From the Research
To comprehensively assess shoulder movements, it is essential to evaluate flexion, extension, abduction, adduction, internal rotation, external rotation, and horizontal adduction/abduction, as outlined in the most recent and highest quality study 1. When examining the shoulder, it is crucial to begin with active range of motion, having the patient perform each movement independently to evaluate function and pain patterns.
- The patient should be instructed to move their shoulder through each plane of motion without assistance to assess for any limitations or pain.
- Following active range of motion, passive range of motion tests should be performed, where the examiner guides the movements to assess joint restrictions.
- Specific tests such as the empty can test for supraspinatus, lift-off test for subscapularis, and external rotation lag sign for infraspinatus should be included to evaluate for rotator cuff pathology, as recommended by 1.
- Resistance testing should also be performed to evaluate muscle strength in each movement plane.
- It is essential to compare findings to the unaffected shoulder to establish baseline function, as noted in 2 and 3. These tests are vital because they help differentiate between muscular, ligamentous, and joint capsule problems, which is critical for guiding treatment options and improving patient outcomes, as emphasized in 4 and 5. Pain during active but not passive movement suggests muscular issues, while pain in both typically indicates joint pathology, highlighting the importance of a thorough physical examination in diagnosing shoulder complaints, as discussed in 1. Testing all movement planes ensures a comprehensive evaluation of the complex shoulder joint, which relies on multiple muscle groups and articulations working together for normal function, as outlined in the most recent study 1.