RANGE OF MOTION ADAPTATIONS IN POWERLIFTERS
STEPHEN J. GADOMSKI,1 NICHOLAS A. RATAMESS,2 AND PAUL T. CUTRUFELLO3
1
Medical Scientist Training Program, Medical University of South Carolina, Charleston, South Carolina; 2Department of
Health and Exercise Science, The College of New Jersey, Ewing, New Jersey; and 3Department of Exercise Science and Sport,
The University of Scranton, Scranton, Pennsylvania
ABSTRACT
P
Gadomski, SJ, Ratamess, NA, and Cutrufello, PT. Range of
motion adaptations in powerlifters. J Strength Cond Res 32
(11): 3020–3028, 2018—The aim of this study was to investi-
Downloaded from http://journals.lww.com/nsca-jscr by BhDMf5ePHKbH4TTImqenVAC0cwDRZApUPQ+3pWG11l5mOOnp0yA59O2B27fqHf2m on 11/03/2018
gate range of motion (ROM) and training patterns in power-
lifters. Upper- and lower-extremity passive ROMs were
assessed through goniometry in 15 male powerlifters (35.3
6 13.7 years) and 15 age-matched controls (34.9 6 14.6
years). The Apley scratch test and modified Thomas test were
used to assess ROM across multiple joints. Training frequency,
stretching frequency, and exercise selection were recorded
using questionnaires. Passive glenohumeral (GH) extension,
internal rotation, and external rotation ROM were significantly
decreased in powerlifters (p , 0.050). Powerlifters displayed
decreased ROM in the Apley scratch test in both dominant (p
= 0.015) and nondominant (p = 0.025) arms. However, knee
extension angle was markedly improved in powerlifters (20.3 6
7.38) compared with controls (29.9 6 6.28; p , 0.001). Bench
press and bench press variations accounted for 74.8% of all
upper-body exercises, whereas back squat and deadlift ac-
counted for 79.7% of all lower-body exercises in powerlifters’
training programs. To determine whether existing ROM adap-
tations were seen in elite powerlifters, the powerlifting cohort
was split into 3 groups based on Wilks score: ,400 (low),
400–500 (intermediate), and .500 (high). GH ROM limita-
tions were more pronounced in elite powerlifters (Wilks
.500), who had more powerlifting experience (p = 0.048)
and greater lean body mass (p = 0.040). Overall, powerlifters
displayed decreased GH ROM, but increased hamstring ROM,
after training programs that were heavily focused on the bench
press, back squat, and deadlift.
KEY WORDS powerlifting, resistance training, hamstring
flexibility, weight training, passive range of motion
Address correspondence to Dr. Paul T. Cutrufello, paul.cutrufello@
scranton.edu.
32(11)/3020–3028
Journal of Strength and Conditioning Research
Ó 2018 National Strength and Conditioning Association
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INTRODUCTION
owerlifting is a sport designed to test dynamic
maximal strength in 3 exercises: the back squat,
bench press, and deadlift (15). Powerlifters are
routinely engaged in rigorous training programs
to improve and maximize strength for competition. Long-
term participation in resistance training programs has been
associated with decreased shoulder range of motion (ROM)
in recreational weightlifters (18,20) and bodybuilders (3).
Several factors have been shown to impact joint flexibility,
including muscle hypertrophy (9,28), exercise execution
through a full ROM (28), and static and dynamic stretching
(2,29,34). Specifically, Morton et al. (28) found that static
stretching and resistance training, with exercises performed
across a full ROM, can improve hip and knee flexibility in
healthy adults.
Only a single study has evaluated flexibility in powerlifters
(5). Chang et al. (5) found that powerlifters displayed
decreased total shoulder ROM, which includes motion at
the glenohumeral (GH), sternoclavicular, acromioclavicular,
and scapulothoracic joints. Although total shoulder motion
is often used to measure the functional ROM of the shoulder,
GH ROM has been shown to be important in diagnosing
and treating pathologies within the shoulder complex (30).
The GH joint is surrounded by a connective tissue capsule
that attaches around the margins of the glenoid labrum,
proximally, and the anatomical neck of the humerus, distally.
Although this capsule is flexible and permits a wide ROM
under normal conditions, exposure to repetitive stress and
weight-bearing loads such as the bench press can lead to
connective tissue changes, resulting in anterior instability
(21) and posterior capsular stiffness (8). Reduced passive
GH ROM from capsular stiffness or tightness in the rotator
cuff musculature is often considered a causative factor in
shoulder injuries related to repetitive stress (35,40). Shoulder
injuries are the most common in powerlifters (1,17,33) with
53.1% of powerlifters reporting past episodes of shoulder
pain (36); yet, no study to date has isolated shoulder ROM
at the GH joint in powerlifters.
Injuries to the lumbar spine and knee are also common in
powerlifters with a lifetime prevalence of 40.8 and 39.2%,
respectively (36). Reductions in lower-extremity ROM at the
hip and knee joints have been associated with knee joint
dysfunction and injury (13,27). In particular, reduced
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TABLE 1. Participant characteristics.

Powerlifters (n = 15) Controls (n = 15)

Mean SD Mean SD p

Age (yrs) 35.3 13.7 34.9 9.8 0.929

Body mass (kg) 98.8 19.1 96.7 19.1 0.776
Percent body fat (%) 21.7 9.7 24.2 9.4 0.485
Lean body mass (kg) 76.6 13.1 71.9 7.9 0.265
Weight training experience (yrs) 17.9 12.8 — — —
Wilks score 416.3 86.9 — — —

hamstring flexibility has been associated with low back from each participant before testing. Flyers were sent to the
pain and greater knee joint loads (27,32). A paucity of e-mail addresses of those who participated in at least 1 U.S.
research exists on the effects of resistance training on powerlifting competition. For inclusion in the study, power-
lower-extremity ROM. Chang et al. (5) found that power- lifters were required to be actively competing and have at
lifters displayed improved flexibility in the sit-and-reach least 4 years of weight training experience. After initial
test, a nonspecific measure of low back and hamstring screening, 15 male powerlifters from Northeast Pennsylvania
mobility. To understand this benefit, additional research were included (aged 20–62 years) along with carefully
is needed to isolate hamstring flexibility and monitor selected age- and weight-matched controls (aged 20–63
training patterns in powerlifters. years), who were not actively participating in resistance
Therefore, the purpose of this study was to evaluate
upper- and lower-extremity passive ROM in powerlifters
using goniometric analysis at the GH, hip, knee, and ankle
joints. Furthermore, no study has examined factors that may
lead to ROM adaptations in powerlifters, such as stretching
frequency, muscle hypertrophy, and exercise selection.
Therefore, a secondary outcome measure of this study was
to examine the relationship between ROM and training
patterns (e.g., exercise selection and flexibility training
frequency) using questionnaires to ultimately guide future
recommendations for improving flexibility and preventing
injury in chronic resistance training populations.

METHODS
Experimental Approach to the Problem
This study provides a cross-sectional examination of passive
ROM (PROM) in powerlifters relative to controls
with minimal weight training experience. Passive ROM of
the GH, hip, knee, and ankle joints was assessed using
goniometry. The Apley scratch test and modified Thomas
test were used to measure ROM across multiple joints.
Exercise selection, training frequency, and stretching fre-
quency were measured using questionnaires. After initial
ROM comparison with age-matched controls, the entire
powerlifting cohort was divided based on Wilks score to
determine whether any existing ROM adaptations were
present in elite powerlifters (Wilks .500).
Subjects
This study was approved by the University of Scranton Figure 1. Knee extension angle (KEA).
Review Board, and written informed consent was obtained

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 Range of Motion Adaptations

described (7). Because of posi-

tioning requirements, flexibility
measurements were performed
in the following order: the Ap-
ley scratch test, GH flexion,
GH horizontal adduction, GH
internal rotation, GH external
rotation, hip flexion, hip
abduction, hip adduction,
KEA, GH extension, GH hori-
zontal abduction, hip exten-
sion, modified Thomas test,
ankle plantar flexion, and ankle
dorsiflexion.

Questionnaire. Powerlifters were

instructed to complete a 32-
item questionnaire before test-
ing. Training and exercise
frequency were measured in
days per week and sets per
session for the back squat,
bench press, and deadlift.
Frequency of flexibility train-
ing (i.e., upper- or lower-
body static or dynamic
stretching) was measured in
days per week. To assess
exercise selection, power-
lifters were instructed to list
frequency of all exercises
used on a weekly basis. Fre-
quency of bench press and
Figure 2. Hip (top) and knee (bottom) angle measurements for the modified Thomas test.
bench press variations
(i.e., barbell or dumbbell
bench presses with any angle
of incline) was calculated as
training and had less than 6 months of total weight training a proportion to all upper-
experience. All study participants were free of injury at the body exercises, and frequency of back squat and deadlift
time of testing. Multifrequency bioelectrical impedance anal- was calculated as a proportion to all lower-body
ysis (MBIA) was performed to assess total body mass, body exercises.
fat percentage, and lean body mass, as previously described
(6). The Wilks coefficient, a validated measure of relative Passive Range of Motion. Upper- and lower-extremity PROM
strength in powerlifting (39), was determined for each were assessed on the dominant arm and leg using a 12-in.
powerlifter based on published online tables from USA plastic goniometer (Baseline; Medline Industries, Middle-
Powerlifting (38). To calculate Wilks score, Wilks coefficients town, NY, USA). All PROM measurements involved a pas-
were multiplied by total weight lifted according to self- sive movement by the examiner with the participant’s limb
reported, nonequipped maximum lifts from the most recent relaxed. The same examiner with more than 20 years of
powerlifting event. Subject characteristics are summarized in experience conducting ROM assessments as a certified ath-
Table 1. letic trainer and educator performed all PROM measure-
Procedures ments. Three measurements were taken for each PROM,
After MBIA measurements, participants were instructed to and the average was used for analysis. Common anatomical
perform a warm-up on a rowing machine (Concept2 indoor landmarks were used as reference for goniometric place-
rower; Concept 2, Morrisville, VT, USA), as previously ment, according to Norkin and White (30).
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end-feel was determined when scapular elevation or tilt

became apparent (30). Measurements of GH internal rota-
TABLE 2. Minimal detectable change at the 90%
confidence level (MDC90).*† tion and external rotation were taken in the supine position
at 908 of shoulder abduction with pressure placed across the
MDC90 coracoid process (25,30). GH horizontal adduction measure-
ments were taken in the supine position, where the arm was
GH flexion 4.10
GH extension 3.56 neutrally rotated at 908 of shoulder abduction and passively
GH internal rotation 2.33 horizontally adducted to a soft end-feel, as previously
GH external rotation 4.33 described (24). GH horizontal abduction was measured in
GH horizontal abduction 3.88 the prone position, where the neutrally rotated arm was
GH horizontal adduction 2.40
passively horizontally abducted to a firm end-feel.
Hip flexion 4.73
Hip extension 3.05 Lower-extremity PROM was assessed at the hip, knee,
Hip abduction 1.55 and ankle using established methods (30). Hip flexion was
Hip adduction 1.35 measured in the supine position with the knee flexed, and
Knee extension angle 2.36 the pelvis stabilized, until a soft end-feel was reached. Hip
Ankle plantar flexion 2.06
extension measurements were taken in the prone position
Ankle dorsiflexion 2.80
Apley scratch test, dominant (cm) 3.56 with the knee extended, until a firm end-feel was reached.
Apley scratch test, nondominant (cm) 4.85 Any rotation in the pelvis marked the end ROM for hip
Modified Thomas test, hip 2.69 flexion and extension. Hip abduction and adduction meas-
Modified Thomas test, knee 3.88 urements were taken in the supine position with the pelvis
*GH = glenohumeral.
stabilized, until a firm end-feel was reached or rotation or
†Data are presented in degrees unless noted other- tilting of the pelvis became apparent. KEA measurements
wise. were performed in the supine position: the nondominant
limb was secured at 08 hip flexion, while the dominant hip
was passively flexed to 908 hip flexion, and the knee was
passively extended, until the end-feel was observed (Fig-
Passive ROM of the GH joint was evaluated in all 3 planes ure 1). Ankle plantar flexion and dorsiflexion measurements
of motion to assess any limitations that may be indicative of were taken in the seated position at 908 knee flexion with the
capsular tightness, and end-feel was determined when ankle suspended in the air, and the distal tibia and fibula
attempts to overcome resistance caused scapular movement. stabilized, until a firm end-feel was reached.
GH flexion and extension were assessed in the supine and Intrarater reliability of PROM measurements using a uni-
prone positions, respectively, with the scapula stabilized, and versal goniometer have been established by several studies,

TABLE 3. Single-joint range of motion.*†

Controls (n = 15) Powerlifters (n = 15) p

GH flexion 101.2 6 13.4 94.8 6 18 0.285

GH extension 20.6 6 6.4 10.5 6 10.8 0.004z
GH internal rotation 50.1 6 8.2 43.1 6 12.1 0.040§
GH external rotation 92.6 6 17.1 78.2 6 12.6 0.024§
GH horizontal abduction 16.4 6 7.9 14.3 6 8.6 0.488
GH horizontal adduction 20.73 6 5.3 0.53 6 10.2 0.673
Hip flexion 124 6 7.8 120 6 9.3 0.171
Hip extension 15.1 6 6.7 14.1 6 6 0.671
Hip abduction 35.1 6 5.4 36 6 4.3 0.631
Hip adduction 14 6 4.1 13.9 6 3.9 0.962
Knee extension angle 29.9 6 6.2 20.3 6 7.3 ,0.001k
Ankle plantar flexion 48.3 6 6.5 55.9 6 8.6 0.060
Ankle dorsiflexion 14.8 6 7.7 14.1 6 8.9 0.812

*GH = glenohumeral.
†Data are presented in degrees as mean 6 SD.
zPaired 2-tailed t-tests were used to determine significance, p , 0.010.
§Paired 2-tailed t-tests were used to determine significance, p , 0.050.
kPaired 2-tailed t-tests were used to determine significance, p , 0.001.

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 Range of Motion Adaptations
Figure 3. Multijoint range of motion. A) The Apley scratch test for dominant (top) and nondominant (bottom) arms. B) Modified Thomas test assessing hip flexor
(top) and rectus femoris (bottom) flexibility through hip angle and knee angle, respectively.
reviewed in Norkin and White (30). Intraclass correlation
coefficient (ICC) values ranged from 0.87 to 0.99 for shoul-
der PROM measurements and 0.81–0.98 for lower-extremity
PROM measurements (30).
Special Tests. Range of motion was evaluated across multiple
joints using the Apley scratch test and modified Thomas test.
For the Apley scratch test, each participant was instructed to
raise the dominant arm over the head and place the hand at
the lowest-possible position on the back, while the other
arm reached behind the back in an attempt to touch
fingertips, as previously described (3). The distance
between fingertips was recorded, and the test was
repeated for the nondominant arm. For the modified
Thomas test, each participant began in the seated posi-
tion on the edge of a table while flexing and holding the
nondominant hip and knee. The examiner rolled the par-
ticipant to a supine position with both knees flexed and
passively lowered the dominant limb to the resting posi-
tion, after which hip and knee angles were recorded (31)
(Figure 2). Intrarater ICC values for the Apley scratch
test and modified Thomas test were above 0.94 and
0.82, respectively (3,31).
Statistical Analyses
Data were organized using Microsoft Excel, and statistical
analyses were performed in GraphPad Prism 7 software. All
the
3024 Journal of Strength and Conditioning Research
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data are represented as mean 6 SD unless noted otherwise.
Paired 2-tailed t-tests with an alpha-level of 0.05 were
used to determine statistical significance. Minimal detect-
able change at the 90% confidence level (MDC90) was
determined for intrarater measurements, using an estab-
pffiffiffi
lished algorithm p(19):
ffiffiffiffiffiffiffiffiffi MDC90 = 1.65 * SEM * 2 where
the SEM = SD 12r. MDC90 values are presented in
Table 2.
RESULTS
Single-Joint Passive Range of Motion
Single-joint PROM in the upper extremity was signifi-
cantly restricted in powerlifters, particularly in GH
extension, internal rotation, and external rotation
(Table 3). Interestingly, powerlifters did not demonstrate
any PROM limitations in the lower extremity and dis-
played greater hamstring flexibility, as measured by KEA
(Table 3).
Multijoint Range of Motion
The Apley scratch test and modified Thomas test were used
to assess multijoint ROM in the upper and lower extremities,
respectively. Powerlifters displayed significant ROM limita-
tions in the Apley scratch test in both dominant and
nondominant arms (Figure 3A). No significant differences
in hip and knee angle measurements were observed between
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TABLE 4. Range of motion in low, intermediate, and high Wilks powerlifters.*†

Controls (n = 15) ,400 (n = 6) 400–500 (n = 5) .500 (n = 4)

GH flexion 101.2 6 13.4 97.6 6 10.4 96 6 25.8 89.2 6 13.2z

GH extension 20.6 6 6.4 20.3 6 5.3 6 6 7§ 1.25 6 8.8§
GH internal rotation 50.1 6 8.2 48.8 6 11 38.6 6 10.9z 40 6 11.6z
GH external rotation 92.6 6 17.1 92.6 6 17.1 78.2 6 12.6z 75.2 6 13.1§
GH horizontal abduction 16.4 6 7.9 17 6 4.3 15.4 6 10.5 8.7 6 8.4
GH horizontal adduction 20.73 6 5.3 2.3 6 8.2 1.6 6 14 23.5 6 3.5
Apley scratch test, dominant (cm) 3.90 6 8.93 9.9 6 7.7 17.5 6 10.3z 20 6 20z
Apley scratch test, nondominant (cm) 7.83 6 9.66 15.1 6 10.2 18.1 6 11.7z 24 6 18.1§

*GH = glenohumeral.
†Data are presented as mean 6 SD in degrees.
zPaired 2-tailed t-tests were used to determine significance between powerlifting subgroup and controls with minimal weight
training experience, p , 0.050.
§Paired 2-tailed t-tests were used to determine significance between powerlifting subgroup and controls with minimal weight
training experience, p , 0.010.

powerlifters and controls in the modified Thomas test
(Figure 3B).
Training Assessment in Entire Powerlifting Cohort
Powerlifters trained on 4.29 6 1.33 days per week and
incorporated flexibility training on 1.87 6 0.54 days per
week. Powerlifters performed the bench press on 2.07 6
1.06 days per week, the back squat on 1.67 6 1.08 days
per week, and the deadlift on 1.40 6 0.71 days per week.
Bench press and bench press variations accounted for
74.8% of all upper-body exercises, whereas the back
squat and deadlift accounted for 79.7% of all lower-
body exercises in powerlifters’ training programs. No
significant differences between back squat training fre-
quency and deadlift training frequency were observed, as
measured by days per week (p = 0.451) or sets/session
(p = 0.690).
Range of Motion in Elite Powerlifters
To determine whether ROM limitations in the upper
extremity were seen in elite powerlifters, the powerlifting
cohort was split into 3 groups according to Wilks score:
,400 (low, n = 6), 400–500 (intermediate, n = 5), and .500
(high, n = 4). Upper-extremity ROM discrepancies seen in
entire cohort were diminished in the low Wilks group and,
interestingly, were more pronounced in the high Wilks
group compared to controls with minimal weight training
experience (Table 4).

TABLE 5. Training assessment of low and high Wilks powerlifters.*†

,400 (n = 6) .500 (n = 4) p

Wilks score 333 6 39.9 534 6 34.2 ,0.001

Age (yrs) 37.8 6 13.3 34.75 6 9.9 0.732
Body mass (kg) 93.4 6 14 105 6 12 0.240
Body fat (%) 24.4 6 11 20.4 6 6.6 0.580
Lean body mass (kg) 69.8 6 9.9 83.5 6 3.9 0.040
Powerlifting experience (yrs) 6.9 6 4.4 14.8 6 7.4 0.048
Off-season training (d$wk21) 3.8 6 1.3 3.75 6 0.83 0.955
Precompetition training (d$wk21) 4.8 6 1.2 4.5 6 0.87 0.716
BP days per week 2 6 0.82 2 6 0.71 1.00
BP sets per session 5.5 6 1.4 5.9 6 2.4 0.788
BP variation sets per session 4.2 6 2.8 6.5 6 2.3 0.278
Flexibility training (d$wk21) 1.8 6 1.6 2.3 6 1 0.486

*BP = bench press.

†Data are presented as mean 6 SD.

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 Range of Motion Adaptations
Training Assessment in Elite Powerlifters
The high Wilks group had more than a 2-fold increase in
powerlifting experience (i.e., years actively competing) and
a significantly higher lean body mass compared with the low
Wilks group (Table 5). No differences in training frequency,
bench press frequency, or flexibility training were observed
between low and high Wilks powerlifters (Table 5).
DISCUSSION
The primary aim of this study was to determine the presence
of ROM limitations associated with chronic resistance
training by studying the powerlifting population. In this
study, we found that powerlifters displayed reduced GH
ROM, particularly in GH extension, internal rotation, and
external rotation, as determined by both single-joint gonio-
metric measurements and the Apley scratch test. Chang
et al. (5) found similar upper-extremity ROM restrictions in
powerlifters, demonstrating a loss of mobility in shoulder
flexion, extension, and internal rotation, and external rota-
tion using shoulder complex ROM measurements. Previous
studies also reported ROM restrictions in shoulder internal
rotation in recreational weightlifters (18) and bodybuilders
(3). The results of this study suggest that the shoulder ROM
discrepancies seen in previous studies (3,5,18) are attributed,
at least in part, to decreased mobility in the GH joint, which
suggests capsular tightness and reduced flexibility in the
rotator cuff musculature (8,10).
Normative values differ between shoulder complex ROM
and GH ROM measurements because of the degree of
scapular motion (26). For adult men, mean values for total
shoulder flexion, extension, internal rotation, and external
rotation are 167, 62, 69, and 1048, respectively (4). These
measurements correspond with previous studies assessing
total shoulder ROM (3,5,18). Mean values for GH flexion,
extension, internal rotation, and external rotation are 106, 20,
49, and 948, respectively (23). These measurements corre-
spond with age-matched controls in this study and explain
the differences in ROM values from previous studies. In
addition, differences in normative values may be attributed
to sample size and the age of the population studied (30).
The controls and powerlifters in this study had a mean age
of 34.9 and 35.3 years, respectively, and these values are 7–8
years higher than previous studies (3,5,18), indicating that
the age of the population studied may have led to slightly
lower ROM values because of decreased joint laxity associ-
ated with aging (16). Finally, the characteristics of the target
population can have a significant impact on ROM adapta-
tions. Kolber et al. (18) found that recreational weight lifters
display reductions in active shoulder ROM, with the excep-
tion of external rotation ROM, which was improved. This
benefit is likely due to the incorporation of more exercises
that require end-range external rotation ROM, such as lat-
issimus pull-downs and shoulder presses. Powerlifters place
more focus on exercises related to the bench press—as 74.8%
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3026 Journal of Strength and Conditioning Research
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of all upper-body exercises among powerlifters involved the
bench press and bench press variations—and less focus on
exercises that require end-range external ROM, and this
training pattern may explain the absence of this benefit in
the powerlifting population.
Because nearly 75% of all upper-body exercises among
powerlifters involved the bench press and bench press
variations in training, it is likely that the observed GH
ROM limitations in powerlifters may be attributed to
a chronic focus on the bench press. Biomechanically, the
movement phase of the bench press is performed primarily
in the horizontal abduction/horizontal adduction plane,
while the shoulder is fixed at a certain degree of motion in
GH flexion and rotation (16). Interestingly, we found no
significant ROM limitations in the movement plane
(i.e., horizontal abduction/adduction), while severe ROM
restrictions were observed in the supportive planes of
motion (i.e., flexion/extension and rotation), especially
among elite powerlifters. These data support the findings
of Morton et al. (28) and suggest that resistance training
through a joint’s full ROM is an important factor in prevent-
ing negative ROM adaptations. Overall, these results suggest
that an overemphasis on the bench press may lead to shoul-
der ROM adaptations that specifically impact motions with
fixed degrees of movement in exercise execution.
Both passive and active stretching used in flexibility
training programs have been shown to improve flexibility
(2,34). Powerlifters in this study incorporated flexibility train-
ing in less than half of their training sessions (i.e., 1.87 6 0.54
days per week), which is considered insufficient according to
current recommendations for healthy adults (12). These data
indicate that GH ROM adaptations may be dependent not
only on the degree of motion involved in exercise execution,
but also on the frequency of flexibility training. Stretching
protocols addressing GH extension (16), internal rotation
(25), and external rotation (37) should be used in training
programs with special attention to internal and external rota-
tion, as these limitations are commonly seen in weightlifters
with impingement syndrome (22). In addition to stretching
protocols, strength training professionals must also prescribe
exercises to maintain proper strength balance of the rotator
cuff musculature to prevent unfavorable postural adaptations
(7) and anterior instability (21) in populations that expose
the shoulder joint to chronic, repetitive loading.
Powerlifters in this study displayed no significant ROM
limitations in the lower extremity. Chang et al. (5) found that
powerlifters displayed better flexibility on the sit-and-reach
test, a nonspecific measure of hamstring, low back, and glu-
teal flexibility. Correspondingly, we hypothesized that these
reported benefits were primarily caused by improved ham-
string flexibility, as the hamstring muscle groups are acti-
vated through a wide ROM in powerlifting training and
competitions (11). The results of this study supported our
hypothesis, demonstrating improved hamstring flexibility as
measured by the KEA. In addition, Chang et al. (5) reported

ROM limitations in hip flexion; yet, our data indicate no
significant limitations in hip flexion through both goniomet-
ric measurements and the modified Thomas test. We sup-
pose that the larger sample size in this study may account for
these differences; however, as these are the only studies to
date assessing lower-extremity ROM adaptations in any
resistance training cohort, further research is warranted in
this area.
Powerlifters in this study focused the majority of their
lower-body training on the back squat and the deadlift
(about 80%) with no significant differences in the frequency
of these 2 exercises. To meet the requirements for the back
squat in competition, the knee joint must be above the hip
joint at the bottom phase, and the knees must be fully locked
at the top phase of the lift (15) allowing for hamstring acti-
vation along a wide ROM (11). A study by Hales et al. (14)
has shown that the deadlift elicits different hip and knee joint
angles than the back squat, requiring hamstring activation
along an even wider ROM. Therefore, the balanced combi-
nation of the back squat and deadlift in powerlifting requires
the hamstrings to generate concentric and eccentric forces
along a wide ROM, and this tendency may have improved
hamstring flexibility in this study. This phenomenon—here-
after termed the full ROM hypothesis—has been the basis for
strength training recommendations for decades (9,16), but
has not been extensively studied in the literature.
We found that elite powerlifters (Wilks .500) have more
pronounced upper-extremity ROM restrictions that are also
seen exclusively in the supportive planes of motion (i.e., GH
flexion/extension and rotation). Although exercise and flex-
ibility training frequency did not differ between low and high
Wilks groups, elite powerlifters possessed significantly
greater lean body mass, an indirect measure of muscle hyper-
trophy, which has been shown to structurally limit mobility,
especially in the degree of shoulder and elbow flexion
required for the Apley scratch test (3,16,41). Furthermore,
elite powerlifters possessed more than a 2-fold increase in
powerlifting experience, measured by years of active compe-
tition. As most of the upper-body training in powerlifting
involves the bench press, chronic focus on bench press
and limited focus on exercises that stress full ROM in GH
flexion/extension (e.g., rows, pull-downs, and military
presses) may gradually limit shoulder mobility, as explained
by the full ROM hypothesis. Overall, these data suggest that
both increased muscle girth and a chronic overemphasis on
the bench press produce more pronounced limitations in
GH ROM.
While the findings of this study have direct implications
for methods to improve flexibility and potentially prevent
injury in powerlifters, the limitations of this study must be
acknowledged. Although powerlifters represent an ideal
population to study the effects of chronic resistance training
because of their strict adherence to training programs, this
study was limited with the relatively small sample size,
especially with elite powerlifters. In addition, although GH
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Journal of Strength and Conditioning Research | www.nsca.com
ROM measurements provide insight into joint mobility and
susceptibility to injury, they are limited in their functional
approach compared with total shoulder ROM measure-
ments. Goniometric measurements in future studies should
be extended to include nondominant limbs, as ROM may
differ between dominant and nondominant limbs. Finally,
this study was cross-sectional in nature, and training patterns
may change over time. Prospective studies using large
sample sizes can address these issues and provide confirma-
tive insight into the full ROM hypothesis.
PRACTICAL APPLICATIONS
The bench press, back squat, and deadlift are important
exercises to include in any strength training regimen. When
designing strength programs that use the bench press,
strength training professionals should carefully evaluate
ROM and prescribe stretching exercises to maintain GH
ROM—particularly in GH extension, internal rotation, and
external rotation—and strengthening exercises for the rotator
cuff musculature to maintain strength balance and prevent
injury. To elicit improvements in hamstring flexibility and
reduce the risk of knee and low-back pathologies, the prac-
titioner can also use the back squat and deadlift, while paying
close attention to proper exercise form and execution
through a full ROM.
ACKNOWLEDGMENTS
This study was funded through an internal research grant
from The University of Scranton. The authors have no
conflict of interest to declare. The results of this study do not
constitute the endorsement of any product by the authors or
the National Strength and Conditioning Association.
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