Shoulder Region Palpation Techniques

Shoulder Region Palpation Techniques

General Principles

• Palpation is a systematic and gentle examination of the shoulder region using the fingertips to gather information about the underlying soft tissue structures.
• It is essential to palpate with the patient's arm in a relaxed position to avoid muscle tension.

Bony Landmarks

• Acromion process: palpate the lateral edge of the acromion process to identify the anterior, middle, and posterior aspects.
• Scapula: palpate the superior angle, spine, and inferior angle to identify the scapular body and its borders.
• Clavicle: palpate the medial and lateral ends to identify the sternoclavicular and acromioclavicular joints.

Soft Tissue Structures

• Deltoid muscle: palpate the anterior, middle, and posterior deltoid muscles to identify areas of tenderness or tension.
• Supraspinatus muscle: palpate the supraspinatus fossa to identify areas of tenderness or tension.
• Infraspinatus muscle: palpate the infraspinatus fossa to identify areas of tenderness or tension.
• Subacromial bursa: palpate the subacromial space to identify areas of tenderness or swelling.

Palpation Techniques

• Light palpation: use gentle pressure to assess for superficial tenderness or swelling.
• Deep palpation: use firmer pressure to assess for deeper structures, such as the rotator cuff muscles.
• Resisted palpation: use resistance to assess for muscle strength and tendonitis.

Special Tests

• Hawkin's test: palpate the supraspinatus tendon with the arm in internal rotation to assess for tenderness or pain.
• Speed's test: palpate the bicipital groove with the arm in flexion to assess for tenderness or pain.

Common Findings

• Tenderness: indicates inflammation or irritation of the underlying soft tissue structures.
• Swelling: indicates fluid accumulation or inflammation in the subacromial bursa or surrounding soft tissues.
• Trigger points: indicates areas of hypersensitivity or muscle spasm.