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A patient is instructed to stretch their upper extremities using a foam roller as depicted in Image A. The physical therapist realizes that this stretch is not targeting the intended muscles and instead educates the patient on how to perform the stretch as seen in Image B. Which muscles are targeted with the modified stretch?

1. Pectoralis major and subscapularis
2. Pectoralis major and infraspinatus
3. Latissimus dorsi and subscapularis
4. Latissimus dorsi and infraspinatus

Transcript

Welcome back to the Scorebuilders’ Question and Answer Podcast! This podcast provides members of the Scorebuilders’ team with the opportunity to explore challenging multiple-choice examination questions with students actively preparing for the licensing examination. My name is Scott Giles and I will be your host for today’s journey.

I will read the question and provide you with an additional 60 seconds to answer the question. 

Ready? Let’s go!

A patient is instructed to stretch their upper extremities using a foam roller as depicted in Image A. The physical therapist realizes that this stretch is not targeting the intended muscles and instead educates the patient on how to perform the stretch as seen in Image B. Which muscles are targeted with the modified stretch?

Image A

Image B

1. Pectoralis major and subscapularis
2. Pectoralis major and infraspinatus
3. Latissimus dorsi and subscapularis
4. Latissimus dorsi and infraspinatus

More questions involving foam rollers! As Yogi Berra said, it’s like déjà vu all over again. 

Foam Rollers
Foam rollers are often employed with stretching techniques to properly position the patient. In the depicted stretches, the foam roller is placed along the spine. This elevates the patient off the supporting surface so that their shoulders can move further into positions of flexion and/or horizontal abduction and provide a more intense stretch.

Armed with this knowledge, let’s explore each of the options:

Option 1 - Pectoralis major and subscapularis 
The pectoralis major performs the movements of shoulder horizontal adduction and medial rotation. Therefore, it would receive the greatest stretch when in positions of horizontal abduction and lateral rotation (i.e., the stretch in Image B). The subscapularis performs the movement of shoulder medial rotation. 

Therefore, it would receive the greatest stretch when the shoulder is positioned in lateral rotation.

Option 2 - Pectoralis major and infraspinatus
Though the pectoralis major would receive a greater stretch in Image B, the infraspinatus would not. The infraspinatus performs the movements of shoulder lateral rotation and horizontal abduction. Therefore, it would not be stretched in a position of lateral rotation and horizontal abduction.

Option 3 - Latissimus dorsi and subscapularis 
The stretch depicted in Image A shows the patient’s shoulders in flexion, which would provide a stretch to the latissimus dorsi since it performs the movement of shoulder extension. However, the shoulders then transition to a position of horizontal abduction in Image B and therefore would provide less of a stretch to the latissimus dorsi.

Option 4 - Latissimus dorsi and infraspinatus
Neither the latissimus dorsi nor the infraspinatus would be stretched in Image B. The depicted stretch would more likely isolate the pectoralis major and subscapularis muscles.

The correct answer is Option 1

Let’s explore the all student data:
80% of students selected Option 1, Pectoralis major and subscapularis, the correct response
10% of students selected Option 2, Pectoralis major and infraspinatus
7% of students selected Option 3, Latissimus dorsi and subscapularis
3% of students selected Option 4, Latissimus dorsi and infraspinatus

System Classification
This question is a Musculoskeletal Systems question which represents approximately 27% of all exam items.

Content Outline Classification
This question is an Interventions question which represents approximately 29% of all exam items.

Level Classification
This question is a Level 1 question since the question requires students to possess basic foundational academic knowledge. Remediation of Level 1 questions occurs through academic review of entry-level content using textbooks, review books, Basecamp, and flash cards.

Academic Focus Area
Looking to review related academic content? Check out pages 55-57 and 122-123 in PTEXAM: The Complete Study Guide.

Thanks for joining us on the Scorebuilders Q and A podcast! See you next week!