Tuesday, March 11, 2014

Measuring internal rotation in abduction - the key to diagnosing posterior capsular tightness

Accuracy and reliability testing of two methods to measure internal rotation of the glenohumeral joint

The authors compared the accuracy and reliability of a traditional method of measurement (most cephalad vertebral spinous process that can be reached by a patient with the extended thumb) to estimates made with the shoulder in abduction to determine if there were differences between the two methods.

Internal rotation estimates made with the shoulder abducted demonstrated interobserver reliability superior to that of spinous process estimates, and reproducibility was high.

Comment: We use this method as well. Here's a nice illustration from a website:

It nicely shows how to examine the shoulder for loss of internal rotation with the arm abducted.

Interestingly, pain on this test used to be called a positive 'impingement sign'.

Such an internal rotation deficit can often be resolved by the sleeper stretch.

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