Shoulder Examination / Subacromial, Cuff - Everything You Need To Know - Dr. Nabil Ebraheim
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- Опубликовано: 1 окт 2024
- Dr. Ebraheim’s educational animated video describes the clinical evaluation tests for Shoulder and Rotator Cuff injuries.
Neer’s test
•Position of the patient: patient is standing or sitting upright.
•Performing the tets: the examiner will passively elevate the pronated arm of the patient above the level of the shoulder.
•Positive finding: pain at the anterolateral aspect of the shoulder indicates subacromial impingement.
Hawkin’s test
•position of the patient: patient is standing or sitting upright with the arm fully adducted and forwardly flexed. The elbow is also flexed.
•performing the test: the examiner will place one hand on the patient’s shoulder and apply internal rotation to the affected arm with the other hand.
•positive findings: pain at the shoulder indicates subacromial impingement.
Drop arm test:
•position of the patient: patient is standing or sitting upright.
•performing the test: the patient is asked to hold the affected arm in abduction at the level of the shoulder then smoothly adduct the arm.
•positive findings: a patient who is suffering from a rotator cuff tear can lower the arm smoothly to the side. A patient suffering from a rotator cuff tear will not be able to hold the arm in abduction and the arm will drop rapidly.
Belly press test
•position of the patient: patient is standing with the hand of the affected arm at rest against the stomach with the elbow anterior to the midaxillary line.
•performing the test: the patient is then asked to press the belly using the affected arm without moving the elbow.
•positive findings: failure to maintain the elbow anterior to the midaxillary line while pressing against the belly indicates predominantly an infrapsinatus tendon tear.
Lift off test
•position of the patient: patient is standing with affected arm internally rotated behind the back so that the dorsum of the hand will be resting on the lumbar area.
•performing the test: the examiner will passively lift the arm away from the patient’s back.
•positive findings: once the examiner releases the arm, failure to maintain the position of the arm away from the back indicates a subscapularis tendon tear.
Adduction/external rotation test
•position of the patient: patient is standing with the affected arm adducted (slightly abducted) and elbow flexed.
•performing the test: the examiner will fully externally rotate the arm.
•positive findings: with the release of the arm, failure to maintain active full external rotation indicates a supraspinatus and infraspinatus tendon tear.
Jobe test
•position of the patient: patient is standing or sitting upright. The arm should be anteriorly flexed at the level of the shoulder. Fully pronate the arm into “empty can position”
•performing the test: the patient should resist the downward force applied on the forearm by the examiner.
•positive findings: pain or weakness indicates a supraspinatus tendon lesion.
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Nice video,Doc. But just one error: Belly-press test is to detect SUBSCAPULARIS muscle whose function is to internally rotate the humerus, not infraspinatus(lateral rotate).
Impingement test
1. Neer test- Arm passively flexed from elbow
2. Hawkins test- Shoulder flexed and adducted. Elbow flexed across chest.
IR applied. Pain
Rotator cuff tests:
1. Drop arm test- Supraspinatus, cannot lower arm from abduction
2. Belly press test- Subscapularis unable to press on stomach without bringing elbow anteriorly, in front of midaxillary line
3. Lift off test- Subscapularis
Unable to keep arm away from small of back when IR
4. Adduction/ER- Supra/infra spinatus
Arm placed into adduction and ER
Failure to maintain full ER
5. Jobe test- supraspinatus
Anteriorly flexed and fully pronate
Resist downwards force, pain or weakness
Innervation:
Supraspinatus & Infraspinatus- Supraspinatus nerve
Subscapularis- upper and lower Subscapularis nerve
Teres minor- Axillary nerve
Action
1. Supraspinatus- Abducts
2. Infraspinatus- Greater tubercle, ER humerus.
Test for ER weakness
3. Teres minor- Greater tubercle, ER
4. Subscapularis- Lesser tubercle, IR
See Hyperabduction and ER
Lift off and belly press
Guys.. why my shoulder blade keep making sound? Only right tho T.T it's like 9 years after i fall straight to floor but i stop my fall with my elbow when im like 11 years old and it hurt like hell after the fall but im not see any doctor and let it recover itself. Now im almost 22 and i more aware of this shoulder blade of mine when im doing any work, my right hand feel easy to tired. I cant describe the "sound" on my shoulder blade but i guess it's like.. "clicky sound"? Also, does it effect my growth on my clavicle as my clavicle is not so "wide" and and my muscle between my neck and the collarbone is small (maybe genetic but idk T.T).
9 by,,,v
I WAS UNABLE TO GET ALL THE TESTS IN ONE PAGE
WILL HAVE SUBSCAP EXAM VIDEO
you are correct ,the test is for subscapularis tear
Belly press test
2:08 belly press test -> infraspinatus? Please correct with subscapularis
+HCarota I agree the belly press is testing the patient's strength in medial rotation of the humerus, i.e., subscapularis.
In fact it seems logical : the infra-spinatus maintain the posterior position the humeral head in the way this belly-press test is done ... If the elbow went posterior due to deficiency of the infra-scapularis i would agree with you : it's a quite disturbing way to do the test.
I agree
so, I had a positive result for the impingement tests, as well as the jobe test indicating a supraspinatus tendon lesion. What would need to be done for a supraspinatus tendon lesion? will it clear up if I just do theraband exercises to alleviate the impingement?
I agree
Doctor I salute your clarity and contributions.
this is what practitioners need to help the patients thankd for this video more power
one of the best videos I've ever watched
Belly press test is for subscapularis muscle. Sir you have probably by mistake showed that it is for infraspinatus muscle.
You must have categorize shoulder test as follows
1) impingement test( neer, hawking, scarf or cross arm test.)
2) instability tests. ( sulcus test, anterior n posterior translation or load shift test, apprehension test, jobes relocation test)
3) rotator cuff insufficiency tests( empty can test for supra spinatus, gerber lift-off and belly press tests for subscapularis, adduction external rotation for infraspinatus, abduction external rotation or horn blower test for teres minor.)
mentioned the instabilty tests as well.
Thank u for explanation do u have telegram group or what-app i like your explanation
Wc. Sir. No i am just orthopedic surgery resident in pakistan
@@drmubashir Do u have group on telegram ?
Excuse me sir drop arm test for which muscle ?
Drop arm test is positive in supra spinatus full thickness tear
Nice video and informative too sir ; but in the test heading " Belly Press Test " ; you write it for subscapularis muscle , but in demonstration of test you have written Infraspinatus tendon lesion. Any explanation Pl .
thanks
My back shoulder got a pain when i use hawkin's test, what should i do to release from the pain treatment?
انا كنت اتمرن كمال الاجسام 10سنوات واصبت في الكتف والاصابة استمرت ست سنوات لا استطيع ان اتمرن البنش برس وتمارين الظهر عملت اشعة رنين وما زالت المشكلة والالم في هذا المفصل اللعين عملت اشعة رنين لايوجد شيء هل اتمرن ام لا وما السبب وراء الالم بالرغم ان المفصل سليم اذا كنت تتحدث العربية احتاج الي نصيحة منك وللك جزيل الشكر والتقدير
thanks
thanks
It is really very helpful for those who have shoulder pain. Nice video sir.
Yahhoo news
THANKS
I have pain with every test.. I box... I don’t like this..
very nice post. tks.ok it hurts me when i do belly press (5) lift off test (9) external rotation (7). what should i do?
A question regarding the belly press test. Your summary slide for all the tests indicates it is a test for subscapularis. The more detailed explanation at 2:04 indicates it is for infraspinatus. Is it for both?
THANKS
SPREAD THE WORD
thanks
THANKS
THANKS
THANKS
THANKS
I had a heart attack at 3:44
This test is for detection of a SUBSCAPULARIS tear. NOT INFRASPINATUS
very nice video!!
okay but i mean that internal rotation of the arm is the subscapularis muscle working, not the infraspinatus....but if it is, that i guess its the infraspinatus muscles inability to stabilize?
once i identify what is the injury, what is the treatment for each findigs? please
THANKS
Thank you!
You spent your time to better educate people who you don't know them but they will apply your knowledge to their patients. I deeply appreciate your kind intention and efforts. Vahid
Wow, this is pure gold! Thank you so much!
What kind of doctor can perform these tests for me? I am in so much pain and do not know why. Please help.
I lift weights. My shoulder feels fine usually. It hurts when I extend my arm out to the side. If I try to press something with my arm away from my body, it hurts. I can press if I keep my arm close to my body. No pain when I sleep.
Me too
Sir Bellypress test displays as infraspinatus pathology in your video. M confusing
non of these helped with telling me what shoulder injury I have, if anyone can help please send me a message or comment on this post. If I flex my left trap it triggers pain at what seems like the end of my clavicle closes to my humerus.
I'm on the same boat
Why Nabil sir is not responding?
thank you very much for this great video
change the music its really irritating
+RestoreEyesightNow Turn it off man and watch the vid. Somebody puts up such an educational vid for free and here you are cribbing about the music.
I like it :D
There are a few factors in about this . One plan I found which succeeds in merging these is the Seans Shoulder Fixer (google it if you're interested) it's the best guide i've seen. Check out the interesting info .
Do you have any videos to cure this?
Which apk u use for making special test video??
The deltoid only starts to be the primary abducter when the arm is 25 degrees or so from neutral. The supraspinatus does the first part. Also when the rotator cuff tendons are inflamed,the impingement keeps smooth abduction and adduction even at 90 degrees or so. Excellent video Dr. Nabil!
Wrong things
Fire beats in the background
الترجمة .الصور توضح حالتي هذا ما دفعني للمتابعة والتعليق برجاء العلاج أوالنصيحة
Thank you for sharing
I can't help but think this was named after Chief O'Brien's shoulder.
damn it the lift-off test got me good.. time to go see a doctor
I have pain but none of these works. But when i cross hold other shoulder through front side i feel pain. So could you please identify the painful part from that?
Would not the Adduction / External rotation test indicate an infraspinatus and teres minor tear instead of a supraspinatus tear, since the the supraspinatus muscle does not intervene in rotation of the shoulder?
+Alexander Martinez The supra is involved in the first 15 deg of abduction.
I'm in pain just watching this. 6 weeks post-op SLAP tear & biceps tenodesis.
Thank you for the great videos Dr. Ebraheim. However, I don't quite understand the drop arm test. I thought that the deltoid muscle would keep the arm raised but it's not part of the rotator cuff. So how is the test related to the rotator cuff muscles? I've just started anatomy so I'm probably missing something very obvious.
very interresting thanks alot
If rotator cuff tear,is it comes to normal without taking any medication???
Your Video is good except for the distracting music. I hope this feedback is useful to you as much as to future audience.
VERY MUCH SIMPLE AND USEFUL...THANK YOU
👍👌
With all of these tests, I think that jumping to the conclusion of a tear or a lesion in the muscle or tendon is a bit premature. You would first have to rule out an imbalance of tension in the antagonist muscles, or a condition where the indicated muscles may be fatigued or atrophied due to overuse or misuse, habitual postural defects, etc. Combine these with specific muscle tests and you will get a much more accurate picture of what is going on.
Thanks for the video. Its a good reference when trying to understand my shoulder pain.
music is very soothing .... please tell me where from you got this
I see the comment now...
Thank you, Professor. Bless You.
No music plz we want explanation
None of these are positive for me. What hurts though is lateral movement about halfway up. I can control it fine up and down.
verry good job!
i have pain in shoulder for 5 years. i can feel the hurting tendon or muscle when i press it. i even have pain while at rest
Audio has been tampered with
It seems that I have subacromial impingement in my left shoulder ;(
should the belly press test not have been for the subscapularis??
Y
I have problem in my in rotating
Help me plz.
Thanks for your dedicated experiment for medical science and the sake of people
I'm confused . My shoulder hurts even when I'm not doing anything. Just lying down. My doctor diagnosed it as impingement. I'm doing exercises for this but it seems like it don't feel better. Help
I feel no improvement and it hurts a lot. I can't sleep
thanks a lot ^_^
Thank you both for watching. Please share the videos you enjoy.
Great video. Thanks!
shoulder exercises dislocated
I cannot position my arm to take any of these tests. Pain in upper shoulder
Excelente, gracias.
Salamat po...🙏
thanks a lot dr ebrahim
Very helpful video
Xlent vedio
Nabil Are you professor or Doctor, thanks for sharing all test?
Idont understand my self i just fel the red one on the video and with sound like is get broken -__-
Awesome video Sir. which tests would you suggest to use on the sports field, hockey soccer or rugby as there so many
Thank you!
Thank you.
cool video
my shoulder has been keeping me from lifting weights for about a month but I do know I didn't tear my rotator cuff... any ideas what could be the cause of the discomfort in my shoulder
Shoulder impingement?
Or osteolysis of the distal clavicle : common cause of pain and loss of shoulder strength for the weight lifters. There are many possibilities in fact : get a professional opinion before it gets worse.
Damn all. Of the above
I m hurt each one.... why can I do, plz
play with the penis less.
Sir hinde me
Mii de mulțumiri!
جزاك الله خيرا
Excellent Video
good
very useful. THANKS