Shoulder Painful arc + Neer + in at least

Normal ROM resisted ER 3/5 tests

Flexion 160-180° Posterior Pain felt 75.5 85
Extension 50-60° impingement: posteriorly
Abduction 170-180° apprehension
Adduction 50-75° position
Medial rotation 70-90° Instability
Lateral rotation 80-100° Relocation Relief of 96.7 78
apprehension
Myotomes: Apprehension Apprehensive 98.3 71.6
C4 Shoulder elevation feeling
C5 Shoulder abduction Load and shift Increased 71.7 89.9
translation of
C6 Elbow flexion, wrist extension
humeral head
C7 Elbow extension, wrist flexion
anteriorly
C8 Thumb abduction & extension
Release Sudden 91.7 83.5
T1 Finger abduction
apprehension
Dermatomes:
Sulcus Increased 28-72 86-97
C4 Clavicle to AC joint
translation of
C5 Lateral deltoid humeral head
C6 Anterior arm, radial side of hand to thumb & inferiorly
index finger Posterior Increased 50-91 85-100
C7 Lateral arm & forearm to index, middle and ring subluxation test translation of
fingers humeral head
C8 Medial arm and forearm to middle, ring and little posteriorly
fingers SLAP and biceps related injury
Speed’s Pain: ?long-head 54 81
Reflexes: of bicep tear
C5 nerve root Biceps brachii O’Brien Pain: ?SLAP tear 61 84
C6 nerve root Brachioradialis Biceps load test Pain: ?SLAP tear 29 78
C7 nerve root Triceps Cluster Test of: Pain 25 92
Pathological Hoffman’s reflex Speed’s +
Pathological Inverted supinator reflex Apprehension +
O’Brien
Muscles and their movements: Passive Pain: ?SLAP tear 82 86
Flexion Deltoid, pec major, compression
coracobrachialis, biceps brachii test
Extension Deltoid, latissimus dorsi, teres Scapular Dyskinesis
major, triceps brachii Scapular Decreased pain 21-24 71-21
Abduction Deltoid, supraspinatus assistance test
Adduction Deltoid, pec major, lat dorsi, teres Scapular Increased 26- 33-70
major resistance test strength or 100
Internal rotation Deltoid, pec major, lat dorsi, teres decreased pain
major, subscapularis
External rotation Deltoid, infraspinatus, teres minor Causes of Referred Pain & Red Flags:
Somatic referred pain: Visceral referred pain:
Special Tests: cervical/thoracic spine, diaphragm, heart, spleen,
Testing Positive Sensitivity Specificity myofascial structures gall bladder, apex of lungs
for: result: Tumours Acute compartment
Rotator cuff pathology syndrome
Full Can Weakness and pain 59-89 54-82 Fractures Infection
Lift-Off Weakness: 50 88 Nerve/vascular Myocardial infarct (left
(Gerber) ?subscapularis tear compromise shoulder pain commonly
ER lag sign Weakness: 36 95 reported)
?infraspinatus tear Thoracic outlet syndrome Axillary/long thoracic nerve
Impingement injury
Cluster Test of: Pain 75 74
Jobe + Hawkins + reproduced
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