2 Simple Tests For Shoulder Pain!

Pain in your shoulder can be a truly limiting factor in your life and while a lot of people consider the shoulder a single joint. In reality, It’s not in reality. There are two joints in the shoulder. We can see here the Acromioclavicular joint. Now, This one over here is the Clavicle but this weird looking bone is the scapula. This part of the scapula is called the Acromion and it articulates with the clavicle. So, Therefore the joint is called Acromioclavicular joint. Now, In order to see that second joint in the shoulder, We would have to look at these bones from the posterior view and this one over here is the humerus. Whereas this bone is the scapula. Now, We already saw the scapula over here. Now, We’re looking at it from the posterior view and therefore we see it like this. The joint between the scapula and the humerus is called the Clano-humeral joint. Clenohumeral joint but, why cleno? why not scapula humeral joint? Well because this fossa over here is called the clanoid fossa and that is where the head of the humerus is articulating with the scapula. So, Those are the two joints of the shoulder. The acromioclavicular joint and the clenohumeral joint but where does the pain usually happen? where does it start? Well, Besides these structures, There are many structures, nerves muscles and arteries in the shoulder and this question cannot be answered easily but there is something we can do easily that helps us identify which one of these structures causes the pain. We can perform clinical examination tests and there are two examinations I would like to highlight and explain the possible results of these examinations. The first test I want to talk about is the Empty Can Test. It is used to test the function of the supraspinatus muscle this which you can see here is the scapula and this is the humerus. They articulate here in the glenohumeral joint but that was already explained but what is this illustration up here. Well, That is basically the same region of the body with the same bones Illustrated but with the acromion removed. It was removed so that we can see the joint better and also we can see muscles over here and specifically this muscle, that is the supraspinatus muscle. The supraspinatus muscle was cut and then inverted like this but normally it originates here in the supraspinatus fossa that’s why it’s called supraspinatus. Now, Why spinatus? Well because this here is the spine of the scapula and therefore supraspinatus muscle is above that spine. So, It starts here and inserts over here. So normally, This muscle once it contracts would abduct the humerus therefore it would cause the movement like this. That’s why if we want to test this muscle, The patient is required to elevate his arms like this and point his thumbs downwards as if he’s trying to empty a can and then the examiner will apply pressure from above and try to bring his arms down. Now, The patient is required to perform an opposite movement and try to bring his arms up. If the patient experiences pain or weakness when the examiner presses from above then that might indicate an injury of supraspinatus muscle or its tendon. Now if we look closely, There is another muscle over here and that is the infraspinatus muscle. Now, infra spinatus muscle has its origin below the spine of this scapula that’s why it’s called the infraspinatus muscle. Now, The infraspinatus muscle does not attach from above over here but it attaches somewhat from the side over here. Therefore, When this muscle contracts, It actually performs a different type of movement, so, once this muscle contracts it normally performs the external rotation of the arm that is basically this movement but you know it’s really hard for someone to hold you like this and then tell you to rotate your arm externally, right? How can you oppose this rotation? Well, That’s why you should flex your arms and the elbows like this and then try to externally rotate the arm and the examiner can then oppose that movement and prevent you from doing so, a pain or weakness during this examination would indicate a possible injury of the infraspinatus muscle or its tendon. So, to test the supraspinatus muscle and its tendon, We can perform The Empty Can Test and to test the infraspinatus muscle we can perform the infraspinatus test but those are just two possible tests and they test for two possible injuries. The reason why I choose to explain these tests is because supraspinatus muscle and its tendon is most commonly injured muscle and the tendon of the rotator cuff and the infraspinatus muscle is usually injured in athletes when they’re trying to throw something strongly and far away but other structures in muscles, in the shoulder region can be injured as well. A skilled and a competent doctor should be able to find the cause of your pain. Both of you doctors and patients, You can all benefit from videos like these. If you’re a doctor you want to make a video like this one then go to anatomsky.com but if you have more questions about shoulder and shoulder pain then go to this link symptomskey.com/help/shoulder