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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] Once rotated, the clinician pushes down on either the wrists or the elbow, and the patient is instructed to resist the downward pressure.
This is a shortened version of the thirteenth chapter of the ICD-9: Diseases of the Musculoskeletal System and Connective Tissue.It covers ICD codes 710 to 739.The full chapter can be found on pages 395 to 415 of Volume 1, which contains all (sub)categories of the ICD-9.
Localized pain on the anterior shoulder suggests subacromial impingement, whereas posterior shoulder pain suggests internal impingement. [45] For the diagnosis of full-thickness rotator cuff tear, the best combination appears to include once more the painful arc and weakness in external rotation, and in addition, the drop arm sign . [ 42 ]
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]
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.
The shoulder joint is considered a ball-and-socket joint. However, in bony terms the 'socket' (the glenoid fossa of the scapula) is quite shallow and small, covering at most only a third of the 'ball' (the head of the humerus). The socket is deepened by the glenoid labrum, stabilizing the shoulder joint. [1] [2]
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The Spencer technique (also known as the "7 stages of Spencer") is an articulatory technique used in Osteopathic medicine to help relieve restriction and pain at the shoulder. [1] Although variations exist, normally 7 steps are included. [2] Indications for the Spencer technique include adhesive capsulitis. [3] The following is a common ...
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