Shoulder Clinical Examination Station
This patient has pain in the right shoulder. Examine his shoulder.
| Item | Procedure |
|---|---|
| Opening | • Greet the patient and Introduce yourself. • Ensure proper hygiene and Ensure adequate privacy. • Take permission and Expose the patient. • Note general position, swelling, etc. |
| Look | • Inspect in all sides for scars, discolouration, swelling, and deformities from the front, sides, top, and back. • Look for muscle wasting of supraspinatus and infraspinatus muscles • Compare both deltoids; comment if they seem symmetrical. • Check for winged scapula. |
| Feel | • Temperature: Compare both sides (proximal to distal) and comment if symmetrical. • Tenderness: Palpate for tenderness (always compare to the left shoulder) starting at: • Sterno-clavicular (SC) joint • Clavicle • Acromio-clavicular (AC) joint • Greater Tuberosity (GT) & Biceps tendon • Scapular spine • Palpate and compare rotator cuffs (supraspinatus, infraspinatus) and deltoids. |
| Move | • Ask the patient to stand up. • Active ROM: First Assess range of motion - screen for pain. Ask to perform: • Forward flexion / Extension • Abduction / Adduction • External / Internal rotation • Comment on the motion (e.g., “full active motion, no need for passive”). • Passive ROM: If active motion is limited, assess passively. • Examine joints above and below (e.g., C-spine, elbow). |
| Special Tests | Rotator Cuff Power (compare both sides): • Supraspinatus (Empty Can Test): Flex shoulder to 30° with thumbs down; ask patient to resist. • Infraspinatus: Ask patient to perform external rotation against resistance (elbows at 90°). • Teres Minor: Ask patient to perform external rotation against resistance in 90° of shoulder abduction. • Subscapularis: Ask patient to perform internal rotation against resistance OR use the Lift-Off Test. • Instability (Bankart): Apprehension Test (abduct and externally rotate arm, apply anterior pressure, watch patient’s face). • AC Joint: Cross Body Adduction Test. • Biceps Tendon: Speed’s Test (resisted shoulder flexion with elbow extended and supinated) OR Yergason Test. |
| Overall | • Maintain a professional and empathetic attitude with the patient. |
- Compare both shoulders during all parts of the assessment.