Shoulder
Topic
Presentation Anterior Lateral Image Image
Impingement Syndrome (Bursitis / Supraspinatus Tendonitis) Diagnosis AROM Effected PROM Preserved Pain w/ Overhead Activities Pain with IR (Putting on a Jacket / Bra) Night Pain of Affected Side DDx Rotator Cuff Tear Osteoarthritis Special Tests Spurling's Test Referred Pain: Cervical Spondylosis
Neer's Sign (Subacromial Impingement)
Hawkins-Kennedy Test (Supraspinatus Tendon Impingement)
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Topic
Hawkins-Kennedy Test (Supraspinatus Tendon Impingement)
Painful Arc Pt Abducts Arm (Pain: 70-120° = Impingement)
Treatment Rest, Ice, NSAIDs, Steroids, NO X-ray Rotator Cuff Tear Diagnosis AROM Effected PROM Preserved Partial: Weakness raising arm Complete: Inability to raise arm DDx Impingement Syndrome Osteoarthritis Special Tests Spurling's Test Referred Pain: Cervical Spondylosis
"Empty-Can" Test Supraspinatus
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"Empty-Can" Test
Topic
Supraspinatus
Drop Arm Test Rotator Cuff Tear
Treatment MRI, NSAIDs Anterior Image Image
Bicipital Tendonitis Diagnosis Shoulder Pain with Overhead Activities Point Tenderness on Bicipital Groove Localize: 10° of ER
DDx SLAP Lesion Rotator Cuff Tear Adhesive Capsulitis
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Topic
Adhesive Capsulitis Special Tests Spurling's Test Referred Pain: Cervical Spondylosis
Speeds Test Biceps Tendinopathy
Yergason’s Test Biceps Tendinopathy (Resist Supination)
Treatment NSAIDs Posterior Adhesive Capsulitis Diagnosis AROM and PROM Limited Inflammation → Freezing → Thawing Minimal or No Trauma Pain out of Proportion to Findings Progressive and Vague Pain DDx Diabetes Rheumatoid Arthritis Special Tests Spurling's Test Referred Pain: Cervical Spondylosis
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Topic
Spurling's Test Referred Pain: Cervical Spondylosis
"Lift-Off" Test Subscapularis
Neer's Sign Impingement Sign
ROM: Flexion, Abduction, IR, ER Pain with Shoulder Shrug Treatment ROM, NSAIDs, Steroid Injection or Oral X-ray to Rule out Osteoarthritis Osteoarthritis (DJD) Diagnosis Crepitus and/or Popping ? Age Activity Level Steroid Use? Special Tests Spurling's Test Referred Pain: Cervical Spondylosis
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Topic
Spurling's Test Referred Pain: Cervical Spondylosis
Speeds Test Biceps Tendinopathy
"Empty-Can" Test Supraspinatus
Treatment Tylenol, X-ray, Opioids Popping, Locking, Snapping SLAP Lesion Diagnosis Acute Shoulder Compression, Traction Fell On Hand from Distance Shoulder Pulled Forward (Skier) DDx Bicipital Tendonitis Rotator Cuff Tear Osteoarthritis Special Tests Spurling's Test Referred Pain: Cervical Spondylosis
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Topic
Spurling's Test Referred Pain: Cervical Spondylosis
Anterior Compression (O'Briens) Flex Shoulder 90°, Elbow Straight, Adduct 15° Max IR, Elbow Extended
Max ER, Elbow Extended
Drop Arm Test Rotator Cuff Tear
Treatment NSAIDs, MRI Paresthesias Instability / Dislocation Diagnosis Sulcus Sign Test (w/ Traction)
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Topic
Diagnosis Sulcus Sign Test (w/ Traction)
Special Test Anterior Release is More Specific and Sensitive Anterior Apprehension Test Anterior Dislocation
Relocation Test Anterior Dislocation
Treatment NSAIDs, Neurologic Evaluation for Nerve Damage (Axillary) Medially (Mid Clavicle) AC Arthritis Scarf Test Painful Arc at 170-180° Inspection Scar, Color, Edema, Deformities, Atrophy, Asymmetry, Guarding, ecchymosis Palpation Pain or Point Tenderness? SC → AC → GH → Biceps Image
Long Head of Biceps Localize: 10° of ER
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Long Head of Biceps Topic Localize: 10° of ER
Range of Motion Active Abduction 1. Raise arms 90 w/ palms down (Glenohumeral) 2. Continue to 180 with palms facing each other (60 scapulothoracic, 30 combined GH & ST) Initial Abduction Weakness = Rotator Cuff
Adduction Image
External Rotation Arm at Side, Elbow Flexed 90°
Reach behind head as far down as possible (N: C7)
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Topic
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Reach behind head as far down as possible (N: C7)
Internal Rotation (w/ Adduction) Reach behind back as far up as possible (N: T8)
Flexion Elbow straight, raise arms above head (N: 180°)
Extension Elbow straight, move arms backwards (N: 50°)
If AROM Elicits Pain → Evaluate Through PROM Passive Abduction
Topic Abduction
Glenohumeral
Scapulothoracic
External Rotation Image
Internal Rotation Image
Flexion Image Extension Image Muscle Strength
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Topic
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Muscle Strength Grading Table
Movements Abduction Supraspinatus, Infraspinatus, Subscapularis
Internal Rotation Subscapularis, Ant Deltoid
External Rotation Infraspinatus, Teres Minor
Flexion Anterior Deltoid, Coracobrachialis
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Topic Flexion
Anterior Deltoid, Coracobrachialis
Extension Latissimus Dorsi, Teres Major, Posterior Deltoid
Muscles Supraspinatus "Empty Can" Test
Subscapularis "Lift-Off" Test
Infraspinatus, Teres Minor External Rotation
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Topic Infraspinatus, Teres Minor
External Rotation
Subscapularis, Ant Deltoid Internal Rotation
Deltoid Abduction
Biceps Flex Elbow → Supination
Special Tests Spurling's Test Referred Pain: Cervical Spondylosis
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Spurling's Test Topic Referred Pain: Cervical Spondylosis
Anterior Compression (O'Briens) Flex Shoulder 90°, Adduct 15° Max IR, Elbow Extended
Max ER, Elbow Extended
Anterior Lateral Pain Neer's Sign Impingement Sign
Hawkins Test Impingement Sign
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Topic Hawkins Test
Impingement Sign
"Lift-Off" Test Subscapularis
"Empty-Can" Test Supraspinatus
Painful Arc Pt Abducts Arm (70-120° = Impingement)
Drop Arm Test Rotator Cuff Tear
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Topic Drop Arm Test
Rotator Cuff Tear
Anterior Pain Speeds Test Biceps Tendinopathy
Yergason’s Test Biceps Tendinopathy (Resist Supination)
Dislocation Anterior Release is More Specific and Sensitive Anterior Apprehension Test Anterior Dislocation
Relocation Test Anterior Dislocation
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Topic Relocation Test
Anterior Dislocation
Medial Pain Scarf Test (AC) DDx Anterior Lateral Pain Impingement Syndrome Rotator Cuff Tear Anterior Pain Bicipital Tendonitis SLAP Lesion Posterior Pain Adhesive Capsulitis Osteoarthritis Cervical Spondylosis Dislocation
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