Shoulder Examination Flashcards
Observation
How do they move
Position of clavicles/ scapular, humeral head, neck, spine.
How do they hold themselves
Dominant side
Muscle bulk and activity
Swelling
Scapula position related to the spine - scoliosis
Functional tasks
Action that replicates the symptoms
Whole kinetic chain - in gait; arm swing
Assess Proprioception
Shoulder shrugs
Hand behind the back
Taking off their coat
Palpation
Acromioclavicular and subclavicular joint
Acromioclavicular arch
Lesser and greater tuberosity
Bicipital groove
Glenohumeral joint line - rheumatoid arthritis, infection, septic arthritis
Active range of motion
Glenohumeral - flexion, extension, abduction, adduction, medial and lateral rotation (elbow at 90 degrees, by the side or raised), horizontal flexion (arm across the body)
Shoulder/ scapula - protraction, retraction, elevation, depression
Passive range of motion
Glenohumeral - flexion, extension, abduction, adduction, medial and lateral rotation (elbow at 90 degrees, by the side or raised), horizontal flexion (arm across the body)
Isometric
Glenohumeral - flexion, extension, abduction, adduction, medial and lateral rotation (elbow at 90 degrees, by the side or raised), horizontal flexion (arm across the body)
Shoulder/ scapula - protraction, retraction, elevation, depression
AP glide
Supine
One hand (thenar eminence) over the humeral head
Other hand stabilises the Acromioclavicular joint
Straight arms
Push down on the humeral head so there is movement
Associated with physiological flexion and internal rotation
PA glide
Prone or side lying
Place both thumbs on the back of the humeral head, wrap your fingers round to stabilise it
Straight arms
Push forward on the humeral head so there is movement
Associated with physiological extension and external rotation
Longitudinal caudad
Supine
End of the lateral aspect of the clavicle
With your thumbs and straight arms push forwards (superior to inferior) so the clavicle moves slightly
Empty can test
Standing or sitting
Arms elevated/ flexed 90 degrees in scapula plane
Fully internally rotate the arms
Then add resistance downwards
Hawkins Kennedy test
Impingement
Shoulder in 90 degrees flexion and elbow flexed to 90 degree
Internally rotates their arm
Positive if patient experiences pain with internal rotation
Speeds test
Long head of biceps
Shoulder flexion, external rotation, full elbow extension, forearm supinated
Apply resistance downwards
Positive is pain in the bicipital tendon or groove
Apprehension test
Supine
Abduct shoulder to 90 degree
90 degree flexion of elbow
Passively externally rotate their arm (backwards)
Positive if there is apprehension
Belly press test
Sitting or standing
Elbow flexed 90 degrees
Palm of the hand on the upper abdomen
Press the palm against the abdomen, through shoulder internal rotation
Rotator cuff dysfunction if they compensate and the elbow drops behind their trunk
Lift off test
Place the back of the hand on their back/ lumbar spine
Internal rotation by lifting the hand off of the back
The therapist can move the hand off of the back and ask the patient to hold it
Positive if the patient can’t lift the hand off or compensates by extending the elbow and shoulder
Sulcus test
Pull down on the distal arm so the humeral head is pulled down
Feel between the acromion and the humeral head
Positive result would be a space of more than 1cm
