Grip Strength Testing Protocols with Normative Data
Grip Strength Testing Importance, Procedures and Norms
If I could only do one test that gave me information about the integrity and function of the entire upper quarter including the rotator cuff, elbow, wrist, cervical spine, and dare I say core function, it would be grip strength.
It is an essential return to sport or return to activity test for any upper extremity or cervical spine injury. Additionally, grip strength should be tested for any overhead athlete (e.g. baseball, volleyball, tennis, etc.) in the pre-season to identify any potential weak links.
I am continually amazed that it is a biomarker for health and vitality. Having a left/right asymmetry of greater than 10% or being weak is a substantial risk factor for morbitity and mortality.
The great thing is that while the JAMAR dynamometer is the gold standard, grip strength testing is affordable and accessible to most for under $30 with this Camry dynamometer. It is important that your measurement device is reliable and I have found this to be the case clinically.
What is normal grip strength?
The number one thing I look for is that the overhead grip is greater than grip at the side. I really can’t explain it physiologically. Maybe it is in our DNA to have stronger grip overhead (think hanging from a cliff). Maybe the neural pathway and muscle length-tension relationship. Researchers indicate that overhead should be about 2% stronger than at side. Clinically, I have seen so many problems manifest in grip, particularly with the overhead athlete. In baseball pitchers whether high school, college or pro, our data indicate it is essential that the overhead grip is stronger than at side.
Additionally, you want to see that athletes (and the general population for that matter) are at least above the mean for their age, gender, sport, and competition level. Weight should also be considered but is not frequently reflected in the research. For example, if you were to consult the normative data tables for a 24-year-old who had a grip strength of 130 lbs, you would think that is good until you consider that they are a starting MLB pitcher and we would expect their grip to b over 150lbs.
I have included a table of normative grip strength for the general population as well as a sample of grip strength in baseball. We are gathering a large database of grip strength normative data. If you would like to get notified when population-specific (age, sport, position, weight, etc.) grip strength norms are available click HERE
How do you measure grip strength?
Two positions are essential: at the side with elbow bent to 90 degrees and overhead with the elbow straight. In the video and instructions below you will also notice a position with the arm in 90 degrees of ABD and 90 degrees of elbow flexion. This position can be added to the primary two in overhead athletes if you want to see the players strength in a position close to layback (the more vulnerable position of the shoulder) as well as take out the effect of lat tightness seen in the overhead grip.
Grip Strength Testing Procedures
It is important to note that most research on grip strength is the subject seated and elbow bent at 90 degrees. The standing procedure will result in grip strength being about 2% great. However, we most commonly test grip in the large group setting in standing.
- Set the dynamometer to the 2 position.
- The individual will stand holding the dynamometer with shoulder adducted with neutral rotation at side, elbow flexed to 90 degrees with wrist/forearm in neutral
- Instruct the person to squeeze the dynamometer as hard as possible for 5 seconds and then relax
- Record the trial in kg
- Repeat two more trials in this position
- Switch to the opposite hand and repeat procedure for 3 trials
- Switch hands and repeat the procedure in the second arm position with the shoulder fully flexed overhead with neutral rotation, elbow extended, and wrist/forearm in neutral. Be sure to have person bring arm down to side between reps.
Note: Be sure to collect all three trials as we are seeing an important trend in how much each trial decreases.
Grip Strength Normative Data Tables
|Age||Mean (lbs)||Mean (kg)||SD (kg)|
|20 to 24||70||32||6|
|25 to 30||74||34||6|
|30 to 34||78||36||8|
|35 to 39||74||34||5|
|40 to 44||70||32||6|
|45 to 49||62||28||6|
|50 to 54||66||30||5|
|55 to 59||57||26||6|
|60 to 64||55||25||5|
|Age||Mean (lbs)||Mean (kg)||SD (kg)|
Camry Grip Dynamometer
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