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The Shoulder Joint

Detailed examination guide for the shoulder joint, including subjective assessment, inspection, palpation, active and passive movements, resisted tests, and differential tests to identify potential issues. Includes overview of symptoms, pain areas, and relevant tests.

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The Shoulder Joint

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Presentation Transcript

  1. The Shoulder Joint Examination

  2. Subjective Examination • Age • Occupation and sports – overhead activities • Site – vague, C5 • Spread – large eg below elbow more severe • Onset – overuse, trauma, insidious • Duration – stages • Behaviour – constant, cannot lie on sh. ? • Symptoms – dizzyness, p + ns, cough and sneeze • PMSH – other joints, diabetes, heart probs, ops etc

  3. Inspection • Posture – level of sh, csp, thsp, position of scap • Deformity • Colour • Wasting • Swelling • State at rest • Site of pain

  4. Palpation • Heat and swelling - rare

  5. Cervical Spine - Elimination • Extension with OP • Rotation with OP • Side Flexion with OP • Flexion

  6. Active Movements • Active elevation with OP Pain, power, range, end feel and willingness • Abduction – painful arc?

  7. Passive Movementspain, range and end feel • Lateral Rotation • Medial Rotation • Abduction – palp scapula to look for early movement • CAPSULAR? • LR>ABD>MR

  8. Resisted Testspain and power • Abduction - supraspinatus • LR – infraspinatus and teres minor • MR - subscapularis • Elbow Flex - biceps • Elbow Ext - triceps • Add – pec maj, teres major and lat dorsi

  9. Palpation

  10. Differentiating Tests • In supine • Resisted abd • Resisted abd with distraction • Resisted LR • Resisted LR with distraction

  11. Other tests • Scarf test – AC, lower fibres of subscap and bursae • Apprehension test – dislocation • Neural tension • Xray, scan, bloods

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