Shoulder Examination Inspection & Palpation - Everything You Need To Know - Dr. Nabil Ebraheim
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- Опубликовано: 26 окт 2016
- Dr. Ebraheim’s educational animated video describes shoulder impingement examination and palpation, explains its signs and symptoms, etiology, prognosis, and treatment options in a simple and easy way.
When you examine the patient with a shoulder problem, you need to look at the shoulder.
Inspection of the shoulder is not as easy as inspection of the lower extremity.
Start looking at the muscles, if they are small, atrophied, wasted or big.
So if you look at the back and you find that the suopraspinatus is wasted, then you should start thinking about the suprascapular nerve, if the patient is young, or maybe a couple of tears if the patient is old.
Then you start inspecting the deltoid, check its size and compare it.
Then the biceps, flex the elbow and test it, rule out the tear, biceps tear maybe associated with rotator cuff tear.
Look at the pectoralis and the axillary fold, make sure that the folds are the same on both sides.
Look for deformities:
- Are the shoulders at the same level?
- Does the patient have AC separation?
- Are the clavicles sticking out?
- Does the patients scapula winging? And what type of winging? Is it a medial or a lateral winging?
Then we look at the scars: the scars of previous surgeries and where is it located, because we may incorporate these scars in our future surgery.
Then we look at the swelling, it’s hard to see but sometimes you can see it.
Also we look at the skin, do you have redness around the shoulder?
Palpation:
You are going to palpate all the bony prominences around the shoulder and also the important muscles.
Start from the sternoclavicular joint, to the clavicle, to the AC joint, the AC joint can be a source of pain, the you go to the coracoid process, to the axillary crease, then try to role the finger to find the biceps, and find out if you have a biceps tenderness or not, then palpate the pectoralis tendon at the axillary fold, tenderness over the leading edge of the acromion can be an impingement syndrome or a rotator cuff problem, palpate the deltoid, the trapezius, then palpate for trigger points: which comes from the levator scapulae muscle and physiotherapy will make a big deal about it, then you make the decision: is it a neck problem or a shoulder problem.
Don’t miss the cervical spine: palpate the posterior cervical spine and examine the movement of the spine, check the spurling maneuver.
Palpate the spine of the scapula the medial border of the scapula, the lateral border of the scapula; in slap lesion we have pain in the posterior edge of the acromion in the soft spot.
So as you can see It is a 360° palpation, and don’t miss the cervical spine.
You may actually start the examination by examining the neck first, then the trapezius, then the clavicle, and start the 360° examination.
Try to check for any crepitus or any swelling, go after the known area of anatomy that can elicit tenderness, that can lead you to the diagnosis.
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How can I Thank You for all your effort to make such an incredible video you made for us. I learn so much and helping others.... Much Love to YOU dr. Nabil..Xoxox
Quite a wonderful and enlightening education.Thanks for the selfless gift to those who want to know how wonderfully we are made. Excellent explanation and illustration..
Very helpful, experience combined with knowledge and rationale
thank you
excellent explanation and presentation
Big Thanks. Exactly what I have specially min 3:33. 3 months and same problem.
super stuff Dr, thank you ...
Excelente Dr. Thank You very much.
Thank you, Doctor, I have the same problem I do not find one knows the correct treatment her
Thankyou for the videos. Can you please make a video on knee and hip examination as well. That would be really helpful!
Thanks
Very good and informative video! Dr, Is this just informative or do you actually see patients with these potential issues? If so, I would love to travel to you or If you could recommend someone in the Midwest. I live in Wisconsin but willing to travel to see the right specialist
Thanks
Can you make video telling shoulder problem with required exercise
How can you palpate the bone structures if the patient has high muscle density?
could u plz tell me how can l relax from the pain
awesome
Palpitating the deltoid causes severe pain. What's the possible diagnosis? Calsifetic tendonitis shows up an x-ray of the supraspinatus. Does it mean there's also a tear?
dr my shoulder muscles don't develop after Jim
Evidently the first thing you check for is posture. Have them stand up in a relaxed position and stick their thumbs out. Thumbs pointed straightforward is good posture. Thumbs pointed towards each other is bad posture and evidently is the cause of my shoulder problems that hundreds of doctors and physical therapist could not detect. Only a chiropractor figured it out. The practice of medicine is just that. They are practicing on people. Chiropractors is a science.
mera right hand km ni krha plz help
Tq sir
plz tell who is the appropriate specialist for this examinational ? spinal specialist or neurologist ? physiotherapist? or who ? please please reply
pysioterapist
ياريت تقدم فديوهات باللغة العربية عشان انا عارف انك عالم كبير على فكرة انا لاعب كمال اجسام وعايز استفيد منك
Hmmm .. what do you do if youve had two surgeries and still have every single problem/symptom listed in this vid? Seen over 12 different "specialists" who haven't been able to provide any information or help
What was your diagnosis and was your cervical spine ever checked?
@@mohammedjawad1873 initial injury was from football.. a collision with arm extended but in a chicken wing position. Complete numbness, felt like the arm was in my neck. Bent over and shook it until it popped in. continued to play and dislocated/separated multiple times.
from what I can remember: torn labrum, bony bankhart lesions, rotator cuff tear, bicep tendonitis, scapular dyskinesis, intramuscular edema throughout Teres major and within posterior belly of deltoid muscle.
I have 10 degrees external rotation to 70 on my right. Left clavicle protrudes out slightly more and inwards towards trachea.. feels like I have something stuck in my throat. Any cross body or pushing motion/exercise makes tendon near AC joint inflamed and pushes against collar bone. When doing any physical therapy or light weight lifting, I cannot activate my lat, rear delt, lower pec, outer tricep.
In relaxed state, shoulder droops forward and internally rotated. When trying to pull back scapular , shoulder still remains drooped forward. Arm, shoulder, collar bone and upper trapezius feel significantly shorter.
Every specialist has said there is an obvious problem , but without being able to pinpoint exactly what the cause is on my MRIs, they say I can't help you and send me to another specialist. Only one doctor at HSS was willing to admit that he will not know exactly what is wrong until I am under the knife. Due to insurance and the pandemic , I never went through with a third operation. It's been 5 years since last operation, and after consistent physical therapy for 2 years, I still have the same ROM and no real improvement.
I have not gotten anything examined with my cervical spine.
@@mohammedjawad1873 I just recently turned 25 so it has been very stressful. I've spent hundreds of hours of trying to diagnose myself since no one seems to be able to help me and/or they do not want to take on the liability of a third operation. At this point, I'm just grateful that you even responded to my first comment. Thank you
Physiotherapist make a big deal about it??
In what sense was that said?
My doctor did none of this.... Time for a new doctor.
2:50 All was cool until wtf?!