Shoulder Evaluations

1
Shoulder Evaluations
2
History

• Ask questions to find out the following
• Location of the pain
• Onset of the pain
• Mechanism of injury
• What and how much activity have they been doing?
• Symptoms
• Prior injuries

3
Inspection

• General
• Position of head
• Position of arm
• Anterior Structures
• Shoulders level?
• Contour of clavicle?
• Symmetry of deltoid muscle
• Anterior humerus
• Biceps brachii

4
Inspection

• Lateral Structures
• Deltoid muscle group
• Acromion process step deformity
• Position of the humerus
• Posterior Structures
• Alignment of the spinal vertebrae
• Position of scapula
• Muscle tone
• Position of humerus

5
Palpation

• Anterior Structures
• Sternoclavicular joint
• Clavicular shaft
• Acromion process
• Acromioclavicular joint
• Coracoid process
• Pectoralis major

6
Palpation

• Humerus
• Humeral head
• Deltoid group
• Humeral shaft
• Biceps brachii
• Triceps brachii
• Rotator cuff
• Teres major
• Latissimus dorsi

7
Palpation

• Scapula
• Scapular spine
• Superior angle
• Inferior angle
• Axial border
• Trapezius
• Levator scapulae
• Rhomboids

8
Special Tests

• Functional Tests (all movements)
• Active ROM
• Passive ROM
• Resisted ROM
• Apleys Scratch test

9
Special Test

• Apprehension Test
• Athlete will become apprehensive and resist
  further movement
• Positive results means that anterior capsule
  and/or glenoid labrum have been injured
• Helps to determine subluxation or dislocations
  that have relocated

10
Special Tests

• Shoulder Impingement Test
• Athlete will have pain with motion, espically
  near end range
• Rotator Cuff has been injured

11
Special Tests

• Drop Arm Test
• Arm will fall uncontrolled
• Positive results mean rotator cuff strain,
  especially to supraspinatus

12
Special Tests

• Empty Can Test
• Weakness or pain with movement
• Positive results could mean one of the following
  for the supraspinatus tendon
• Impinged
• Inflamed
• Contains a tear

13

• Empty Can Test

14
Throwing Phases

• Correct throwing will help prevent many overuse
  injuries
• 5 distinct phases

15
Wind-up

• From 1st movement
• Until ball leaves gloved hand
• Lead leg strides forward
• Both shoulders abduct, externally rotate, and
  horizontally abduct

16
Cocking

• Begins when hands separate
• Ends when maximum external rotation has occurred
• Foot comes into contact with ground

17
Acceleration

• From maximal external rotation
• Until ball release
• Humerus abducts, horizontally abducts, and
  internally rotates
• Scapula elevates, protracts, and upward rotates
• Velocities approach 8000 degrees/sec

18
Deceleration

• From ball release
• Until maximum internal rotation
• Muscles of external rotation and the rhomboids
  contract eccentrically

19
Follow-through

• From maximum internal rotation
• Until end of motion
• Ends in balanced position