Shoulder Assessment
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Transcript Shoulder Assessment
Sports med 2
A“Type of pain”
pins and needles = radiating pain from
cervical pathology
sharp pain = acute inflammation
dull, aching, sense of heaviness = chronic
rotator cuff
deep, aching pain in the neck/shoulder
region = thoracic outlet compression
syndrome (TOCS)
night pain = rotator cuff tear
burning pain = acute tendinitis
weakness, numbness =
nerve pathology
B“specific movements that cause pain”
neck = cervical spine injury
shoulder ER = dislocation/subluxation
above 90 degrees = ACJ
Normal
activities
Ability to talk/swallow = SCJ
Which hand is dominant
shoulder often lower
differing ROM
differing strength
From all sides
symmetry
• level of shoulders
muscle
wasting v. hypertrophy
deformities
discoloration
swelling
how the shoulder is carried
Anteriorly
Step deformity at the ACJ = dislocation
Flat deltoid = anterior dislocation
Laterally
kyphosis: shoulders slumped forwards
Posteriorly
muscle definition
scapulohumeral rhythm
scapular winging during flexion and
abduction
Anterior structures
clavicle
sternoclavicular joint
sternocleidomastoid
muscle
acromioclavicular joint
trapezius
deltoid
coracoid process
sternum
ribs and costal cartilage
humerus and rotator cuff
muscle
with thumb on
subscapularis, second,
third and fourth fingers
will be over the insertion
of other three rotator cuff
muscles: supraspinatus,
infraspinatus, teres minor
axilla
posterior wall = lats
anterior wall = pec major
medial wall = serratus
anterior
Posterior structures
scapula
spine of scapula
medial border of the scapula
inferior angle
lateral border
supraspinatus and infraspinatus
muscles
abduction
note painful arc (45 – 60 – 100 degrees)
observe scapulohumeral rhythm
first 30 degrees no net movement of the scapula
setting
30-90 degress scapula abducts and upwardly rotates
1 degree for each 2 degree of humeral elevation
90 – 180 degrees scapula moves 1 degree for each 1
degree of humeral elevation
observe any apprehension
flexion
ER
Sort of!
IR
Extension
Adduction
Horizontal adduction/abduction
Circumduction
Appley’s scratch test
Name
Purpose
Description
Apley’s Scratch
Test
Tests for limitations
in motions of the
upper extremity.
Each motion is
performed
bilaterally to
compare.
Action 1: The subject is instructed to
touch the opposite shoulder with
his/her hand. This motion checks
Glenohumeral adduction, internal
rotation, horizontal adduction and
scapular protraction.
Action 2: The subject is instructed to
place his/her arm overhead and reach
behind the neck to touch his/her
upper back. This motion checks
Glenohumeral abduction, external
rotation and scapular upward rotation
and elevation.
Action 3: The subject puts his/her
hand on the lower back and reaches
upward as far as possible. This motion
checks glenohumeral adduction,
internal rotation and scapular
retraction with downward rotation