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 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.
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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 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
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