Shoulder R L
Injury__________________________________ Trauma? ________________ Sports injury_______________ Overhead injury
(Date)________
Noninjury_____ How long has the problem been active _________
Popping_____ Clicking ________ Catching______
Night pain________________ Weakness in arm
Sharp (when) _______________ Dull/Ache (when) ______________ Constant (at rest) __________
Pain Level (non-active) ____/10 (activity)____/10
Maximum point of pain_____
What makes it worse: ______________________ Better: _____________________
Been seen for this in the past: ______________________ What tests or treatment_____________________
EXAM
Inspection: Ecchymosis __Erythema or warmth____ Edema/Swelling____ Deformities______ Atrophy_____
Muscle asymmetry____ Scapular Winging_____
Palpation: Tenderness _____________ AC joint _____ Bicipital groove tenderness_____
Range of Motion: Extension_______ Passive: Extension _______ Internal Rotation______ External (80-80) _______
Strength: Adduction _____ Deltoid _____ RCT supraspinatus 3-4/5
Rotator Cuff: AROM significantly less than PROM + Hawkin’s older=gradual onset youth=trauma
Abduction: _____ External Rotation (elbow bent) _____ Gerber’s Lift off test _______ Empty Can _____ Joint Stability_____
Bicep/Labral: Speed’s _____ Yergason’s ______ O’Brien’s_______ Crank _______
Impingement: AC joint tenderness ______ Hawkins _______ NEER: _______ Neg: speed, yergson’s, Obrien's.
AC Joint disease: Localized pain ______ Night Pain______ Step off pain______ Scarf (pressed crossbody) ______ Crepitus ____
Painful Arc @ 150-180 degrees.
Chronic Shoulder Instability: Sulcus _____ Apprehension test with relief on pressure to joint _____
Neurovascularly Intact: __________
OA: Generalized Joint tenderness, AC tenderness with limited AROM
