Shoulder elevation is important for overhead lifting, swimming, throwing, reaching, climbing, hanging, pressing and many sport or daily movement patterns. When combined elevation is limited, a client may compensate through the spine, ribs, scapula, neck or opposite side of the body.
The Single Arm Combined Elevation Test is useful because it assesses overhead mobility as a combined movement rather than an isolated shoulder angle. It captures how the shoulder, scapula and thoracic spine work together when the client moves one arm overhead.
Test name: Single Arm Combined Elevation Test
Alternative names: Single Arm Shoulder Elevation Test, Single Arm Overhead Mobility Test, Unilateral Combined Elevation Test
Category: Shoulder flexibility / overhead mobility assessment
Primary score: Arm elevation angle, hand-to-floor distance or side-to-side difference
Best use: Shoulder overhead mobility baseline, side-to-side comparison and retesting
Key limitation: Results depend on test position, arm path, thoracic extension, scapular movement, elbow position, symptoms and measurement method.
The Single Arm Combined Elevation Test assesses unilateral overhead elevation in a standardised position.
It can be measured as:
arm elevation angle
hand-to-floor or thumb-to-floor distance
side-to-side difference
ability to reach a defined overhead position
pain or symptom response
movement quality and compensation
The test is often more functional than isolated shoulder flexion ROM because it reflects combined contribution from the glenohumeral joint, scapulothoracic region and thoracic spine.
The test may be used to assess:
unilateral overhead mobility
shoulder flexion contribution
scapular upward rotation and posterior tilt context
thoracic extension contribution
left-right shoulder mobility differences
baseline and retest change
symptoms during overhead movement
movement restrictions that may influence swimming, throwing, pressing, climbing or reaching tasks
It is especially useful when the goal is to monitor overhead movement quality and side-to-side change over time.
The test measures single-arm combined overhead elevation.
It may reflect:
glenohumeral flexion range
scapular upward rotation
scapular posterior tilt
scapular retraction where relevant
thoracic extension
rib and trunk control
latissimus dorsi and posterior shoulder tissue tolerance
pectoral and anterior shoulder tissue tolerance
pain or symptom response
side-to-side mobility difference
movement confidence overhead
It does not directly diagnose shoulder pathology, identify one limiting structure, measure isolated shoulder strength or determine sport readiness on its own.
The test may be useful for:
swimmers
throwers
field and court sport athletes
overhead athletes
gym clients
climbers
CrossFit and Olympic lifting athletes
clients with overhead mobility goals
clients returning to pressing, reaching, throwing or hanging tasks
professionals monitoring shoulder and thoracic ROM
It may need modification if the client cannot tolerate prone lying, overhead arm positioning, shoulder loading or end-range elevation.
Floor, mat or treatment table
Tape measure if recording hand or thumb distance
Optional goniometer or inclinometer if recording arm angle
Optional Measurz inclinometer to record arm elevation angle
Optional Measurz AR measurement to document distance or setup
Measurz/MAT platform to record side, distance or angle, symptoms and retest comparison
Optional video recording for scapular and trunk compensation
Optional MAT tools such as Anker, Gripper or Muscle Meter for related shoulder or upper-limb strength testing
Measurz can store this test alongside shoulder ROM, upper-limb strength, orthopaedic tests, outcome measures, endurance tests and overhead performance assessments within the broader Measurz/MAT test library.
Choose the testing position
Select the position that best matches your protocol. A common version uses prone lying with the test arm overhead, although wall, floor or standing versions may also be used.
Prepare the surface
Use a firm, flat surface. Record whether the test is performed on a table, mat, wall or floor.
Position the client
For a prone version, the client lies face down with the test arm overhead. Keep the elbow straight unless the protocol states otherwise.
Standardise the non-test arm
Record whether the opposite arm rests by the side, under the forehead or in another position. Keep this consistent.
Set the head and trunk position
Keep the head, ribs, trunk and pelvis as still as possible. Record whether the forehead, chin or chest remains in contact with the surface.
Perform the elevation movement
Ask the client to lift or reach the test arm as high as comfortably possible while keeping the elbow straight and maintaining the agreed body position.
Measure the result
Measure the selected score, such as hand-to-floor distance, thumb-to-floor distance or arm elevation angle.
Repeat on both sides
Repeat using the same setup, instructions and measurement method.
Record symptoms and compensation
Record pain, stiffness, shoulder symptoms, neck symptoms, thoracic stiffness, rib flare, trunk rotation, scapular control and elbow bend.
Common scoring options:
arm elevation angle in degrees
hand-to-floor or thumb-to-floor distance in centimetres
left-right difference
pain or symptom response
movement-quality notes
compensation notes
active versus passive comparison if tested separately
Greater arm elevation angle or distance from the surface may indicate greater combined elevation capacity under the tested setup.
Interpretation is stronger when combined with:
pain score
symptom location
side-to-side comparison
shoulder flexion ROM
shoulder abduction ROM
shoulder external rotation
thoracic extension
scapular movement
overhead strength
overhead sport or gym task findings
The result does not explain the cause of reduced overhead mobility by itself. It helps guide exercise selection, monitoring and further assessment decisions.
Exact universal norms for the Single Arm Combined Elevation Test are limited.
Combined elevation results depend on:
test position
arm path
elbow position
thoracic extension
scapular movement
body size
arm length
measurement method
symptoms
sport background
whether the test is single-arm or bilateral
Practical field guidance:
compare left and right sides
compare baseline to retest
track distance or angle consistently
track pain and symptom response
track rib flare, trunk rotation and scapular compensation
compare with bilateral Combined Elevation Test
combine with shoulder flexion, thoracic extension and shoulder strength tests
For bilateral Combined Elevation Test protocols in swimming-related contexts, a practical angle range of approximately 5–15 degrees relative to horizontal has been described. This should not be applied directly to every single-arm variation unless the protocol is comparable.
Combined elevation testing can be useful when the protocol is standardised.
Research on the Combined Elevation Test supports it as a practical measure of shoulder and thoracic mobility in swimming-related and youth assessment contexts. The test reflects combined movement across the shoulder, scapula and thoracic spine rather than one isolated joint.
Reliability improves when the same:
testing position
arm path
elbow position
head and trunk position
measurement landmark
measurement tool
instructions
number of trials
endpoint definition
symptom scale
are used each time.
Small changes should be interpreted cautiously unless they are repeated, exceed likely measurement variation and align with symptoms, function or related testing.
Common errors include:
changing from prone to standing testing
comparing single-arm and bilateral scores directly
allowing elbow bend
allowing rib flare or lumbar extension
allowing trunk rotation
not recording head or chest position
measuring from inconsistent landmarks
not recording pain or symptoms
using a bilateral benchmark for a single-arm variation without caution
assuming the result identifies the exact limiting structure
Limitations include:
values are protocol-specific
thoracic extension strongly affects the result
scapular movement affects the result
arm length and body size influence distance measures
pain may reduce performance
active control may differ from passive capacity
single-arm norms are limited
the test does not diagnose shoulder pathology
the test does not determine sport or work readiness on its own
The Single Arm Combined Elevation Test can help professionals:
monitor overhead mobility progress
compare sides
track shoulder and thoracic movement changes
support overhead mobility programming
add context to swimming, throwing, pressing, hanging and reaching assessment
monitor symptoms during overhead movement
combine shoulder ROM findings with strength, trunk and performance tests
It is most useful when paired with:
Combined Elevation Test
Shoulder Flexion Test
Shoulder Abduction Test
Shoulder External Rotation Test
Shoulder Internal Rotation Test
Thoracic Extension Test
Wall Slide Test
Push Up Test
Chin Up Test
Dead Hang
Upper-limb strength testing
Record:
test name: Single Arm Combined Elevation Test
side tested
testing position
distance or angle
measurement method
arm path
elbow position
head and trunk position
pain or symptoms
scapular movement
rib flare
trunk rotation
compensation notes
retest date
Use the Measurz inclinometer for arm elevation angle, Measurz AR measurement for distance or setup, and notes for symptoms and compensations.
A useful Measurz note may read:
“Single Arm Combined Elevation Test, prone on plinth, elbow straight, forehead down. Right thumb-to-floor height 18 cm, left 22 cm. Mild right anterior shoulder tightness, no pain. Slight rib flare on right. Retest same setup.”
It measures how far one arm can elevate overhead in a combined shoulder, scapular and thoracic movement pattern.
No. Shoulder flexion ROM is more isolated. The Single Arm Combined Elevation Test includes shoulder, scapular and thoracic contribution.
Yes. Side-to-side comparison is one of the most useful parts of the test.
There are limited universal norms for single-arm versions. Baseline, side-to-side comparison and retest change are usually most useful.
No. It measures overhead mobility and symptom response but does not diagnose the cause of shoulder pain.
Yes. Pain, stiffness, rib flare, trunk rotation, scapular movement and elbow bend all change interpretation.
The Single Arm Combined Elevation Test measures unilateral overhead mobility.
It reflects combined shoulder, scapular and thoracic contribution.
Side-to-side and baseline comparison are often more useful than universal norms.
Test position, arm path, elbow position and measurement method must be standardised.
Pain and compensation should always be recorded.
Measurz can record angle, distance, side, symptoms, setup and progress.
Blanch, P. (2004). Conservative management of shoulder pain in swimming. Physical Therapy in Sport, 5(3), 109–124. https://doi.org/10.1016/j.ptsp.2004.05.002
Hill, L., Collins, M., Posthumus, M., & Botha, A. (2018). The Combined Elevation Test in adolescent school children: A reliability study. South African Journal of Sports Medicine, 30(1), 1–5. https://doi.org/10.17159/2078-516X/2018/v30i1a4914
Movement Assessment Technologies. (n.d.). Combined Elevation Test. https://www.matassessment.com/
Physiopedia. (n.d.). Combined Elevation Test. https://www.physio-pedia.com/Combined_Elevation_Test
Swimming Australia. (2021). Pathways testing protocols. Swimming Australia.
