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The rotator cuff muscles of the shoulder produce a high tensile force, and help to pull the head of the humerus into the glenoid cavity. The glenoid cavity is shallow and contains the glenoid labrum which deepens it and aids stability. With 120 degrees of unassisted flexion, the shoulder joint is the most mobile joint in the body.
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.
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.
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.
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.
Medial rotation of the arm [16] Medial rotation of the arm is most easily observed when the elbow is held at a 90-degree angle and the fingers are extended so they are parallel to the ground. Medial rotation occurs when the arm is rotated at the shoulder so that the fingers change from pointing straight forward to pointing across the body.
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]