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A positive test is indicated by pain in the anterior or lateral shoulder when in full flexion. It is indicative of problems involving the supraspinatus and the long head of the biceps brachii tendons. The examiner needs to be aware of a false positive test which is due to the patient having limited forward flexion. [1]
In both tests, the patient is placed in a standing or sitting position, and the arms are raised parallel to the ground in the scapular plane. [2] The tests differ in the rotation of the arm; in the empty can test, the arm is rotated to full internal rotation (thumb down) and in the full can test, the arm is rotated to 45° external rotation, thumb up. [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
Rounded shoulder posture (RSP), also known as “mom posture”, [1] is a common postural problem in which the resting position of the shoulders leans forward from the body’s ideal alignment. [1] Patients usually feel slouched and hunched, [ 2 ] with the situation deteriorating if left untreated.
Jobe's test is a physical exam test that is used to detect anterior shoulder instability. It is used to distinguish between anterior instability and primary shoulder impingement. This test should be performed after the Apprehension test. [3] This test was named for Christopher Jobe. [4]
Combining abduction with 30° flexion in the plane of the scapula causes a delay in the tightening of the ligament resulting in a maximum abduction of 110°. [ 3 ] During rotation of the arm lateral rotation stretches all three ligaments while medial rotation relaxes them.
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]
Now test internal rotation of the hip with the knee joint flexed to 90 degrees (moving the foot laterally with the knee flexed causes internal rotation of the hip joint - early OA causes pain and limitation of this movement). Test for the balloon sign on the knees. Inspect the soles of the feet for any calluses, or skin changes.