How is a physical exam performed in suspected rotator cuff injuries?

Updated: Oct 25, 2018
  • Author: Gerard A Malanga, MD; Chief Editor: Craig C Young, MD  more...
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Answer

Approach the shoulder examination systematically in every patient with a suspected rotator cuff injuries. Expose the entire shoulder and perform inspection, palpation, ROM testing, motor strength testing, and special shoulder tests as clinically indicated.

Inspection

Examination begins with patient observation during the history portion of evaluation. Carefully inspect the shoulder from the anterior, lateral, and posterior positions. Note any swelling, atrophy, asymmetry, or other findings.

Supraspinatus and infraspinatus atrophy can be observed in massive rotator cuff tears and in entrapments of the suprascapular nerve.

Scapular winging is rare in rotator cuff injuries; however, ST motion abnormalities are often present and should be addressed as part of the treatment plan.

Palpation

Tenderness is often localized to the greater tuberosity and subacromial bursa.

The biceps tendon is palpated anteriorly in the bicipital groove and can become inflamed and painful in this condition.


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