Testing strength and range of motion as part of assessment of the musculature of the shoulder girdle is important and useful as a first step in reducing shoulder pain and improving shoulder function. There many assessment techniques that are used by massage therapists and physiotherapists (although obviously massage therapists are not permitted to diagnose conditions).
Typically the assessment of the shoulder will include the following steps:
1. Visual assessment – including active movement of the shoulder.
2. Passive movement of the shoulder.
3. Strength testing by resisted movement techniques.
Specific routine that may be used
Online assessment videos
Neck ROM – flexion, extension, rotation, lateral flexion looking for Px and restriction
Shoulder ROM – forward flexion, adduction (looking at scapula movement – comparing L/R)
Internal rotation – hand up behind back – compare L/R
External rotation – elbows by side
Horizontal adduction – arm across chest. Px may be indicative of AC joint pathology
Resisted movements – for adduction firstly in full can position, half can and then empty can. Internal/external with 90° of adduction.
Lift of test – push arm out from back with resistance is indicative of subscapularis pathology
Impingement test – forward flexion with internal rotation + shoulder abducted at 90°
Speeds test – biceps pathology
3.15 Scapula assistance test. One hand on upper trapezius/other on the medial/inferior border of scapula. Assist upward movement of scapula with abduction. Greater ROM/reduced Px is indicative of scapula control being important part of rehab.