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How to examine the shoulder

Other platforms explain it with text and video. In Making Synapses you practice it on the patient.

MD / DOPA
Practice it in VR with Blocky

Shoulder pain is usually the rotator cuff, but the neck can send pain there too. A structured exam tells them apart.

Step by step

  1. Prepare

    Introduce yourself, get consent and expose both shoulders. [1]

  2. Look

    From the front, side and back: asymmetry, swelling, muscle wasting above or below the shoulder blade, and winging of the scapula. [2]

  3. Feel

    Sternoclavicular joint, collarbone, acromioclavicular joint, front of the shoulder and the shoulder blade. [2]

  4. Range of motion

    Forward lift, backward reach, arm out to the side, and rotation in and out, active then passive. [1]

  5. Painful arc

    Pain between about 60 and 120 degrees while raising the arm to the side points to the rotator cuff. [2]

  6. Rotator cuff strength

    Empty can (supraspinatus), external rotation against resistance (infraspinatus and teres minor), lift-off or belly press (subscapularis). [2]

  7. Impingement tests

    Neer and Hawkins-Kennedy: pain suggests impingement. [2]

  8. Finish

    Check the neck, pulses and sensation in the arm, and explain the findings. [1]

Common errors

Practice it in Making Synapses

In Making Synapses you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.

Making Synapses cases that train this skill

37 Making Synapses cases train this skill: open the case library

Sources

  1. NCCPA PANCE Content Blueprint
  2. Stanford Medicine 25 (bedside exam)

Facts and steps follow NCCPA PANCE Content Blueprint; Stanford Medicine 25 (bedside exam). Making Synapses is not affiliated with these organizations. Updated: 2026-10-11.