Generalized Versus Specific Flexibility

One can think of flexibility either as the general ability to move in a combination of ways, or as the particular ability to move one or two joints in a specific motion. For example, chapter 1 mentioned a generalized test of shoulder flexibility, the Apley's scratch test. The object of the test is to bring the hands together in the middle of the back, one hand reaching from below and the other from above. This movement uses internal rotation, extension, and adduction together for one shoulder, while the other uses a different combination of motions.

You use combined motion in many functional activities that require general flexibility, such as combing your hair or tucking your shirt in at the back. Sometimes a person cannot perform a combined movement because of loss of motion in one specific direction. If you cannot move your arm above the level of your shoulder, you lack one component of the combined movement and thus do not have general flexibility. Often one loses a little bit from each type of movement that contributes to the total motion.

As you determine your needs, decide if you need general or specific flexibility; most people need some of each. Chapter 2 mentioned two generalized tests of flexibility. Specific flexibility is usually measured by a health care provider using a special tool called a goniometer, which quantifies the range of motion for a joint.

If you have severe limitations, I suggest you see a therapist who can assess your specific needs and help you determine realistic goals. It may be necessary to set a goal that aims for less than complete range of motion but facilitates function. For example, in a previous chapter I discussed a patient who had lost significant motion in her shoulder and could not touch the top of her head. Because of her age and the degeneration in her shoulder joint, we set a goal that would make it possible for her to lift her hand to the top of her head. We did not try for the ability to reach her arm straight up from her shoulder; she did not need that much motion and was unlikely to attain it.