Examination of the Athlete’s Shoulder Damon H. Petty, MD a.m. SEATA Conference

Background  Cleveland Clinic  ASMI with Jim Andrews and Bill Clancy  Team MD for AAA Baseball, Professional Soccer, Middle Tennessee High Schools  Practices in Nashville & Lebanon  No conflict of interest statements

Aim of Talk  Special Tests for Exam of the Athlete’s Shoulder  Live Demonstration  Categorized by Pathology and Complaints  Questions

The Thrower’s Shoulder  80% is internal impingement  Rotator Cuff  Posterior Labrum  Anterior-inferior instability

Remember the Basics  Inspect  Palpate  ROM  Neurovascular  Special Tests

Thrower’s Rotator Cuff  Strength Testing  ER  0 & 90 deg abd  Elevation  Cuff Avoidance  Posterior Cuff & Capsule tenderness

Thrower’s Rotator Cuff  ROM  ER/IR  GIRD  Pain with max IR  The myth of Posterior Capsular Tightness

Thrower’s Rotator Cuff  Internal Impingement Test  “Andrews Test”

The Thrower’s Labrum  Posterior Labral Tear  Kim Test  Jerk Test  SLAP Tear  O’Brien’s Test  Resisted Supination- External Rotation Test  Kibler Test  Speed Test  Yergason’s Test

Posterior Labral Tear  Kim Test  Jerk Test

SLAP Lesion  O’Brien’s Test  Kibler Test  Speed Test  Yergason’s Test  Resisted Supination- External Rotation Test

SLAP Lesion  O’Brien’s Test  Kibler Test  Speed Test  Yergason’s Test  Resisted Supination- External Rotation Test

SLAP Lesion  O’Brien’s Test  Kibler Test  Speed Test  Yergason’s Test  Resisted Supination- External Rotation Test

SLAP Lesion  O’Brien’s Test  Kibler Test  Speed Test  Yergason’s Test  Resisted Supination- External Rotation Test

Shoulder Instability  MDI/hyperelasticity  Traumatic/Bankart  Drawer Test  Load and Shift  Sulcus Sign  Apprehension Test  Relocation Test

Shoulder Instability  Drawer Test  Load and Shift  Sulcus Sign  Apprehension Test  Relocation Test

Shoulder Instability  Drawer Test  Load and Shift  Sulcus Sign  Apprehension Test  Relocation Test

Shoulder Instability  Drawer Test  Load and Shift  Sulcus Sign  Apprehension Test  Relocation Test

Adhesive Capsulitis  Supine Horizontal Abduction  90/90 attempt  90 deg  Forward Flexion

AC Joint Arthrosis/Separation  Grade I  Tenderness over AC joint  Cross-body adduction  Grade II +  Prominent distal clavicle

Neurological Dysfunction  Cervical Disc Herniation  Stinger/burner  Long Thoracic Nerve  Spinal Accessory Nerve  Brachial plexopathy  Axillary Nerve

Thank You Questions?