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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 (or extorsion or lateral rotation) is an anatomical term of motion referring to rotation away from the center of the body. The external rotator muscles include: Muscles
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 .
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 .
Medial and lateral rotation of the shoulder (also known as internal and external rotation). Medial rotation is carried out by the anterior fibres of the deltoid, teres major, subscapularis, pectoralis major and the latissimus dorsi. Lateral rotation is carried out by the posterior fibres of the deltoid, infraspinatus and the teres minor.
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.
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]
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.