{"id":181100,"date":"2026-08-17T10:53:23","date_gmt":"2026-08-17T10:53:23","guid":{"rendered":"https:\/\/pabau.com\/?p=181100"},"modified":"2026-08-17T12:09:22","modified_gmt":"2026-08-17T12:09:22","slug":"morley-test","status":"publish","type":"post","link":"https:\/\/pabau.com\/es\/blog\/morley-test\/","title":{"rendered":"Morley test: How to perform and interpret it for TOS"},"content":{"rendered":"
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Key takeaways<\/h3>\n <\/div>\n
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The Morley test screens for thoracic outlet syndrome by pressing directly on the brachial plexus in the supraclavicular fossa.<\/p>\n <\/div>\n

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A positive result reproduces the patient’s own arm symptoms, such as radiating paresthesia, rather than plain local soreness.<\/p>\n <\/div>\n

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Neurogenic thoracic outlet syndrome accounts for over 90% of cases, so this test speaks mainly to that subtype.<\/p>\n <\/div>\n

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No single provocative test confirms thoracic outlet syndrome, so pair the Morley test with Adson’s test and the Roos test.<\/p>\n <\/div>\n

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Practice management software like Pabau keeps each special test result, the side tested, and your reasoning in one client record.<\/p>\n <\/div>\n <\/div>\n <\/div>\n \n\n\n

Arm tingling with a heavy, aching shoulder is one of the harder patterns to sort out. Nerve roots, the brachial plexus, and the peripheral nerves can all produce it. The Morley test takes about a minute and helps you narrow the field.<\/p>\n\n\n\n

Also called the brachial plexus compression test, the Morley test presses on the plexus in the supraclavicular fossa. It counts as positive only when that pressure brings back the patient’s familiar arm symptoms, not just a wince. <\/p>\n\n\n\n

Getting that distinction right starts with knowing exactly what sits under your fingers.<\/p>\n\n\n\n

What the Morley test presses on, and why that works<\/h2>\n\n\n\n

That precision matters because the brachial plexus sits unusually close to the surface in the supraclavicular fossa. That fossa is the shallow dip just above the clavicle, lateral to the sternocleidomastoid. <\/p>\n\n\n\n

Press there and you load the plexus trunks with very little tissue in the way. That is exactly why a heavy-handed press produces a false wince instead of a true finding.<\/p>\n\n\n\n

The plexus forms from the C5 to T1 nerve roots. It then travels through the scalene triangle, bounded by the anterior scalene, the middle scalene, and the first rib. The subclavian artery shares that narrow space. That is why TOS symptoms range from tingling and weakness through to color change and swelling.<\/p>\n\n\n\n

Compression at the outlet usually traces back to one of three sources. Scalene hypertrophy is common in overhead athletes. A cervical rib, an extra rib arising from the C7 vertebra, is present in roughly 0.5% to 1% of people. The rest usually come down to a tight costoclavicular space.<\/p>\n\n\n\n

An imaging review of neurogenic TOS<\/a> names the same anatomical culprits, plus post-traumatic callus on the clavicle or first rib. Press into a space that is already crowded and symptoms follow. That is the whole mechanism behind the test.<\/p>\n\n\n\n

How to perform the Morley test in five steps<\/h2>\n\n\n\n

Consistency matters more than force here. Change your finger placement or your pressure and you change what you are loading, which changes what the result means.<\/p>\n\n\n\n

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  1. Seat the patient:<\/strong> Sit them upright with the neck neutral or slightly extended and the arms resting in the lap. Do not add head rotation yet.<\/li>\n\n\n\n
  2. Find the landmark:<\/strong> Palpate just above the clavicle, medial to the upper trapezius and lateral to the sternocleidomastoid. In most patients the plexus trunks are palpable there.<\/li>\n\n\n\n
  3. Apply pressure:<\/strong> Press down into the fossa with two or three fingertips, perpendicular to the trunks. Hold for 30 to 60 seconds.<\/li>\n\n\n\n
  4. Ask the right question:<\/strong> Ask whether the pressure brings on their familiar symptoms, not simply whether it hurts. Local soreness carries far less weight than radiating paresthesia.<\/li>\n\n\n\n
  5. Record it:<\/strong> Note the side tested, the exact symptom you reproduced, and your verdict. Digital intake forms<\/a> keep that detail attached to the client record instead of a loose sheet of paper.<\/li>\n<\/ol>\n\n\n\n

    Always test the quiet side as well. Pressure tolerance varies enormously between people, so the asymptomatic side gives you a personal baseline to compare against.<\/p>\n\n\n\n

    A physical therapy EMR<\/a> can hold the full TOS battery as one assessment template. The Morley result then arrives with its context attached, rather than as a lone plus or minus in a note.<\/p>\n\n\n

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    Pro Tip<\/h3>\n

    Ramp the pressure up over five to ten seconds rather than pressing suddenly. An abrupt press triggers guarding and local discomfort, which can mask or mimic a genuine neural response. A slow build gives the patient time to separate ordinary soreness from their own arm symptoms.<\/p>\n <\/div>\n <\/div>\n \n\n\n

    A positive Morley test reproduces symptoms, not just tenderness<\/h2>\n\n\n\n

    The test is positive when compression brings back the symptoms the patient walked in with. Discomfort under your fingers, on its own, does not qualify.<\/p>\n\n\n\n

    So what counts as positive?<\/strong> Any of the following, as long as the patient recognizes the sensation as their own:<\/p>\n\n\n\n