Shoulder Joint Conditions

Rotator Cuff Tendinitis

• Condition: inflammation of the RC tendon due to impingement by the acromion

  • Acute: 20-40 yrs

  • Chronic: 30-70 yrs

• Examination/ Obs:

  • painful overhead mvmts and resisted abduction

  • limited active abduction (chronic- abduction & flexion limited)

  • Chronic- pain on passive IR/ ER at 90 degrees abduction

• Special tests

  • Drop arm (tear/ rupture)

  • Empty can test (supraspinatus tendon)

Rotator Cuff Rupture

• Condition: complete rupture of the supraspinatus tendon

  • Age: 40+

• Examination/ obs:

  • Pain with arm elevation

  • Limited active abduction and pain with/ without restriction depending on partial/ full tear

  • Pain with resisted abduction

  • Passive range is full without pain

• Special Tests

  • Drop arm

  • Empty can

  • Hornblower’s sign

  • IR lag sign

  • Lift off sign

  • belly press

  • bear hug

Bicipital Tendinitis

• Condition: Repetitive overhead injury, long head of biceps tendon gets impinged between bicipital groove and anterior acromion

• Examination/ Obs:

  • Pain with overhead movements

  • Pain with full extension to flexion

  • Active ER is limited when arm is at 90 degrees abduction

  • Passive shoulder and elbow extension combined is painful

  • Resisted elbow flexion is painful

• Special tests:

  • Speeds test

  • Yergason’s test

Subacromial Bursitis

• Condition: repetitive overhead activity

• Examination/ Obs:

  • Painful arc 60-120 of abduction

  • Active abduction and IR is limited

  • Passive IR with 90 degree of shoulder abduction is painful

  • Resisted movements painful

• Special tests

  • Hawkins Kennedy

  • Neers test

Acromioclavicular joint sprain

• Condition: fall on tip of shoulder or outstretched arm

• Examination/ obs:

  • step deformity (3rd degree) at point of shoulder

  • Palpation painful on AC joint

  • Horizontal adduction and elevation painful

• Special tests

  • AC shear test

  • Horizontal adduction

  • Paxinos sign

Sick Scapula

• Condition: scapular malpositioning

  • Ages 20-40

• Examination/ obs

  • Scapular malposition

  • Inferior medial border prominence

  • Coracoid pain and malposition

  • Kinesis abnormalities of scapular movement

• Special tests

  • Scapular assistance test

  • Scapular reposition test

SLAP- Labrum tear

• Traumatic sudden onset

• Deep anterior shoulder pain

• Clicking/ clunking/ joint locking- pain with throwing or biceps loading (shoulder flexion and arm supination)

• Special tests

  • Active O’Brien’s test

  • Biceps load

  • clunk test