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The range of motion at the shoulder may be limited by pain. A painful arc of movement may be present during forward elevation of the arm from 60° to 120°. [4] Passive movement at the shoulder will appear painful when a downward force is applied at the acromion but the pain will ease once the force is removed. [2]
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.
Subacromial bursitis is a condition caused by inflammation of the bursa that separates the superior surface of the supraspinatus tendon (one of the four tendons of the rotator cuff) from the overlying coraco-acromial ligament, acromion, and coracoid (the acromial arch) and from the deep surface of the deltoid muscle. [1]
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 of the shoulder with the arm at a 90-degree angle is an additional exercise done to increase control and range of motion of the Infraspinatus and Teres minor muscles. Various active exercises are done for an additional 3–6 weeks as progress is based on an individual case-by-case basis. [9]
Localized pain on the anterior shoulder suggests subacromial impingement, whereas posterior shoulder pain suggests internal impingement. [45] For the diagnosis of full-thickness rotator cuff tear, the best combination appears to include once more the painful arc and weakness in external rotation, and in addition, the drop arm sign. [42]
It is a common shoulder ailment that is marked by pain and a loss of range of motion, particularly in external rotation. [3] There is a loss of the ability to move the shoulder, both voluntarily and by others, in multiple directions. [1] [2] The shoulder itself, however, does not generally hurt significantly when touched. [1]
From 90-180 degrees it is the trapezius and the serratus anterior. Adduction is carried out by the pectoralis major, latissimus dorsi, teres major and the subscapularis. Horizontal abduction and horizontal adduction of the shoulder (transverse plane) Medial and lateral rotation of the shoulder (also known as internal and external rotation).