shoulder impingement

[Sillevis]

What should be the clinical tests to perfrom to determine that there isa case of shoulder impingement. Can we establsih if the is a cuff tear? partial or complete?
What should be the clinical approach for patients with impingement symptoms?

[Paula]

The special tests that I use in addition to rom/strength for patients with a shoulder diagnosis are the Neer's Impingement, Hawkin and Abrams Impingement, Supraspinatus test and drop arm test. I believe that partial tears demonstrate more pain intensity than complete tears. Most tears in my experience are partial tears of the supraspinatus or infraspinatus and of course respond very well to conservative PT rx. Appoach should be ROM, jt mobs, strengthening/stabilization to include closed chain exercises, STM/MFR and kinesio tex taping for functional correction significantly helps with impingement and RTC issues.

[Sillevis]

So it seems that cluster of tests could lead us to the diagnosis of RTC. It appears from the literture that the combination of the painful arch sign, Hawkins-Kennedy test, and external rotation lag sign could increase the probabaility that we are dealing with a RTC.

[Paula]

Yes, I agree. Also, may I ask what source or sources do you use for the evidence based findings. Do you have a particular web site that you use?

[Sillevis]

Josh cleland's book titled Ortopaedic clinical examination is a great one to have, this could help you quite a bit to look at the research as it relates to clinical testing.