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Shoulder Examination

Look

Examine the shoulder from the front, the side and behind. Looking each time for:

  • Obvious lack of symmetry
  • Muscle wasting
  • or Scars.

Feel

Temperature over the joint line should be assessed, by comparing it to other areas. Then the following areas should be palpated for tenderness.

  • Bony landmarks
  • The joint line
  • and Surrounding muscles

Move

Hands behind head, then down by side

  • Tests shoulder function.

Hands behind back, lifting up as high as possible

  • Tests internal rotation

Full extension, abduction and flexion should be assessed, both active and passive.

  • Feel for crepitus.
  • When passive a hand should be on top to isolate the gilina-humeral movement.

With the elbow flexed to 90 degress and held to the side, test external rotation.

  • Tests for frozen shoulder.

Passive movement will be particularly helpful in assessing a painful arc in abduction.

  • Pain may be felt between 10 and 120 degrees.

Scapula movement

  • Abduct the arm fully, whilst feeling and observing the scapula from behind the patient.