Impingement pain
Rotator cuff tear
Shoulder OA
Frozen shoulder
AC joint dislocation
Shoulder dislocation
Shoulder fractureTo help the student understand how the assessments work, these diagnostic guides outline the path that the assessments take that lead to relevant treatment...
1: Has there been a fall/ accident? No = go 3
3: Can the patient lift their arm above their head? Yes = go 4
4: Is there pain in the middle of the movement? Yes = go 5
5: Holding arm out in front, with thumb down, push up against physio’s hands. Is it painful? Yes = go 6
6: Hold arm up at 90° flexion with elbow bent. Internally rotate. Is it painful? Yes = Impingement
Impingement treatment 
1: Has there been a fall/ accident? No = go 3
3: Can the patient lift their arm above their head? No = go 10
10: Is the patient between 45-55 years old? No = go 11
11: Can the patient move their arm as far as possible, even if painful, without help? No = go 12
12: Put hand behind back. Can the patient lift hand away from body? No = go 13
13: Can you lift the arm further than the patient can lift it? Yes = Rotator cuff tear
Rotator cuff tear treatment
1: Has there been a fall/ accident? No = go 3
3: Can the patient lift their arm above their head? Yes = go 4
4: Is there pain in the middle of the movement? No = go 7
7: Lift arm across body. is it painful? Yes = go 8
8: Is the patient older than 60 years? Yes = go 9
9: Is it painful to touch the edge of the bony tip of the shoulder? Yes = Shoulder osteoarthritis
Shoulder osteoarthritis treatment
1: Has there been a fall/ accident? No = go 3
3: Can the patient lift their arm above their head? No = go 10
10: Is the patient between 45-55 years old? Yes = go 14
14: Is there a loss of external rotation? Yes = Frozen shoulder
Frozen shoulder treatment
1: Has there been a fall/ accident? Yes = go 15
15: Is there an obvious step down deformity at the edge of the shoulder? Yes = go 16
16: Touch edge of shoulder. Is it painful to feel corner of shoulder? Yes = go 17
17: Lift arm across body. Is it painful? Yes = A/C joint dislocation
A/C joint dislocation treatment
1: Has there been a fall/ accident? Yes = go 15
15: Is there an obvious step down deformity at the edge of the shoulder? No = go 18
18: Is the ball of the shoulder joint positioned more to the front of the chest? Yes = go 19
19: Can the patient lift their arm up? No = Shoulder dislocation
Shoulder dislocation treatment
1: Has there been a fall/ accident? Yes = go 15
15: Is there an obvious step down deformity at the edge of the shoulder? No = go 18
18: Is the ball of the shoulder joint positioned more to the front of the chest? No = go 20
20: Feel along upper arm and around shoulder blade. Is it painful? Yes = Shoulder fracture
Shoulder fracture treatment
