Assess bilateral upper limbs: Look for muscle wasting
Assess bilateral upper limbs: Look for muscle wasting
Shoulder Internal rotation (IR):
Shoulder impingement test: Abduct arm to 90 degrees. Internally rotate the arm and assess for pain.
Supraspinatus: Resisted abduction with arm 90 degrees abducted & thumb pointing down (pronated)
Subscapularis: Lift off test. Arm internally rotated at the back with resisted lifting of the arm.
Resisted internal rotation with arm in abduction
Lift off test
Infraspinatus (IS)/Teres minor(TM): Resisted external rotation.
IS & TM is responsible for external shoulder rotation.
Lateral rotation lag sign (IS spring back): keep shoulder in external rotation, if shoulder rotates internally after releasing it is the sign of torn IS/TM as the unopposed agonistic subscapularis pulls the shoulder internally
Speed: extend arm then resisted shoulder flexion with forearm supinated then pronated with elbow completely extended.
Yergasons: Resisted supination with forearm flexed and pronated while patient also laterally rotates arm.
Resisted arm flexion
Anterior apprehension: Abduct arm to 90 degrees and externally rotate while eliciting apprehension.
Posterior apprehension: sitting or standing the shoulder is elevated to 90 degrees and a posterior directed force is applied to the elbow while stabilizing the scapular with other hand and eliciting apprehension.
Inferior:
Pull down on arm while it is at the side of chest. Presence of sulcus indicative of inferior instability.
Anterior instability test
Inferior instability test