During a physical exam for a rotator cuff disorder, your doctor will look at your shoulder for signs of swelling, discoloration, muscle deterioration (atrophy), deformities, or abnormal appearance. He or she also will press around your shoulder and arm to check for any tenderness, swelling, or warmth.
Your doctor will examine your range of motion, stability, strength, blood flow, reflexes, and sensation in both the injured and uninjured arms. Moving the arms in specific ways can provide information about the condition of the rotator cuff tendons and the shoulder joint.
Your doctor may conduct tests to find out whether you have subacromial impingement or a tear in the rotator cuff.
Tests for rubbing of the tendon on the bone (impingement) are based on whether certain movements cause pain and discomfort. To test for impingement, your doctor may have you:
Your doctor will consider how painful these movements are to you and, if there was pain, what position your shoulder was in.
Another test involves injecting a pain reliever (such as lidocaine) into the bursa and near the rotator cuff tendons of your shoulder (subacromial space injection). If this relieves your pain, then you probably have rotator cuff abrasion or subacromial bursitis. Your doctor may then inject corticosteroids into the area to reduce inflammation. But if your shoulder is still weak after the injection of anesthetic, the problem may be a rotator cuff tear.
The main symptoms of a complete rotator cuff tear are pain and weakness. Tests for rotator cuff tears include the following:
The specific movements that cause pain or weakness are clues to the location of a rotator cuff tear.
A physical exam is always done for shoulder pain.
If your doctor thinks your shoulder may be broken or dislocated, X-rays may be done before a physical exam.
In rotator cuff tendinitis, tests usually cause some pain or discomfort.
For a torn rotator cuff, weakness with or without pain is the key diagnostic sign.
You may have a rotator cuff tear but still have normal shoulder motion and strength. In these cases, the tear is usually mild.
More extensive and costly diagnostic studies can help determine the cause of shoulder pain or weakness. Your medical history and overall health status, symptoms, age, and occupation or activity level are things your doctor will think about when recommending whether you should have any of these tests.
For example, a professional athlete or a person who hangs wallpaper for a living may warrant more tests earlier than a relatively inactive older adult. A more complete diagnosis is important if you need a strong shoulder or if you may continue activities that will further damage your shoulder.
Other Works Consulted
- Lin KC, et al. (2010). Rotator cuff: 1. Impingement lesions in adult and adolescent athletes. In JC DeLee et al., eds., DeLee and Drez's Orthopaedic Sports Medicine, Principles and Practice, 3rd ed., vol. 1, pp. 986–1015. Philadelphia: Saunders Elsevier.
Last Revised: November 30, 2011
Author: Healthwise Staff
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