Shoulder examination

Look     [Back To Top] 

From the front, side and above

• Asymmetry, scars, deltoid wasting, SCJ or ACJ deformity, swelling of the joint

• Look and feel for rotator cuff wasting, scapula shape and situation e.g. winging, Sprengel shoulder etc

Feel     [Back To Top] 

• SCJ to the ACJ and acromion
• Greater and lesser tuberosity, feel for rotator cuff defects
• Glenohumeral joint: anterior and posterior aspects
• Biceps tendon/bicipital groove
• Spine of scapula

Move     [Back To Top] 

ALWAYS EXAMINE THE CERVICAL SPINE FIRST

• Move both arms at the same time. Active then passive ROM.
• Quick screening test: "Arms above the head and behind the back "
• Flexion : 0-180 ^o
• Abduction : 0-180 ^o check for painful arc and watch the scapulothoracic rhythm
• If restricted then repeat with the scapula fixed to check for the amount of glenohumeral movement
• Internal rotation: T4
• External rotation : 70 ^o

Feel for crepitation during motion

Special tests     [Back To Top] 

1. Impingement    [Back To Top] 

• Neer's sign: Hold scapula down, pronate forearm and flexion will cause pain
• Hawkin's test: Flexion to 90 ^o internal rotation will cause pain
    Hawkins Test
• Neer's test: Pain caused by Neer's test eliminated by local anaesthetic injection
• Scarf test: forced cross body adduction in 90 ^o flexion, pain at the extreme of motion indicative of ACJ pathology
  Scarf Test

2. Rotator cuff

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