Standing, sitting, or lying prone
For women, a gown over the non-examined side with the examined area exposed or a halter top is recommended.
For men, removal of the shirt is requested.
Posterior to the patient.
May I place my fingers on your shoulder blade? (or point to the demonstrated area).
Keep your elbow tucked to your side.
Bring your hand across your body and back (or demonstrate).
With the patient's shoulder relaxed, place your fingers inferior to the spine of the scapula. Position the patientís arm in neutral with the elbow flexed to 90∞ and elbow tucked to the side of the body. Ask the patient to move the hand across the body and back, which medially and laterally rotates the shoulder joint. Palpate the muscle bulge during the movement of lateral rotation. With unclear muscle activity, provide slightly more resistance by having the patient hold or push against a push on the forearm in the direction of shoulder medial rotation to resist a shoulder lateral rotation effort.
VH - infraspinatus.