Download - ASCM Clinical Skills
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ASCM Clinical SkillsASCM Clinical Skills
ShoulderShoulder
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LOOKLOOK
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InspectionInspection Swelling, bony prominenceSwelling, bony prominence Bruising / lacerations Bruising / lacerations Position of armPosition of arm AsymmetryAsymmetry AtrophyAtrophy Surgical scarsSurgical scars
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FEELFEEL
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PalpationPalpation
• Expose both shoulders
• Palpate bony prominences
• Soft tissue palpation, least tender areas first
• Compare to contralateral side
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AC Joint
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MOVEMOVE
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ACTIVEACTIVEPASSIVEPASSIVE
ABNORMALABNORMAL
Compare both shouldersCompare both shoulders
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Range of MotionRange of Motion
Forward Flexion:
180°
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Range of MotionRange of Motion
Abduction: 180°
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Range of MotionRange of Motion
External Rotation:
60-80°
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Range of MotionRange of Motion
Internal Rotation:
T7
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Range of MotionRange of Motion
Internal Rotation at
90° Forward Flexion: 90°
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Rotator Cuff InjuryRotator Cuff Injury
• Tendonopathy or tear• Partial or complete• Acute or chronic
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Rotator Cuff InjuryRotator Cuff Injury
Jobe Test:SupraspinatusMiddle deltoid
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Rotator Cuff InjuryRotator Cuff Injury
External Rotation:
Teres minorInfraspinatus
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Rotator Cuff InjuryRotator Cuff Injury
Internal Rotation:
SubscapularisPectoralis
majorLatissimus
dorsi
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Rotator Cuff InjuryRotator Cuff Injury Drop Arm TestDrop Arm Test: :
Unable to resist Unable to resist pressure at pressure at 90°90° abductionabduction
Painful ArcPainful Arc: : Between Between 45 °45 ° and and 120°120° abduction abduction
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ImpingementImpingement
• Usually subacromial space• Irritation between AC joint, RC
tendons and bursae
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ImpingementImpingement
Neer’s Test
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ImpingementImpingement
Hawkin’s Test
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Biceps tendonitis/tearBiceps tendonitis/tear
• Usually long head• Related to overuse/activity• Anterior shoulder pain• Acute or chronic• Weakness with resisted
flexion/supination
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Biceps Tendon
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Biceps tendonitisBiceps tendonitis
Yergason’s Test
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Biceps tendonitisBiceps tendonitis
Speed’s Test
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AC Joint arthritisAC Joint arthritis
Crossed Adduction Test
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GH Joint LaxityGH Joint Laxity
•Apprehension Test
•Relocation
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GH Joint LaxityGH Joint Laxity
Sulcus Sign
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GH Joint LaxityGH Joint Laxity
Load and Shift Test
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Referred PainReferred Pain
NeckNeck ElbowElbow HeartHeart DiaphragmaticDiaphragmatic Pan coastPan coast
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Neurological ExaminationNeurological Examination
Radial nerve – Thumbs upRadial nerve – Thumbs up Median nerve – Thumb to hypothenar Median nerve – Thumb to hypothenar
eminenceeminence Ulnar nerve – Abduct VUlnar nerve – Abduct V Axillary nerve - DeltoidAxillary nerve - Deltoid