated testing under the same setup.
These values and comparisons are best used as context. They can help structure interpretation, but they should not be used as diagnostic, injury-risk, performance-prediction, return-to-sport, return-to-work or pass/fail cut-offs.
Use this order:
Compare with the client’s own baseline.
Compare right and left shoulders if the opposite side is symptom-free.
Review force relative to body weight where calculated.
Compare ASH 90, ASH 125 and ASH 180 separately.
Consider symptoms during and after testing.
Consider confidence and effort quality.
Review whether compensations were present.
Compare with shoulder range of motion, rotation strength, abduction strength and overhead task tolerance.
Relate the result to sport, gym, work or daily-life demands.
Retest under the same conditions to monitor change.
Do not use reference values as pass/fail criteria.
Peak force
Use for maximum ASH force output, baseline strength, side-to-side comparison, position-to-position comparison and progress tracking. Look for best score or average score, consistent setup, change from baseline, symptom response and whether compensations occurred.
Force as percentage of body weight
This is especially useful for ASH testing. Use it to compare the client with their own baseline, between sides and between positions. Do not treat broad percentage values as clearance targets.
Torque
Torque is usually not the main routine metric for ASH testing because ASH is a long-lever, multi-segment upper-limb test. Use only when lever arm and contact point are intentionally measured and a biomechanical interpretation is needed. It should not be used as normative data.
Rate of force development
Use when rapid shoulder force matters, such as throwing, swimming, grappling, tackling, contact sport or explosive overhead tasks. Look for early force production and whether rate of force development changes while peak force stays similar.
Time to peak
Use to understand whether force is produced quickly or gradually. A slower time to peak may reflect caution, pain, apprehension, poor cueing or a true force-production difference.
Impulse
Use if a defined force-time window is intentionally analysed. It may help when the aim is to understand whether the client can produce and sustain force briefly in an ASH position.
Fatigue index
Use only if repeated or sustained ASH efforts are part of the protocol. Look for drop-off across repeated trials or positions and whether the decline matches symptoms, fatigue, workload or apprehension.
Youth clients
Consider growth, maturity, coordination, sport exposure, confidence and familiarisation. Use conservative interpretation because effort, attention and testing confidence can influence the result.
Adults and general fitness clients
Use the test for baseline long-lever shoulder strength, progress tracking and comparison between positions. Compare results with range of motion, pushing tolerance, overhead tolerance, exercise exposure and symptoms.
Older adults
Consider comfort, shoulder mobility, neck symptoms, fatigue, confidence and ability to tolerate prone overhead positioning. Use a comfortable setup and avoid repeated maximal efforts if symptoms are provoked.
Athletes and sport clients
Consider throwing, swimming, racquet sports, combat sports, grappling, contact sport, gymnastics, climbing and overhead lifting demands. ASH testing can support overhead strength profiling, but it should not be used alone to judge sport readiness.
Workplace and manual task clients
Consider pushing, pulling, reaching, overhead work, carrying, bracing and sustained arm positions. Do not use one score to clear work duties.
Clients returning after injury
Use the test to monitor force output, confidence and symptom response. Strength alone should not confirm readiness.
Clients with pain or persistent symptoms
Pain, fear, guarding, fatigue, apprehension and confidence may reduce force. Record symptom response carefully and compare with related tests.
Higher body mass clients
Absolute force and force relative to body mass may both be useful. Interpret results in relation to goals, symptoms, body size, arm length and functional demands, not assumptions about body size.
Repeatability improves when the same setup is used each time. Record and standardise:
Same body position
Same test side order
Same ASH position order
Same arm angle
Same elbow position
Same forearm, wrist and hand position
Same head and trunk position
Same device placement
Same contact point
Same device type
Same table, floor or platform setup
Same force direction
Same contraction duration
Same rest period
Same instructions
Same scoring method
Same symptom and compensation recording
ASH testing is highly setup-dependent. Small changes in arm angle, device position, force direction, contact point or trunk control can change the score. Force-plate, handheld dynamometer, Muscle Meter, Wii Fit Balance Board and other device results should not be assumed interchangeable unless a validated comparison supports it.
Common errors include:
Arm angle changing between trials
Elbow bending
Trunk lifting or rotating
Shoulder shrugging
Wrist collapse
Device movement
Contact point changing
Testing a different ASH position than recorded
Breath holding
Testing through worsening symptoms
Poor familiarisation
Comparing different devices directly
Treating the score as a diagnosis or clearance test
Limitations include:
Testing is setup-dependent
Device-specific differences can affect the score
Muscle Meter-specific universal ASH norms may be limited
Published ASH data are often sport-specific
Pain, apprehension or guarding can reduce force output
Peak force does not measure throwing skill, contact ability or overhead performance
Strong force or symmetry does not automatically indicate readiness for sport or work
The Shoulder ASH Test may be useful for:
Baseline long-lever shoulder strength assessment
Monitoring response to exercise, training or workload
Right-to-left shoulder strength comparison
ASH 90, ASH 125 and ASH 180 position profiling
Throwing, swimming, racquet sport and contact sport strength profiling
Occupational overhead strength profiling
Comparing with shoulder internal rotation, external rotation, abduction, flexion, range of motion and endurance tests
Client education
Fitness and performance progress tracking
If force is low across all ASH positions, consider assessing shoulder range of motion, abduction strength, flexion strength, internal and external rotation strength, scapular control, trunk control, neck symptoms, overhead exposure and familiarisation.
If one ASH position is lower than others, compare with symptoms, position tolerance, overhead workload, sport demands, arm angle, confidence and test setup.
If one side is lower, compare with symptoms, dominance, previous injury, sport or work demands, range of motion, rotation strength and ASH setup.
If symptoms limit the result, record symptom location and type, review test angle and compare with related findings rather than forcing repeated maximal trials.
If force improves but symptoms remain, consider reviewing endurance, range of motion, overhead workload, sport exposure, fatigue response and recovery between sessions.
If the client is improving, keep the same ASH setup and monitor whether force, symptoms, confidence and function improve together.
Position: Prone ASH testing position
Start position: Arm in selected ASH position: 90, 125 or 180 degrees
Joint or trunk angle: Record shoulder angle, elbow position, trunk position and scapular observation
Trials: 1–2 practice trials, then 2–3 recorded trials per side and position
Contraction duration: 3–5 seconds
Rest: 30–60 seconds between efforts; longer between positions if symptoms or fatigue occur
Metric: Peak force, side-to-side difference, ASH position profile, plus percentage of body weight if directly calculated
Attachment or device setup: Muscle Meter under hand, wrist or distal arm, or connected to a fixed setup with consistent contact point
Final score: Best trial or average of trials
Key retesting requirement: Same body position, side order, ASH position order, arm angle, device placement, force direction, contraction duration, rest and scoring method
It measures long-lever isometric shoulder force in prone positions such as ASH 90, ASH 125 and ASH 180.
They describe different arm positions, usually moving from arm out to the side, to diagonal overhead, to fully overhead. Record exact arm angles because naming can vary between systems.
Not exactly. It involves the shoulder and rotator cuff, but it also reflects scapular control, trunk control, arm position tolerance and whole upper-limb force transfer.
Yes. Testing both sides allows side-to-side comparison, especially when the opposite side is symptom-free.
The original ASH reliability study in elite rugby players reported excellent reliability with ICC 0.94–0.98 and minimal detectable change values of about 13.2–25.9 N depending on position. These values are useful for monitoring change, not for setting universal targets.
Yes, where possible. ASH results are often easier to interpret when recorded as force relative to body weight, but this should be used for context rather than as a pass/fail target.
No. It can support assessment reasoning, but it should not determine return to sport on its own.
Record side, ASH position, arm angle, device placement, peak force, force relative to body weight, symptoms, confidence, compensations, scoring method and related findings.
The Shoulder ASH Test measures long-lever isometric shoulder force in prone ASH positions.
Peak force is usually the main routine Muscle Meter metric.
ASH 90, ASH 125 and ASH 180 should be recorded and interpreted separately.
The original ASH study reported excellent inter-day reliability with ICC 0.94–0.98.
Minimal detectable change values around 13.2–25.9 N suggest very small changes should be interpreted cautiously.
Force relative to body weight is useful, but not a pass/fail target.
Measurz should capture side, position, setup, symptoms, force, confidence, compensations and retesting conditions.
Ashworth, B., Hogben, P., Singh, N., Tulloch, L., & Cohen, D. D. (2018). The Athletic Shoulder (ASH) test: Reliability of a novel upper body isometric strength test in elite rugby players. BMJ Open Sport & Exercise Medicine, 4(1), e000365. https://doi.org/10.1136/bmjsem-2018-000365
Bradley, H., & Pierpoint, L. (2023). Normative values of isometric shoulder strength among healthy adults. International Journal of Sports Physical Therapy, 18(4), 977–988. https://doi.org/10.26603/001c.83938
Intelangelo, L., Elias, G., Lassaga, I., Bustos, C., & Jerez-Mayorga, D. (2024). Reliability of two devices for shoulder strength assessment: Wii Fit Balance Board and hand-held dynamometer. Shoulder & Elbow, 16(2), 231–238.
Morin, M., Hébert, L. J., Perron, M., Petitclerc, É., Lake, S.-R., & Duchesne, E. (2023). Psychometric properties of a standardized protocol of muscle strength assessment by hand-held dynamometry in healthy adults: A reliability study. BMC Musculoskeletal Disorders, 24, 294. https://doi.org/10.1186/s12891-023-06400-2
Wochatz, M., Rabe, S., Wollesen, B., & Engel, F. A. (2022). Reliability and validity of the Athletic Shoulder Test performed with a portable isometric-based strength training device. Biology, 11(4), 577. https://doi.org/10.3390/biology11040577
