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Evaluation of passive and active range of motion: Neck range of motion should be assessed that may reveal a neck source of shoulder pain. The Apley scratch test specifically tests range of motion and in a normal exam, an individual should be able to reach C7 on external rotation, and T7 on internal rotation. Evaluation of distal pulses
External rotation (lateral rotation or extorsion) is rotation away from the center of the body, [22] carried out by external rotators. Internal and external rotators make up the rotator cuff , a group of muscles that help to stabilize the shoulder joint .
The range of motion for plantar flexion is usually indicated in the literature as 30° to 40°, but sometimes also 50°. The nerves are primarily from the sacral spinal cord roots S1 and S2. Compression of S1 roots may result in weakness in plantarflexion; these nerves run from the lower back to the bottom of the foot.
The muscles and joints of the shoulder allow it to move through a remarkable range of motion, making it one of the most mobile joints in the human body. The shoulder can abduct , adduct , rotate, be raised in front of and behind the torso and move through a full 360° in the sagittal plane .
Range of motion tests external and internal rotation, abduction and adduction, passive and active weakness, and true weakness versus weakness due to pain. The Apley scratch test is the most useful: touch opposite scapular by reaching behind the head for adduction and external rotation and behind the back for abduction and internal rotation.
The normal subacromial space in shoulder radiographs is 9–10 mm; this space is significantly greater in men, with a slight reduction with age. [2] In middle age, a subacromial space less than 6 mm is pathological, and may indicate a rupture of the tendon of the supraspinatus muscle .
The muscles of internal rotation include: of arm/humerus at shoulder. Anterior part of the deltoid muscle [1] Subscapularis [1] Teres major [1] Latissimus dorsi [1] Pectoralis major [1] of thigh/femur at hip [2] Tensor fasciae latae; Gluteus generalis; Anterior fibers of Gluteus meralis; Adductor longus and Adductor brevis; of leg at knee [3 ...
These exercises are used to increase stability, strength and range of motion of the subscapularis, supraspinatus, infraspinatus, and teres minor muscles within the rotator cuff. [26] Passive exercises include internal and external rotation of the shoulder joint, as well as flexion and extension of the shoulder. [26]