Shoulder Joint

Acromioclavicular sprain: Pain and crepitis on

palpation.
+ Ve test: Cross body adduction, O’Brien’s test (seated
with UE in 90° of elevation, 10° of horizontal add and
maximal IR (pronation). Resist elevation in IR and ER

Muhammed Al-Jarrah PhD, PT

Labor Tear
 Pain with IR and adduction
 Weakness with abduction and flexion
 Sense of instability
 +ve Test: Biceps load, Speed’s and O’Brien’s
 Confirmed with CT and MRI
Subacromial bursitis
 Onset of severe pain, localized in deltoid
insertion. Passive shoulder ext to palpate the
bursa
 PROM is painful and resisted motions are not
painful except through the painful arch.
 +Ve tests: Hawkin’s –Kennedy’s, Neers test
 Imaging is of little value
Bicipital tendinitis
 Pain ↑ @ night
 10° of IR (places the tendon directly anterior
and 6 cm below acromion)
 Active elevation results in painful arch
 +Ve speed test, -Ve Yergason’s for click but
painful
 Often associated with RC impingement
Calcific Tendinitis
 ↓ ROM with painful arch 70-110 and
sensation of catching when going through
ROM
 Need to rule our adhesive capsulitis
 +Ve speed test
Rotator cuff strain
 Night pain, deep ache
 Weakness: Abduction and/or ER
 +Ve special tests: Depends on muscle
involved.
Supraspinatus Impingement
 Pain specially when sleeping on affected side
 Painful arch (60-120)
 Catching with flexion and IR
 Little to no TTP
 ↓ ROM with IR and horizontal adduction
 Posterior capsule tightness
 Rule out other shoulder disorders
Adhesive Capsulitis
 Pain radiating to elbow, night pain
 Kyphotic posture, shoulder hiking
 Low grade inflammatory respond
 Empty end feel
 Stages of Adhesive Capsulitis
- Freezing
- Frozen
- Thawing
Shoulder BP: Muscles and function
 Median nerve: C6-8, T1
Muscles: Pronator teres, FCR, Palmaris longus,
thenar eminence, lateral 2 lumbricles
Functional deficits: Weak pronation, wrist
flexion & RD
Weak thumb flexion & abduction
Weak grip and pinch
Shoulder BP: Muscles and function
 Ulnar Nerve: C7-8, T1
Muscles: FCR, Palmaris brevis, edductor
pollicic, medial 2 lumbricales, interossei, and
hypothenar eminence
Functional deficits: Weak wrist flexion and UD
Weak fifth finger flexion, weak finger
abduction/adductor
Benediction sign.
Shoulder BP: Muscles and function
 Radial Nerve: C5-8, T1
Muscles: Anconeus, brachioradialis, ECRL,
ECRB, extensor digitorum, extensor indicic,
extensor digiti minimi
Functional deficits: Weak supination, wrist
extension, fingure flexion, thumb abduction,
weak grip due to loss of wrist stabilization.
Questions and Comments