Muscle strength testing, elbow

Examination of the shoulder revealed no bruising, swelling, or inflammation. Motion of the right shoulder was restricted in comparison to the left in flexion, abduction, extension, and external rotation, both passively and actively. He was unable to perform the Apley scratch test fully. Muscle strength was relatively normal, although it was difficult to test because of pain. The neck, elbow, and wrist were normal on examination. There was marked tenderness to palpation ofthe biceps tendon and some tenderness of the supinator tendon. There was no tenderness or swelling of the bursa of the shoulder. 

Fig. 6.19a,b. Clinical tests for assessing the strength of rotator cuff muscles, a Supraspinatus strength is tested with the patient s arm in a position of 60° of forward elevation with the shoulder internally rotated and the elbow extended. A downward force (arrow) applied by the examiner is resisted by the patient, b A lift-off test is performed to evaluate subscapularis strength. The patient is asked to actively lift (arrow) the hand off of the lumbar region... 

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