Shoulder Exam

ROM

100

What position do you measure shoulder extension ROM in? 

Prone

200

Where is the fulcrum, proximal arm and distal arm placed during shoulder flexion ROM?

Fulcrum: over the lateral aspect of the greater tubercle

Proximal arm: parallel to the midaxillary line of the thorax

Distal arm: aligned w/ lateral midline of humerus or olecranon process

300

What motion is measured in supine with a towel under the arm, the fulcrum over the olecranon process and a norm of 90-100deg?

External rotation

400

When measuring ABD, what is the patient position and placement of fulcrum, proximal arm and distal arm of goni, what is the norm?

Position: Supine

Fulcrum: anterior aspect of acromion process

Proximal arm: parallel to midline of anterior aspect of sternum

Distal arm: anterior midline of humerus or medial epicondyle

Norm: 170-180

500

When measuring shoulder internal rotation, what is the patient positioning and placement of the fulcrum, proximal arm and distal arm? What is the norm?

Patient position: Supine

Fulcrum: olecranon process

Proximal arm: parallel to or perpendicular to floor

Distal arm: olecranon process and ulnar styloid

70-90deg

MMT

100

What position is the pectoralis major tested in? 

Supine

200

During the anterior deltoid MMT, what position is the patient in and where does the examiner apply the force?

Seated

Force applied proximal to the elbow in direction of extension

300

What is the patient position and where is the force applied during the supraspinatus MMT

Seated, arm is slightly ABD w/ thumb up

Force on distal humerus toward the ground

400

Explain the steps of the latissimus dorsi MMT

Pt is prone

PT movse pts shoulder into IR & ADD w/ palm facing ceiling

Pt does this themselves

PT stabilizes pt's thorax & applies a force proximal to the elbow in the direction of flexion

500

Explain the steps of the infraspinatus/teres minor MMT.

Prone w/ shoulder ABD to 90, elbow flex to 90 & handing off table, put towel under pts shoulder

After PROM, pt ER's humerus

PT stabilizes over ipsilateral thorax & applies resistance just proximal to wrist in direction of IR toward the ground

Joint mobility

100

What position is the patient in during the inferior glide of the GH joint?

Supine

200

What is the patient positioning for scapulothoracic joint elevation & depression?

Sidelying, mobilizing scapula off table, pt's arm elevated & resting on PT's hand

300

What position is the patient in during the inferior glide of the GH joint?  What does this motion test for?

Supine; Shoulder flexion/ABD

400

What is the pt positioning and hand placement for a scapulothoracic joint retraction mobilization?

Sidelying, ipsilateral side being treated is off the table, pt's arm is placed behind their back

PT's hand stabilizing anterior acromion & humeral head & other mobilizing hand at lateral border of scapula

500

What is the joint mob shown in this picture? (refer to slides)

AC joint posterior glide

Practice Skill

100

Perform a GH posterior glide

Pt off to side of table w/ arm off of table, stabilizing arm holding arm up, mobilizing arm pushing posteriorly just at GH joint line

200

Perform shoulder flexion ROM

Pt in hooklying

Fulcrum: lateral aspect of greater tubercle

Proximal arm: parallel to midaxillary line of thorax

Distal arm: align w/ lateral midline of humerus or olecranon process

300

Perform anterior deltoid MMT

Seated, pt into 90deg shoulder flexion, stabilize pt posteriorly & apply force in direction of extension proximal to elbow

400

Perform external rotation ROM

Supine, towel roll under humerus

Fulcrum over olecranon process, parallel or perpendicular to floor, align ulna w/ olecranon process and ulnar styloid

500

Perform infraspinatus/teres minor MMT

Prone w/ shoulder ABD to 90, elbow flex to 90 & off table, towel folded under humerus, pt ER's humerus, stabilize over ipsilateral thorax & apply resistance proximal to wrist in direction of IR toward the ground