Shoulder Exam - Orthopaedic Shoulder OSCE - Clinical Skills Revision - Dr Gill

Shoulder Exam Explained - Master Your OSCE! - Clinical Skills Revision - Dr Gill
The most complicated orthopaedic clinical examination is the shoulder assessment. We know this for a fact, as there are over 70 special tests for the shoulder exam - with most of them only having weak clinic significance - ie this is a tough examination and everyone is trying to develop a way to do it effectively
With that said, your orthopaedic shoulder OSCE will have a protocol your institution is expecting your to follow - THIS VIDEO IS AIMED TO ASSIST PEOPLE LEARNING ABOUT THE SHOULDER EXAMINATION PLEASE ENSURE THAT YOU FOLLOW YOUR INSTITUTIONS PROTOCOLS
In this video, we will go through the orthopaedic approach of LOOK, FEEL, MOVE, before demonstrating each section
We will also look at a selection of special tests, including:
- Hawkins-Kenndy
- Neer's Test
- Speed's Test
- Yergason's
There is an associated video to go along with this shoulder exam deep dive
shoulder examination demonstration - • Shoulder Clinical Exam...
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Please note that there is no ABSOLUTE way to perform a clinical examination. Different institutions and even clinicians will have differing degrees of variations - the aim is the effectively identify medically relevant signs.
However during OSCE assessments. Different medical schools, nursing colleges, and other health professional courses will have their own preferred approach to a clinical assessment - you should concentrate on THEIR marks schemes for your assessments.
The examination demonstrated here is derived from Macleods Clinical Examination - a recognized standard textbook for clinical skills.
Some people watching this video may experience an ASMR effect
#ShoulderExamination #ClinicalSkills #DrGill
You can now consult via video or in person with Dr Gill at Dr Finlay’s Private Practice - www.drfinlays.co.uk/services/...
00:00 - Overview of Shoulder Examination
00:22 - Look, Feel, Move Approach
00:35 - Understanding Anatomical Movements of the Shoulder
01:15 - Identifying Abnormal Range of Movements
02:40 - Consent and Preliminary Checks
03:15 - Checking Muscle Bulk
04:03 - Assessing the Posterior of the Shoulder
04:35 - Checking for Scapula Issues
04:56 - Palpating Around the Shoulder
08:23 - Assessing Range of Motion
10:00 - Assessing Subscapular Movement
10:39 - Gerber's Test for Subscapular Dysfunction
11:05 - Muscles of Shoulder Abduction
12:22 - Checking for Smooth Range of Movement
13:03 - Special Tests
13:48 - Hawkins-Kennedy Impingement Test
14:12 - Neer's Impingement Test
14:39 - Empty Can (Jobe's) Test
15:18 - Resisted External Rotation
15:57 - Painful Arch / Drop Arm Test
19:05 - Scarf Test - Acromioclavicular Disease
19:34 - Speed's Test - Labral Tears & Bicep Tendonitis
20:40 - Yergason's Test - Bicep Tendon Pathology, Unstable SLAP Lesions
21:38 - Conclusion

[@thesavagesoutherner]

Shirt removal and discard- 7/10 Turning to his left by jumping- 10/10 amazing form.

[@defaultytuser]

😂😂😂

[@alexn5743]

Finally a shirt removal comment!

[@johnbfilmz8092]

i really liked that you included pictues and examples that we would be looking for such as scars and other things of that sort. Makes it easier to visualize things to watch out for and what findings i might get that are abnormal.

[@DrJamesGill]

That’s the one issue with the deep dives, they take a lot more post filming work, so can’t get them up as regularly

[@johnbfilmz8092]

@@DrJamesGill completely understand! Still thank you for the effort you put into this video it really helps!

[@peeenrs2329]

@@DrJamesGill will

[@peeenrs2329]

@@DrJamesGill , , ,

[@Kyng_K_T]

I always come here for both asmr and just to get educated. I’m not a medical student in anyway but recently I just became a father, so I’ve been just watching videos, not only for my son but myself just to get a better understanding of the human body. I now see what to look for just in case any question I might worry about and I have to say I’m so glad you are here Dr. Gill you’re amazing in your teachings and techniques keep up the good work good sir 😊

[@Joe.484]

Same here.😂

[@Joe.484]

@@Calibrex_Gaming you know everyone reacts to different tones and voices?

[@Joe.484]

@@Calibrex_Gaming it doesn't matter how YOU rate something. It's highly individual.

[@ramonvdklooster9206]

@@Calibrex_Gaming Dr Gill is literally one of the OGs of ASMR. His classic putabitopaper is up there with sandwich breath.

[@Joe.484]

@@Calibrex_Gaming lmao. How old are you 12? Go watch your favorite ASMR artist licking some dirty ears. You're annoying as fuck.

[@kc8818]

as a someone who lifts weights, your videos are really helpful for understanding which muscles are active during different parts of movement patterns. thank you!

[@markmccallum475]

Imagine a child Dr. Gill palpating his Christmas presents trying to feel what it is under the wrapping paper.

[@DrJamesGill]

🤣🤣🤣 maybe there’s a special edition Christmas video in that!

[@officialkodeks9452]

That shirt toss is not accidental anymore 🤣 nice video btw Mr.Gill

[@lindar5413]

🤣🤣

[@niko.ma4873]

I laugh every time I see it 😂

[@Ibelikemj]

I didn’t realize it was the same guy volunteering lol

[@MrZomg17]

@officialkodeks9452...he was waiting for his moment to toss that shirt

[@valmirsousa1995]

Dr Gill, thanks for your videos. I speak about Brazil, and your videos have helped me a lot, a lot of information, but mainly to relax. It's been hard times, I'm unemployed and sometimes I don't even have to eat for days, I use Internet from places that have free access, or the 4g of a phone chip. And always at the end of the day I'm exhausted from trying to find an improvement. And in your videos I find a point to relax and forget a little about the difficult life. thanks

[@DrJamesGill]

I'm so sorry to hear you're struggling like this, do you have any family nearby? Often KZbin isn't the best place for these conversations - please feel free to send me a direct message on Twitter if you need to talk

[@valmirsousa1995]

@@DrJamesGill Of course, I don't know how to use Twitter well, but I'll look for your profile there

[@evanb8495]

Hang in there Valmir ✊🏼 Much love from Australia 🐨

[@kapibara2175]

Valmir, hello! Is there something that we can do for you? I hope you will be happy and healthy.

[@valmirsousa1995]

@@kapibara2175 thanks man, I've been trying day after day. But the situation doesn't look like it's going to get better.

[@nightone9720]

I would actually go to the doctor amd pay money for checkups if Dr. James Gill was my doctor. I can listen to him talk for hours.

[@SousChef1234]

I visit Dr. Gill here every night.

[@ShaiTG]

my man got perfect timing i just needed this

[@DrJamesGill]

Thank you

[@lghostlyl5993]

Really happy you added hyper mobility cuz it’s something I have issues with ! Sometimes I can partly dislocated the shoulder and you can actually feel the head of the shoulder, thank you for making people aware ❤

[@DrJamesGill]

From an injury and musculoskeletal perspective, it’s. Hugely important issue

[@IvyroseGullwhacker]

Bingeing this dude's videos solely for the ASMR. Having a rough time so it helps.

[@DrJamesGill]

Is there anyone you have to talk to currently?

[@cryingcheerios3605]

I really enjoyed this video! I’m studying sport and exercise science with a view towards physiotherapy, so this is fantastic. I especially liked how you included photos of the different pathologies possible with the shoulder, it was very helpful

[@DrJamesGill]

Thanks 😊 physio is a hugely important role. We rely on them SO MUCH in general practice

[@kiarona.]

"Start by taking off your shirt" **throws shirt somewhere into next week**

[@danflak6363]

Brilliant. I’ve been a climber for many years so I’m rather obsessed with the anatomy of our arms in their entirety. Primarily from the perspective of injury prevention & the inevitable rehab process associated with most sport enthusiasts. I imagine it was a lot of work, but the animated diagram along side the tracking of the patients scapula / rotator cuff was so awesome.

[@DrJamesGill]

Thanks. It wasn’t easy, but I think the result was worth it 😊

[@LizaPersson]

Dr. Gill's videos make me want to study Orthopedics. If I weren't so old and poor, I'd do it. It is just so incredibly fascinating, and empowering for people.

[@Billy-dj8zw]

The doctor is cute and has a very soothing voice. I like him.

[@SoberIrishman]

This video was very helpful. Raquetball injury in 1994 still causes right shoulder pain when I sleep on my side and i can't extend it behind my back upwards much better than the patient. Informative, thx.

[@I666U]

Dr. G , you rule !. great upload. TY ! - this helps to understand how much the shoulders work while mountain biking either hardtail or full suspension.

[@jim6070]

Thanks Dr Gill for mentioning marfan syndrome vs ehlers danlos. As a person diagnosed with marfan syndrome, I have come across far too many doctors that don’t know anything about it. Hopefully you mentioning these afflictions will get people to become more knowledgeable.

[@rodneyboulton6410]

Another very interesting video. I've had shoulder problems in the past, thankfully nothing recent.

[@MrZomg17]

@Dr Gill take a moment and realize you are at a point of achievement in your career that you now TRAIN and guide medical students and demonstrate proper medical examinations....i remember MY days at Vocational ..i trained my peers after i myself learned my vocation

[@lethewardssunk5833]

Thank you so much for drawing attention to EDS. I was not diagnosed until 40 and then it was a physio who spotted it. I really had to fight to get a clinical diagnosis due to the lack of understanding of EDS amongst GPs.

[@DrJamesGill]

I don’t really get where the issue with connective tissue disorders. If you are overly flexible, it should be considered right from the get go. Problem is there isn’t a lab test, so we have to rely on the Beighton score in Gp land

[@lordsnooks2804]

3:12 10/10 shirt bowl from the model here

[@paulosborne6517]

Very informative - thank you! I actually had a shoulder exam last week,- not nearly as thorough - and this has helped me understand what I experienced and maybe why certain actions are painful.

[@DrJamesGill]

Hopefully they were able to find the answer ?

[@paulosborne6517]

@@DrJamesGill Yes, very unhappy tendons in both shoulders and elbows... As 'Mr Allen' put it [in YTs most famous Head to Toe Exam] - "It's nice to know I'm symmetrical".

[@AvaConda]

i will watch every one of your videos without question every time

[@trash_kingg4788]

Love that these videos are both relaxing and informative! Definitely a good anatomy review before bed lol

[@starfishgurl1984]

Another great video as always! Although joint problems run in my family thankfully our shoulders aren’t really effected like our knees are but because I sometimes lift heavy boxes/furniture at work I find this very helpful in understanding my muscles movements so that when I do lift them I do so with injury prevention in mind!

[@DrJamesGill]

Understanding movements can certainly help prevent issues

[@lamecasuelas2]

This Is so good! I'm not a medicine students or anything but i just love How well explained everything is

[@tarran2670]

David still looks great, nice back and waist area.

[@SimplyTakuma]

10:28 When you see something is not good and the doctor gets attention pretty fast 😂

[@DrJamesGill]

Yes, that wasn’t supposed to be there!

[@weightliftingwhisper]

Informative and unintentional asmr as usual!

[@martine2651]

Excellent video, thank you so much!

[@brandonthompson1888]

Yay!!! David is back!

[@user-bl6fu1lv8d]

Just what I was looking for! Thank you Dr. Gill!

[@blackriverbootsmaeducation]

Great Video

[@WishMount]

this is better than any anatomy lecture I’ve watched at uni, wish I discovered you years ago… I would have gotten much better marks

[@mobiltyortho]

Thankyou for this video

[@_jules_perez_]

Your videos really helped me boost my performance on my school's OSCE! They don't give us rubrics or specific feedback so reviewing your OSCE videos series helps me remember things I may have missed on a station while also helping prep for the next one. Thanks for making clinical skills clear and easier to understand for students like myself.

[@DrJamesGill]

That’s terrific to hear!! Congrats!! Where are you studying?

[@_jules_perez_]

@@DrJamesGill In Canada :)

[@theharris7207]

I always find these so very interesting. I really liked the graphics on screen as you were doing the tests

[@DrJamesGill]

Thank you very much! it’s a learning curve for me, but I think they are improving

[@thegirlwiththatface]

Great video as always 💕

[@BGD1973]

I actually just had a shoulder injury. What a coincidence!

[@DrJamesGill]

Oh dear I'm sorry to hear that, what happened

[@BGD1973]

@@DrJamesGill rugby lol

[@Jonathan-gj2fe]

Excellent as always, Dr Gill. Question.... when David faced away from you, I noted that his right shoulder blade seemed marginally higher and more pronounced than the left. Is there reason and/cause for concern in such a case?

[@DrJamesGill]

No major concern. Likely just a muscle imbalance. The rest of the right side exam was fine

[@95mudshovel]

I am once again here to feel as though a person is talking to me because just when it feels as though things can't get worse, they do. I am quite sad but doing my best to not to wallow. incidentally, using my manual wheelchair has given me very strong shoulders and grip strength - two very useful things for Jiujitsu, as it turns out. 🙂

[@DrJamesGill]

how you spoken to your Gp. often feelings like this can benefit from discussion 😊

[@95mudshovel]

@@DrJamesGill oh yes. he gives me very good fatherly advice, something of which my dad is incapable, and I see my therapist once a week. 🙂

[@bluewarbler3461]

Thank you so so much for these deep dives! My final osce is in a couple of weeks and this is exactly the kind of crashcourse I need to consolidate my examination skills! Rest assured I'll still be revisiting these videos in a couple of months as an F1

[@DrJamesGill]

Good luck! And other deep divers we can try and push through for you?

[@bluewarbler3461]

​@@DrJamesGill Thank you so much!! I was actually wondering if a deep dive into specific documentation would be possible - e.g. Death certificates (what to put down under 1A and 1B etc.) or FP10/inpatient prescription forms? I have the PSA coming up as well so discussing common prescribing mistakes would be amazing. A palliative care discussions and capacity assessments that test our ethical understanding would make for a great series too! That said, I'm already so thankful for all the content you have and continue to provide to us med students so far! We really appreciate it

[@matthewwilliams3789]

Found this very interesting. I have a very significant turn in on both of my shoulders which was can cause excessive aches and pain and a reduction of movement. Its given me very poor posture too at 32. Never really known where to go with this as not sure what could be done.

[@oliverdevine2181]

I'm not a doctor but I'd recommend plenty of shoulder based exercises which focus on improved strength and mobility (basic calisthenics like rows and press ups) but nothing high intensity like heavy weights which could cause an injury. If you do this then the musculature and joint strength will improve and be more resistant to injury

[@matthewwilliams3789]

@@oliverdevine2181 thanks Oliver. Will certainly give that a go

[@kittybala7951]

Interesting video and useful

[@DrJamesGill]

In terms of trying to improve things, which bits did you find this useful

[@pamw565]

Need to see my GP as I thought I had frozen shoulders and after doing one of theses movements I’m more sure.

[@DrJamesGill]

Yes, I'd strongly recommend seeing somebody if you have shoulder problems, they can take quite some time to resolve

[@pamw565]

Appointment booked to see GP.

[@DrJamesGill]

👍hope you find the answer 😊

[@Chayennaa]

This was the first video i watched on this channel and i loved it

[@DrJamesGill]

Well thank you for joining us!

[@Chayennaa]

Of course i’ll join in at future video’s to

[@niko.ma4873]

@@Chayennaa his vids are great informative and relaxing

[@lindar5413]

Welcome! You’re going to love Dr.Gill’s videos

[@ammar3465]

Thanks

[@dawkinsm]

Another fantastic and very informative video. I followed your steps and have exactly the same pain as this chap but in my left shoulder. What’s the treatment for this as I’ve lived with it for a few months and it’s getting worse.

[@DrJamesGill]

you’ll need to see your doctor, and possibly a physio to confirm, and then look at appropriate management

[@dawkinsm]

@@DrJamesGill Thankyou.

[@gabrielesimionato1210]

Welcome back!

[@pamw565]

Here we go.

[@MrJag37]

Fantastic video!

[@DrJamesGill]

Thank you very much!

[@Flippirino]

Hope you weren't given a cold shoulder when examining Also, David had still got it, as fantastic as ever

[@nemec604]

If you remember I asked you about my problem with walking and Im just here to tell you it's fixed now. My hip was a bit lowerd on my right side so I walked funny. 😃

[@DrJamesGill]

Glad things have improved

[@AminVlogs1]

Yes yes yes thanks so much for this

[@DrJamesGill]

No problem!!

[@valelica131]

Wonderful video :)

[@ethanglenn7299]

Heyyy that’s the dude from the back examination one! :D

[@TaraFinlay]

mentioning EDS is so important and I wish US docs would pay attn to this.

[@DrJamesGill]

All connective tissue disorders are relevant when it comes to MSK issues :)

[@TaraFinlay]

@@DrJamesGill Yes, I agree. In the US however, knowledge of connective tissue disorders and hEDS in particular is so lacking that in my state, a parent of a hypermobile child was arrested for child abuse due to the child's frequent joint dislocations. They had to fly in a doctor from another state to explain what was actually going on. As a person who has had EDS obviously my whole life, nobody ever takes it seriously.

[@nnhk0056]

Are you going to make examination videos like you used to, or are they all going to be the deep dives moving forward?

[@DrJamesGill]

We’ve completed most of the demos now. There are still a few to go, but I’m trying to do a demo for each, a deep dive for each, and relevant anatomy for each

[@richardpruger4772]

I really like your videos, very informative, and very relaxing!

[@DrJamesGill]

How do you find them useful thank you

[@aminmohammadi9520]

I watched the yergason test on physiotutors and it is a bit different than what you demonstrated in the video. which one is the modified one and which is the actual test?

[@loadventureslife5090]

Dr. Gill patients prob show up every day. Hey I'm here for the ASMR.

[@seth.daniel5314]

lovely toss David. keep it nice and floppy m8

[@BigSamy]

Perfect.. Just perfect 👍

[@DrJamesGill]

Thanks a lot 😊

[@BigSamy]

@@DrJamesGill No Thank You !

[@umdoistrestestando5437]

The best videos are the examinations videos! :) where is abby!? :)

[@DrJamesGill]

currently on her elective

[@emmabernardi8138]

I can't wait for a 6 months super chubby baby Gill and videos about baby's anatomy😂

[@DrJamesGill]

There will be a 6 week baby check

[@DeafSeattleGuy36]

So what would be his treatment for his pain? I'm curious to know. I have had shoulder pain in the past, I had to go to physical therapy and it healed away over time.

[@DrJamesGill]

Absolutely physio is hugely important, but it dues depend on the eventual diagnosis

[@DeafSeattleGuy36]

@@DrJamesGill so what is his exact diagnosis? I'm curious to know the medical term for this

[@outlawbrandiewales]

I had a small tear a couple years ago in my rotator cuff and that thing stung for awhile. MRI didn't show anything but I didn't get the dye injected. It bothered me for four months or so. After two years I fanilly regained strength in my shoulder.

[@DrJamesGill]

Small tears are often treated conservatively, getting them to heal and then building the strength back As with so many things though, it depends on exactly what has happened / caused the injury

[@Sam-cr7ez]

I think David did a shot of surgical spirit before this one

[@OG.WILLY.SANTOS]

Do love a deep dive

[@DrJamesGill]

I just wish they didn’t take so long to put together

[@gmkar7766]

I love science.

[@tehbrozpotatoz7267]

I don't know if this is intended but your videos are amazing for asmr!

[@antoinehunter3776]

Detroit in the building!!

[@johnathanleonardo912]

Once in awhile my left shoulder hurts at a certain point when I lift my arm up then the pain disappears when it's fully extended in the air. Inflammed bursa maybe?

[@robgillon]

At 10:28 the patient is clearly having difficulty keeping their hand from moving towards their back, and Dr Gill even paused when he said there was no problem… isn’t this exactly the problem that you were looking for?

[@DrJamesGill]

Which we then addressed with Gerbers test a few moments later The problem was I had planned for a normal exam, so was taken off guard by a finding that shouldn’t have been there

[@robgillon]

@@DrJamesGill I see, thank you for commenting and clearing that up!

[@matthewwilliams3789]

Random question Dr but I had a chest x-ray this week and the radiographer commented that I had 'extremely long lungs'. I've been suffering for months with a cough since long covid and wondered if this could be a cause?

[@DrJamesGill]

Highly unlikely just your anatomy

[@TheTruthWholeTruthNothingButTh]

I sleep on my side or even if i fall asleep on my back ill roll over in the middle of the night and my shoulder problems feel like they never go away ill prob have 3 months out of the year where there is no pain it feels like it kind of not in the socket fully but it also feels like it could just be the muscle and all the flexing im doing trying to fix it might be making it worse

[@j5892000]

He might be really good with the Alexander technique

[@JayToComp]

How tall is dr gill just curious

[@AmorsAverageAdventures]

Lady Camden? 🤔

[@seang2012]

Who else spotted Dr. Gill’s Level 8 watch tan lines?

[@InspiraBoost1096]

What does it mean when your knees makes a clicking noise. Is that bad?

[@tanksoldier]

Dr. Gill posts a vid: like, then watch.

[@DrJamesGill]

👍

[@elizabethrobinette4246]

Dr Gill. On May 1 2022, I suffered a fall that dislocated my right shoulder. I was sedated and it was reset. No one before or since ( here in the US), has performed this type of assessment.

[@DrJamesGill]

The full examinations are more about identifying the problem or pathology If you have any subsequent issues with your shoulder, I’d expect you’d get the full assessment

[@GOTHICforLIFE1]

Almost suspicious in the timing of this video 😂 Im named the same as the patient, have the same pain in the same area, so at this point i'm also curious of what the diagnosis or rather the treatment of this would be?

[@cristianszabo9068]

what”s ur name?

[@fortheentries2382]

What do differences in active and passive movements imply? I don't really understand why we examine them both.

[@DrJamesGill]

A patient may have limited active movement due to muscle injuries, for example, but they may have a good range of movement, during passive movements. There are other reasons we can get a discrepancy, but that is an easy example

[@JWoods-jh7nl]

Why would his arm hurt because mine did too. The movement was also limited like his.

[@ArcaneHazeOfficial]

Chevrolet, Zebra, Honesty

[@jessetobiason1184]

Anyone know the music used during the intro and outro of this video?

[@demainzer]

Hey cool very nice, seems Like you considered my comment in making a Video about The shoulder 👍👍👍😉

[@DrJamesGill]

My intention, is to try and cover all of the joints with three videos, the demo, the explanation, and the anatomy

[@demainzer]

@@DrJamesGill Well then i'm looking forward to watching these videos!👍 Greetings from Germany

[@smilyyyflower175]

I wonder if its normal to hear cracks within a type of movement?

[@DrJamesGill]

As long as not painful.

[@hugheszie]

As an ice hockey player, I always have shoulder injuries, I fail most of these tests regularly, then I’m fine again for a short time. Maybe I should stop playing. I imaged I’ve got permanent damage from repeat trauma. Same with my back. I’d be great for a video Heath check you’d find loads wrong ha! Jokes aside I’m quite healthy & fit. I heal pretty fast, as do rugby players. I image we share the same common regular injuries.

[@DrJamesGill]

I honestly think that hockey, and probably sustain the greatest damage over their careers. As with so many things in life, it’s a balance between enjoyment, and personal risk

[@hugheszie]

@@DrJamesGillI’ve come back to this video two years later to try and replicate the test in my living room, I’ve managed all of them just fine. Why did I do this? Training this evening I had a large body on body collision and my left shoulder hurts 😂

[@nickpilgrim7706]

It wouldn't be a Dr Gill video without someone's shirt coming off!

[@777Joef]

Dr James..... I appreciate your gift for teaching but I would suggest that you wear a t shirt for your videos because it will mitigate the underarm sweaty shirt. You are awesome.

[@KF-cx8bm]

I had frozen shoulder in one shoulder, then a year later in the other shoulder, total nightmare

[@DrJamesGill]

Gosh, that sounds very unfortunate, I wonder if there is an underlying cause?

[@KF-cx8bm]

@@DrJamesGill I think my work contributed to it somewhat, although I have never really had a conclusive answer.

[@giovannigiuliano6683]

Dr. Gill > Dr. Strange

[@chadsmith1200]

I hope the patient gets his shoulder fixed ASAP.

[@DrJamesGill]

i’m sure you understand, I wouldn’t be able to comment

[@chadsmith1200]

Oh I wasn't respecting a reply from you Dr. Gill. Just making a statement because I know he is in pain.

[@charlierobinson1720]

well thats fixed my shoulders but now I have epilepsy from the flash frames

[@bend6292]

Is that a- is that a- is that a Supra spinatus

[@DrJamesGill]

Yes