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Resisted Isometric Testing of the Shoulder

Source: Physiotutors

Execution

  1. 1Position the patient supine with the arm by the side and the elbow flexed to 90° for the initial resisted isometric screen.
  2. 2Test shoulder flexion, extension, adduction, abduction, internal rotation, and external rotation with the instruction, "Do not let me move you."
  3. 3Test resisted elbow flexion and extension because the biceps and triceps cross both the elbow and shoulder regions.
  4. 4Record pain, weakness, rupture signs, and whether the scapula protracts, wings, tilts, or moves during the contraction.
  5. 5Repeat testing in different shoulder positions if the history indicates symptoms occur in a specific functional position.

Positive outcome

Abnormal findings: pain, weakness, rupture signs, or scapular motion during the contraction.

Interpretation
  • Pain with contraction: contractile-tissue involvement
  • Weakness without pain: rupture, inhibition, or neurological involvement
  • Scapular motion during isometric testing: abnormal (scapula should remain stable)
Clinical pearl

This is a contractile-tissue screen, not a validated diagnostic test for one tendon. Several muscles contribute to most shoulder motions, so correlate painful resisted directions with AROM/PROM findings and the patient functional complaint.

CommentThis is a contractile-tissue screen rather than a validated diagnostic test for one tendon. Magee recommends correlating painful resisted directions with AROM/PROM findings and testing positions that reproduce the patient’s functional complaint. Interpretation is limited because several muscles contribute to most shoulder motions.

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