Examination of the shoulder video
With both shoulders fully exposed, look from the front, the side and behind the patient for obvious loss of symmetry, muscle wasting or scars.
The temperature over the joint line should be assessed; and then bony landmarks, joint line and surrounding muscles should be palpated for tenderness.
Shoulder movement and function can be assessed by asking the patient to put their hands behind their head and behind their back. Internal rotation can be given a measure by how far up the back the hands can go – in this case to the mid-thoracic level. Full extension, flexion and abduction should be assessed.
Markedly reduced external rotation with the elbow flexed to 90° and tucked into the patient’s side is a useful diagnostic test of frozen shoulder. Place your hand on top of the shoulder to isolate the glenohumeral movement.
Passive movements should be performed while feeling for crepitus. Passive movement may be particularly helpful in abduction when assessing a patient with a painful arc where pain may be experienced between 10 and 120 degrees.
Assessment of scapular movement during full abduction should be assessed by both feeling and observing the scapula from behind the patient.
Function has already been assessed by asking the patient to place their hands behind their head and behind their back.