What will happen during a physical exam to diagnose a shoulder problem?

Kristofer J. Jones, MD
Orthopedic Surgery
To diagnose a shoulder problem, your doctor will perform a routine clinical examination and obtain standard x-rays, which typically leads to a correct diagnosis in the vast majority of cases.

For any physical exam that involves the shoulder, you will need to put on a gown so that your doctor can visually inspect the shoulder and your cervical spine. All physical exams should start with the neck to ensure the cervical spine is not playing a role in your symptoms. Specific tests such as Lhermitte's and Spurling's tests should be performed. These determine whether or not you have any impingement of the nerves that are coming out of the cervical spine. That's what can cause the referred pain that comes down to the shoulder or even further to the elbow, hand and fingers. 

Visual inspection is important. Your doctor will want to look at the deltoid muscle (the muscle that runs along the side of the shoulder), the supraspinatus muscle and the infraspinatus muscle (two of your four rotator cuff muscles) to detect any signs of atrophy (muscle wasting). He/she will look for skin changes such as scars, including previous scars that would indicate trauma. He or she will then focus on palpation of all the relevant anatomical structures to see if there are any clear pain generators, such as the biceps tendon (from tendonitis) or the AC joint (from AC joint arthritis).

He or she will test active and passive range of motion to see what you can do when your shoulder is moved either on its own or with your doctor’s help. That can be very different sometimes. 

Additionally, strength should be measured to determine if the pathology may be causing any weakness with certain motions such as forward flexion and internal/external rotation. 

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.