The examiner should watch the relative amount of scapular movement. To accomplish Shoulder Adduction movement, the patient first flexes the arm to 90° and then moves the arm across the front of the body. The secondary adductors of the shoulder joint are: Normal Range of Shoulder Adduction is 50–75°. – Clavicle 30–50° posterior rotation and up to 15° elevation. – Humerus 60° abduction and 90° external rotation to clear the greater tuberosity from the acromion process. – 20° of scapular rotation, with minimal protraction or elevation, making a total of 60° of abduction in this phase (2:1 ratio).
– Scapula minimal movement (setting phase). This is divided into 3 phases as follows: Phase 1 Normally, the abduction at the shoulder happens via the scapulohumeral rhythm which comprises of movement of the humerus, scapula and the clavicle.
Abduction of shoulder full#
If the patient is able to perform full active movements, there is no requirement for passive testing of movements. Additionally, the character of the blockade to motion can be assessed passively, with a soft and elastic end point suggesting soft tissue contractures and a firm end point pointing to a bony blockade. In the scenarios with pain, weakness and cuff injury the patient will have reduced active movements, but on testing the movements passively, one would see that the arc of motion is fairly preserved in some cases. This is because patient may have reduced movement in the joint due to pain, weakness, tendon injuries and bony or soft tissue blockade to motion. Thawing stage starts when range of movement at the joint begins to improve.Shoulder Range Of Motion needs to be assessed actively and passively.
A capsular pattern is therefore evident with most loss of external rotation followed by flexion/abduction and then internal rotation There is little change to the level of pain during this stage but range of movement loss can progress further. Generally lasts for 3 – 9 months and is characterized by an acute synovitis of the glenohumeral joint Freezing/painful stage pain, worse at night decrease active and passive movement.There are three distinct clinical phases: Normally classified as either primary: insidious onset of pain and progressive loss of movement at the shoulder or secondary generally due to some form of trauma or subsequent immobilisation.Rarely occurs simultaneously bilaterally although it can occur sequentially bilaterally.A typical patient would be female in her 5th to 7th decade of life.Often described as self-limiting the majority of which resolve in 1-3 years although some patients will experience longer term movement deficit which lasts up to 10 years.Common condition affecting 3 – 5% of the general population and 20% of the diabetic population.
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