Execution
- 1Complete the basic shoulder assessment and identify one painful or limited comparable sign to retest.
- 2Record baseline pain, range, strength, or functional limitation during the comparable movement.
- 3Repeat the comparable sign while modifying thoracic posture, scapular position, or scapular assistance.
- 4Repeat the comparable sign while modifying humeral head position or applying manual correction / load changes.
- 5Test neuromodulatory or adjacent-region modifications when relevant and record which modification produces meaningful symptom change.
Positive outcome
The procedure is positive when a modification produces a clinically meaningful improvement in the comparable sign, commonly a pain reduction of about 30% or more, improved range, or improved strength / function. The result suggests symptoms are mechanically modifiable rather than proving one structural diagnosis.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Lewis et al. (2016) | high inter-rater reliability | NA | NA | NA | NA |
| Meakins et al. (2018) | κ = 0.47 | NA | NA | NA | NA |
CommentMagee mentions SSMP as a way to demonstrate that rotator cuff / subacromial symptoms are modifiable, but also notes that its usefulness has been questioned. Evidence is mixed: Lewis reported favourable reliability, whereas Meakins reported only moderate interclinician reliability and uncertain relationship between within-session changes and later outcome. Use it as a treatment-direction tool, not as a diagnostic test.