ASCM Clinical Skills

Shoulder
LOOK
 Inspection
 Swelling, bony prominence
 Bruising / lacerations
 Position of arm
 Asymmetry
 Atrophy
 Surgical scars
FEEL
 Palpation
• Expose both shoulders
• Palpate bony prominences
• Soft tissue palpation, least
tender areas first
• Compare to contralateral side
AC Joint
MOVE
 ACTIVE
PASSIVE
ABNORMAL

Compare both shoulders

 Range of Motion

Forward
Flexion:
180°
 Range of Motion

Abduction:
180°
 Range of Motion

External
Rotation:
60-80°
 Range of Motion

Internal
Rotation:
T7
 Range of Motion

Internal
Rotation at
90° Forward
Flexion: 90°
 Rotator Cuff Injury
• Tendonopathy or tear
• Partial or complete
• Acute or chronic
 Rotator Cuff Injury

Jobe Test:
Supraspinatus
Middle deltoid
 Rotator Cuff Injury

External
Rotation:
Teres minor
Infraspinatus
 Rotator Cuff Injury
Internal
Rotation:
Subscapularis
Pectoralis
major
Latissimus
dorsi
 Rotator Cuff Injury
 DropArm Test:
Unable to resist
pressure at 90°
abduction
 Painful
Arc:
Between 45 ° and
120° abduction
 Impingement
• Usually subacromial space
• Irritation between AC joint, RC
tendons and bursae
 Impingement

Neer’s
Test
 Impingement

Hawkin’s
Test
Biceps tendonitis/tear
• Usually long head
• Related to overuse/activity
• Anterior shoulder pain
• Acute or chronic
• Weakness with resisted
flexion/supination
Biceps
Tendon
 Biceps tendonitis

Yergason’s
Test
 Biceps tendonitis

Speed’s
Test
 AC Joint arthritis

Crossed
Adduction
Test
 GH Joint Laxity

•Apprehension
Test
•Relocation
 GH Joint Laxity

Sulcus
Sign
 GH Joint Laxity

Load and
Shift Test
 Referred Pain
 Neck
 Elbow
 Heart
 Diaphragmatic
 Pan coast
 Neurological Examination
 Radial nerve – Thumbs up
 Median nerve – Thumb to hypothenar
eminence
 Ulnar nerve – Abduct V
 Axillary nerve - Deltoid