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 Movements pain, range and end feel
Lateral Rotation
Medial Rotation
Abduction – palp scapula to look for early movement
CAPSULAR?
LR>ABD>MR

8. Resisted Tests pain 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