1. ASCM Clinical Skills Shoulder

2. LOOK

3. Inspection Swelling, bony prominence Swelling, bony prominence Bruising / lacerations Bruising / lacerations Position of arm Position of arm Asymmetry Asymmetry Atrophy Atrophy Surgical scars Surgical scars

4. FEEL

5. Palpation Expose both shoulders Palpate bony prominences Soft tissue palpation, least tender areas first Compare to contralateral side

7. AC Joint

8. MOVE

9. ACTIVE PASSIVE ABNORMAL Compare both shoulders

10. Range of Motion Forward Flexion: 180°

11. Range of Motion Abduction: 180°

12. Range of Motion External Rotation: 60-80°

13. Range of Motion Internal Rotation: T7

14. Range of Motion Internal Rotation at 90° Forward Flexion: 90°

15. Rotator Cuff Injury Tendonopathy or tear Partial or complete Acute or chronic

17. Rotator Cuff Injury Jobe Test: Supraspinatus Middle deltoid

18. Rotator Cuff Injury External Rotation: Teres minor Infraspinatus

19. Rotator Cuff Injury Internal Rotation: Subscapularis Pectoralis major Latissimus dorsi

20. Rotator Cuff Injury Drop Arm Test: Unable to resist pressure at 90° abduction Drop Arm Test: Unable to resist pressure at 90° abduction Painful Arc: Between 45 ° and 120° abduction Painful Arc: Between 45 ° and 120° abduction

21. Impingement Usually subacromial space Irritation between AC joint, RC tendons and bursae

22. Impingement Neer’s Test

23. Impingement Hawkin’s Test

24. Biceps tendonitis/tear Usually long head Related to overuse/activity Anterior shoulder pain Acute or chronic Weakness with resisted flexion/supination

25. Biceps Tendon

26. Biceps tendonitis Yergason’s Test

27. Biceps tendonitis Speed’s Test

28. AC Joint arthritis Crossed Adduction Test

29. GH Joint Laxity Apprehension Test Relocation

30. GH Joint Laxity Sulcus Sign

31. GH Joint Laxity Load and Shift Test

32. Referred Pain Neck Neck Elbow Elbow Heart Heart Diaphragmatic Diaphragmatic Pan coast Pan coast

33. Neurological Examination Radial nerve – Thumbs up Radial nerve – Thumbs up Median nerve – Thumb to hypothenar eminence Median nerve – Thumb to hypothenar eminence Ulnar nerve – Abduct V Ulnar nerve – Abduct V Axillary nerve - Deltoid Axillary nerve - Deltoid