Shoulder Interpretation Cases

Question 1

Subacromial distraction, grade 2 with pain

Answer 1

grade 2 = Hypomobile

with pain = inflammation

Question 2

Subacromial distraction grade 4 no pain

Answer 2

grade 4 = hypermobile

no pain = no inflammation

Question 3

Subacromial distraction grade 3 relief of pain

Answer 3

grade 3 = normal

relief of pain with distraction = structure unweighted

Question 4

Which arthokinematic motions are associated with GH Medial rotation

Answer 4

Anterior roll/POSTERIOR glide

Question 5

What is the combination of direction of force required to achieve an accurate GH posterior glide assessment?

Answer 5

Posterior, superior, (cephalic) lateral

Question 6

Which arthokinematic motions are associated with GH lateral rotation

Answer 6

Posterior roll/ANTERIOR glide

Question 7

what is the combination of directions of force required to achieve an accurate GH anterior glide assessment

Answer 7

anterior, inferior (or caudal), medial

Question 8

Which arthokinematic motion is associated with GH flexion

Answer 8

Anterior roll/POSTERIOR glide

Question 9

The patient has limited GH lateral rotation because of capsular restrictions. Which of the following acessory motions might be expected to be hypomobile?

Answer 9

GH anterior glide

Question 10

The patient has significantly limited shoulder flexion and abduction. Which of the following motions would you expect to be hypomobile?

Answer 10

• (GH) posterior glide

- (GH) inferior glide

Question 11

GH Lateral distraction Grade 1, no pain

Answer 11

very hypomobile, no inflammation

Question 12

GH lateral distraction Grade 3, no pain

Answer 12

Normal

Question 13

GH compression, no pain

Answer 13

no joint surface issue

Question 14

GH compression, painful

Answer 14

likely source = joint surface and/or structures getting pinched

Question 15

What is the combination of directions of force required to achieve an accurate AC Anterior Glide Assessment

Answer 15

Anterior lateral

Question 16

What combination of directions of force is required to achieve an accurate AC compression accessory motion test

Answer 16

Posterior, lateral

Question 17

SC distraction grade 2, no pain

Answer 17

hypomobile, no inflammation

Question 18

SC posterior glide, grade 1, painful

Answer 18

very hypomobile, inflamed

Question 19

SC compression acessory motion test, painful, with some crunching sensation

Answer 19

likely s joint surface issue

Question 20

Supportive information for Kim Test (Bicep Load Test)

Answer 20

• Repetitive overhead throwing
• Excessive inferior traction (carrying/lifting heavy objects)
• Poorly localized posterior shoulder pain exacerbated by overhead and behind the back arm motion s
• Popping, catching, or grinding may be present
• tenderness over anterior aspect of shoulder
• pain of resisted bicep contraction

Question 21

Supportive Information for Apprehension (Crank Test)

Answer 21

• Traumatic MOI: commonly moderately forceful abduction and external rotation
• Post-traumatic: true dislocation may not have occurred, symptoms related to recurrent subluxation - common in overhead activites
• shoulder pain
• episodes of “dead arm” syndrome
• excessive lateral rotation
• decreased muscle performance primary and secondary muscles controlling shoulder
• possible tenderness

Question 22

Supportive Information for Active compression test of O’Brien

Answer 22

• Repetitive overhead throwing
• Excessive inferior traction (catching/carrying heavy objects)
• Poorly localized posterior shoulder pain exacerbated by overhead and behind the back arm motions
• popping, catching, or grinding may be present
• tenderness over anterior aspect of shoulder
• pain on resisted bicep contraction

Question 23

Supportive information for Supraspinatus (empty can or Jobe test)

Answer 23

• pain with overhead activites
• anterior and/or lateral shoulder pain
• worse with activity, better with rest
• difficulty sleeping on involved side
• pain with dressing activites

(+) test supraspinatus
GH hypermobility
poor Scapulohumeral rhythm
decreased scapulothoracic stabilizer muscles

Question 24

Supportive information for a lift-off sign

Answer 24

• reports significant weakness and pain with activites involving abduction and external rotation
• localized pain over upper back, deltoid, shoulder and arm
• popping sensation may be present
• Pain, AROM, potentially PROM
• resisted tests weak and painful or weak and no pain of full thickness tear

Question 25

Supportive information for infraspinatus test

Answer 25

- pain with overhead activites - anterior/lateral shoulder pain - worse with activity better with rest - difficulty sleeping on involved side - pain with dressing activites (+) resisted test supraspinatus - GH hypermobility - poor scapulohumeral rhythm - decreased scapulothoracic stabilzers