Shoulder Eval and Exam

Question 1

What are the 3 types of scapular motion?

Answer 1

(A) posterior (upward/downward rotation) - occurs with humeral elevation
(B) superior (internal/external rotation), and
-with ER, medial boarder moves closer to thorax, lateral boarder moves away
(C) lateral (anterior/posterior tilting) views

Question 2

The scapulothoracic joint isn’t a true synovial; mobility is needed for function. What 4 glides does it do?

Answer 2

1. Cranial
2. Caudal
3. Medial
4. Lateral

Question 3

Name the 3 scapular mobility functional tests described at the 2009 scapular summit.

Answer 3

(1) Scapular reposition test
-The scapula is moved toward posterior tilt and external rotation, while the patient generates an elevation force. This test has demonstrated reliability and has been shown to produce decreased pain and increased strength in a subgroup of overhead athletes, but decreased pain
and increased strength were not related

(2) Scapular retraction test
- The scapula is passively moved toward posterior tilt and external rotation with slight voluntary retraction. This test is very similar to the scapular reposition test and has been shown to increase elevation strength in patients and healthy subjects. This test appears to be altering scapular kinematics by increasing posterior tilt, external rotation, and scapular retraction as compared to elevation against resistance without the scapula stabilized

(3) Scapular assistance test
- Scapular upward rotation is manually assisted during arm elevation. This test has demonstrated reliability and has been shown to reduce pain in approximately half of symptomatic patients tested. This test appears to be altering scapular kinematics by increasing posterior tilt and decreasing scapular elevation

Question 4

What is the purpose of the previously described scapular mobility and function tests (scap assessment)?

Answer 4

We’re taking an aberrant tissue that is out of place and putting it into the normal position to see if pain is relieved.

Question 5

The acromion is concave on a convex clavicle. What is the purpose of a ventral glide at the AC joint?

Answer 5

Usually done by mobilizing clavicle on acromion. Restores AC motion.

Question 6

What is a SPADI?

Answer 6

Shoulder pain and disability index.
1. Pain scale
2. Disability scale
0% best, 100% worst

MDC = 13 (90% CI)

Question 7

Describe the 4 different glides at the SC joint and their restorative purpose.

Answer 7

1. Cranial (superior) glide purpose: restore extension
2. Caudal (inferior) glide purpose: restore elevation or flexion
3. Dorsal glide purpose: restore retraction
4. Ventral Glide purpose: restore protraction

Question 8

Describe the glides and their purpose at the GH joint.

Answer 8

1. Distraction technique - short axis
   Purpose: assess overall capsule joint play
2. lnferior (Caudal ) Glide
   Purpose: (restore GH abduction and flexion)
3. Dorsal Glide
   Purpose: (restore GH IR and flexion)
4. Ventral Glide
   Purpose: assess ER and extension