Physical Examination of Shoulder

Last updated: February 8, 2026Reviewed date: February 8, 2026Reading time: 3 min read
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The examiner must support the arm of the patient at the level of the elbow so that the upper extremity can be as much relaxed as possible. Then the examiner has to internally rotate the shoulder while at the same time perform a cross-body adduction...

For severe symptoms, danger signs, pregnancy, child illness, or sudden worsening, seek urgent medical care.

বাংলা রোগী নোট এখনো যোগ করা হয়নি। পোস্ট এডিটরে “RX Bangla Patient Mode” বক্স থেকে সহজ বাংলা সারাংশ যোগ করুন।

এই তথ্য শিক্ষা ও সচেতনতার জন্য। এটি ডাক্তারি পরীক্ষা, রোগ নির্ণয় বা প্রেসক্রিপশনের বিকল্প নয়।

Article Summary

The examiner must support the arm of the patient at the level of the elbow so that the upper extremity can be as much relaxed as possible. Then the examiner has to internally rotate the shoulder while at the same time perform a cross-body adduction of the arm. The test is positive if pain is elicited. Three physical tests used to identify a rotator cuff...

Key Takeaways

  • This article explains Physical Examination of Shoulder in simple medical language.
  • This article explains Special Tests in simple medical language.
Educational health guideWritten for patient understanding and clinical awareness.
Reviewed content workflowUse writer and reviewer profiles for stronger trust.
Emergency safety firstUrgent warning signs are highlighted below.

Seek urgent medical care if you notice

These warning signs are general safety guidance. Local emergency numbers and clinical judgment should always come first.

  • Severe symptoms, breathing difficulty, fainting, confusion, or rapidly worsening illness.
  • New weakness, severe pain, high fever, or symptoms after a serious injury.
  • Any symptom that feels urgent, unusual, or unsafe for the patient.
1

Emergency now

Use emergency care for severe, sudden, rapidly worsening, or life-threatening symptoms.

2

See a doctor

Book a professional medical evaluation if symptoms persist, worsen, recur often, affect daily activities, or occur in a high-risk patient.

3

Learn safely

Use this article to understand possible causes, tests, treatment options, prevention, and questions to ask your clinician.

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Definition

The examiner must support the arm of the patient at the level of the elbow so that the upper extremity can be as much relaxed as possible. Then the examiner has to internally rotate the shoulder while at the same time perform a cross-body adduction of the arm. The test is positive if pain is elicited. Three physical tests used to identify a rotator cuff injury include the drop arm test, empty can test, and Neer test. A more invasive test is known as the pain-relief test. In this, an orthopedic specialist injects lidocaine into the shoulder joint.Mar

Physical Examination of Shoulder

Follows the IP-PASS examination methodology

    • Inspection
    • Palpation
    • Passive Range of Motion
    • Active Range of Motion
    • Strength & Neurovascular
    • Special Tests

Inspection

  • Skin
    • Color: allergy, infection, or inflammation. সহজ বাংলা: চামড়া লাল হয়ে যাওয়া।" data-rx-term="erythema" data-rx-definition="Erythema means skin redness, often from irritation, allergy, infection, or inflammation. সহজ বাংলা: চামড়া লাল হয়ে যাওয়া।">erythema, ecchymosis, white, black
    • Trophic changes (altered hair growth, sweat production)
    • Scars
    • Swelling
  • Muscle tone: atrophy, hypertrophy
    • Rotator cuff atrophy
  • Deformity: asymmetry, rotation, amputation
  • Areas of emphasis for shoulder exam
    • Scapular winging?

Palpation

  • Palpate for
    • Effusion
    • Clicking
    • Snapping
    • Crepitus
    • pain when an area is touched or pressed. সহজ বাংলা: চাপ দিলে ব্যথা।" data-rx-term="tenderness" data-rx-definition="Tenderness means pain when an area is touched or pressed. সহজ বাংলা: চাপ দিলে ব্যথা।">Tenderness
    • Temperature
    • Masses
  • Areas of Emphasis
    • Acromioclavicular Joint
    • Sternoclavicular Joint
    • Coracoid Process and proximal Biceps Brachii
    • Insertion of Rotator Cuff (greater tuberosity)
    • Trapezius

Range of Motion

  • Shoulder
    • Abduction: 180 degrees
    • Adduction: 50 degrees
    • Forward flexion: 180 degrees
    • Extension: 50 degrees
    • External Rotation: 90 degrees
    • Internal rotation: 90 degrees
  • Elbow
    • Flexion: 150-160
    • Extension: 0

Strength

  • Abduction:
    • 0-90: Deltoid, Supraspinatus, Coracobrachialis
    • 90-180: Trapezius, Serratus Anterior
  • Adduction: Pectoralis Major, Latissimus Dorsi, Teres Major, Subscapularis
  • Flexion: Pectoralis Major, Deltoid, Coracobrachialis
  • Extension: Latissimus Dorsi
  • External Rotation: Deltoid. Infraspinatus, Teres Minor
  • Internal rotation: Deltoid, Teres Major, Subscapularis, Pectoralis Major, Latissimus Dorsi

Neurovascular

  • Motor Nerves:
    • Axillary Nerve: Abduction, External rotation, Shoulder flexion, and extension
    • Musculocutaneous Nerve: Shoulder flexion
  • Sensory Nerves
    • Needs to be updated
  • Dermatomes: C5-T1
    • Deltoid (C5)
    • Thumb (C6, median n)
    • Posterior 1st webspace (C6, radial n)
    • Middle finger (C7, median n)
    • Little finger (C8, ulnar n)
    • Proximal medial forearm (T1)
  • Deep Tendon Reflexes (C5-C7)
    • Biceps (C5, C6)
    • Brachioradialis (C6)
    • Triceps (C7)
  • Myotomes: C5-T1
    • C5: shoulder abduction
    • C6: Elbow flexion Wrist extension
    • C7: Elbow extension
    • C8: Finger flexion
    • T1: Finger abduction
  • Vascular
    • Radial pulse
    • Ulnar pulse

Special Tests

  • Subacromial Impingement Syndrome
    • Neers Test
    • Hawkins Test
    • Jobes Test
    • Painful Arc Test
    • Yocums Test
  • Rotator Cuff Disease: Subscapularis
    • Lift Off Test
    • Belly Press Test
    • Internal Rotation Lag Sign
    • Bear Hug Test
    • Resisted Internal Rotation Test
  • Rotator Cuff Disease: Supraspinatus
    • Drop Arm Test
    • Jobes Test
    • Painful Arc Test
    • Empty Can Test
    • Full Can Test
  • Rotator Cuff Disease: Infraspinatus/ Teres Minor
    • External Rotation Lag Sign
    • Hornblowers Sign (Patte Sign]
    • Resisted External Rotation Test
  • Proximal Biceps Tendon Injuries
    • Speeds Test
    • Yergasons Test
    • Passive Biceps Subluxation Test
    • Uppercut Test
    • Ludington Test
  • AC Joint Disease (Sprain, pain, swelling, stiffness, or reduced movement. সহজ বাংলা: জয়েন্টের প্রদাহ।" data-rx-term="arthritis" data-rx-definition="Arthritis means joint inflammation causing pain, swelling, stiffness, or reduced movement. সহজ বাংলা: জয়েন্টের প্রদাহ।">Arthritis, etc)
    • Crossover Test
    • Obriens Test
    • Resisted AC Joint Extension Test
    • One Finger Test
  • Glenoid Labrum (see: Shoulder instability, Biceps)
  • Shoulder Instability (General)
    • Internal Rotation Resistance Test
    • Crank Test
    • OBriens Test
    • Passive Compression Test
    • Dynamic Labral Shear Test
  • Anterior Instability/ Laxity
    • Apprehension Test
    • Jobe Relocation Test
    • Load and Shift Test
    • Anterior Shoulder Drawer Test
    • Shoulder Fulcrum Test
    • Anterior Release Test
  • Posterior Instability/ Laxity
    • Kim Test
    • Jerk Test
    • Posterior Apprehension Test
    • Posterior Shoulder Drawer Test
  • Inferior laxity Instability/ Laxity
    • Sulcus Sign
    • Gagey Test
  • Multidirectional Instability
    • Sulcus Sign
    • Load and Shift Test
  • Thoracic Outlet Syndrome
    • Wrights Test
  • Glenohumeral pain, swelling, stiffness, or reduced movement. সহজ বাংলা: জয়েন্টের প্রদাহ।" data-rx-term="arthritis" data-rx-definition="Arthritis means joint inflammation causing pain, swelling, stiffness, or reduced movement. সহজ বাংলা: জয়েন্টের প্রদাহ।">Arthritis
    • Passive Compression Test
  • Scapular Dyskinesis
    • Scapular Assistance Test
    • Scapular Retraction Test
    • Lateral Scapular Slide Test
    • Isometric Pinch Test
  • Suprascapular Nerve Injury
    • Drop Arm Test
    • Jobes Test
  • Winged Scapula
    • Scapular Assistance Test
Doctor visit helper

Prepare before seeing a doctor

A simple rural-patient checklist to help you explain symptoms clearly, ask better questions, and avoid unsafe self-treatment.

Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

Orthopedic doctor, rheumatologist, or physiotherapist depending on cause.

What to tell the doctor

  • Write which joints hurt, swelling, morning stiffness duration, fever, injury, and walking difficulty.
  • Bring X-ray, uric acid, ESR/CRP, rheumatoid factor, or previous reports if available.

Questions to ask

  • Is this injury, osteoarthritis, rheumatoid arthritis, gout, infection, or another cause?
  • Which exercises, supports, or lifestyle changes are safe?
  • Do I need blood tests or X-ray?

Tests to discuss

  • Joint examination and range of motion
  • X-ray when chronic arthritis or injury is suspected
  • ESR/CRP, uric acid, rheumatoid tests when inflammatory arthritis is suspected

Avoid these mistakes

  • Do not ignore hot swollen joint with fever.
  • Avoid repeated steroid injections/tablets without a clear diagnosis and follow-up.

Medicine safety and first-aid guide

This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

  • Drink safe fluids and monitor temperature.
  • In dengue-prone areas, discuss CBC and platelet count when fever persists or warning signs appear.
  • Use tepid sponging for high fever discomfort; avoid ice-cold bathing.

OTC medicine safety

  • For fever, common fever medicine may be discussed with a clinician or pharmacist.
  • Avoid aspirin/ibuprofen-like medicines in suspected dengue unless a doctor says it is safe.

Avoid these mistakes

  • Do not start antibiotics without a proper medical decision.
  • Do not use steroid tablets or injections casually for quick relief.
  • Do not delay emergency care because of home remedies.

Get urgent help if

  • Fever with breathing difficulty, confusion, repeated vomiting, bleeding, severe weakness, stiff neck, or dehydration needs urgent care.
Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

For rural patients and family caregivers

Patient health record and symptom diary

Write your symptoms, medicines already taken, test results, and questions before visiting a doctor. This note stays on your device unless you print or copy it.

Doctor to discuss: Doctor / qualified healthcare provider
Tests to discuss with doctor
  • Basic vital signs: temperature, pulse, blood pressure, oxygen level if needed
  • Relevant blood, urine, imaging, or specialist tests only after clinical assessment
Questions to ask
  • What is the most likely cause of my symptoms?
  • Which warning signs mean I should go to emergency care?
  • Which tests are really needed now?
  • Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Safe pathway to proper treatment

Care roadmap for: Physical Examination of Shoulder

Use this simple roadmap to understand the next safe steps. It is educational and does not replace examination by a doctor.

Go to emergency care if you notice:
  • Severe or rapidly worsening symptoms
  • Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration
Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.
  1. Step 1

    Check danger signs first

    If danger signs are present, seek emergency care and do not wait for online information.

  2. Step 2

    Record the symptom story

    Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.

  3. Step 3

    Visit a qualified clinician

    A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.

  4. Step 4

    Do only useful tests

    Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.

  5. Step 5

    Follow up and return early if worse

    If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips
  • Take a written symptom diary and all previous prescriptions/test reports.
  • Do not hide medicines already taken, even herbal or over-the-counter medicines.
  • Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

RX Patient Help

Ask a health question safely

Write your symptom story. A health professional or site editor can review it before any answer is prepared. This box is not for emergency care.

Emergency first: Severe chest pain, breathing trouble, unconsciousness, stroke signs, severe injury, heavy bleeding, or rapidly worsening symptoms need urgent local medical care now.

Frequently Asked Questions

Is this article a replacement for a doctor?

No. It is educational content only. Patients should consult a qualified clinician for diagnosis and treatment.

When should I seek urgent care?

Seek urgent care for severe symptoms, rapidly worsening condition, breathing difficulty, severe pain, neurological changes, or any emergency warning sign.

References

Add references, clinical guidelines, textbooks, journal articles, or trusted medical sources here. You can edit this area from the RX Article Professional Blocks panel.

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