Shoulder MSK Assessment

Question 1

Order of shoulder assessment

Answer 1

• Inspection
• Palpation
• Active ROM
• Passive ROM
• Muscle tests
• Neer impingement
• Hawkins impingement
• Crossover
• Apprehension sign
• Sulcus sign
• Jerk

Question 2

Components of shoulder inspection

Answer 2

• Inspect anterior and posterior shoulder with patient standing for
• Deformities
• Asymmetry
• Swelling
• Redness
• Nodules
• Muscle atrophy
• Etc?

Question 3

Components of shoulder palpation

Answer 3

• Anterior and posterior
• “I am palpating for tenderness, bogginess, and bone enlargement, etc.”
• Begin at SC joint
• Along clavicle to AC joint
• Include subacromial bursa
• Scapula
• Deltoid
• Biceps tendon

Question 4

Active ROM

Answer 4

• Flexion
• Extension
• Adduction
• Abduction
• Internal rotation
• External rotation
• External rotation with abduction (hands behind the neck)
• Internal rotation with adduction (hands behind the back)

Question 5

Passive ROM

Answer 5

• Flexion
• Extension
• Internal rotation
• External rotation

Describe what you are looking/feeling for in each

Question 6

Muscle test- deltoid

Answer 6

• Abduct at 90 degrees against resistance

Question 7

Muscle test-supraspinatus

Answer 7

Empty can test

Question 8

Muscle test-infraspinatus and teres minor

Answer 8

External rotation against resistance

Question 9

Muscle test-subscapularis

Answer 9

Lift-off test

Question 10

Muscle test-serratus anterior

Answer 10

Flex shoulder at 90 degrees palpating for scapular winging - may perform wall push up

Question 11

Muscle test- rhomboid

Answer 11

• Arm on hip, push arm forward at elbow with patient resisting. Watch for scapular winging

Question 12

Neer impingement

Answer 12

• Passive forward flexion of the shoulder up to the ear
• If patient has pain, rotator cuff tear or impingement syndrome suspected

Question 13

Hawkins impingement

Answer 13

• Shoulder flexed at 90
• Elbow flexed at 90
• Passive internal rotation
• Describe what it indicates: rotator cuff tear or impingement syndrome

Question 14

Crossover test

Answer 14

• Passively extended arm over chest
• Describe what it indicates: AC joint arthritis

Question 15

Apprehension test

Answer 15

• Pt supine, abduct, and externally rotate the shoulder
• Apprehension due to anterior instability

Question 16

Sulcus sign

Answer 16

• Inferior traction, arm relaxed side
• Subluxation of the shoulder indicates inferior instability

Question 17

Jerk test

Answer 17

• Shoulder 90 degree flexion
• Internal rotation
• Elbow flexed at 90 degrees
• Adduct the arm across the body while pushing the humerus in the posterior position
• Sensation of posterior subluxation = posterior instability