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
 Drop
Arm 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
