Passive examination should only be carried out for movements which are painful and/or limited during the active movement examination, where the course of the movement is abnormal, or if hypermobility or a mild musculotendinous injury is suspected.
The passive movement examination of the acromioclavicular and sternoclavicular joints does not provide any extra information and therefore can be omitted.
Procedure
- The patient stands or sits comfortably with their arms hanging down.
- The examiner stands behind or beside the patient.
- Place one hand on the shoulder involved; the acromioclavicular joint should, preferably, be palpated using the fingertips.
- With the other hand, the upper arm should be grasped distally (except in the case of outward and inward rotation). It is essential here that one of the examiner’s hands is fixed and that the other hand carries out the movement.
The illustrations show:
- Anteflexion [Figures 30a, 30b].
Figure 30a
Figure 30b
- Retroflexion [Figure 31].
Figure 31
- Abduction [Figures 32a, 32b].
Figure 32a
Figure 32b
- Horizontal adduction [Figure 33].
Figure 33
- Outward rotation [Figure 34].
Figure 34
- Inward rotation [Figure 35].
Figure 35
Assess:
- The course of the movement.
- The maximum range of motion.
- Occurrence of pain.
- Presence or disappearance of crepitations.