Shoulder Telehealth Assessment Tool

  • Pain and Activity

  • Range of Motion

    In order to assess how your shoulder is functioning we are going to ask you to complete a few simple movements and respond by circling yes or no with the corresponding movement. All of these movements should be completed with your affected shoulder.  For the first section please stand or sit with your back and head against a wall. 
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  • 4. Can you touch your chest?*
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  • 5. Can you touch your chin?*
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  • 6. Can you touch your nose?*
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  • 7. Can you touch the top of your head?*
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  • 8. Can you touch the back of your head?*
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  • 9. Can you reach your opposite armpit?*
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  • 10. Can you reach your back pocket on the same side?*
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  • 11. Can you reach your lower back?*
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  • 12. Stand with your affected shoulder against the wall facing right for right shoulder and left for the left shoulder. Hold your elbow at 90 degrees and try to touch the wall with the back of your hand. Can you touch the wall with the back of your hand?*

  • Special Tests

    For the next section we are going to ask you to complete a few tasks that will tell us what motions are painful for you. These movements will involve both arms.
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  • 13. Raise your hand as high as you can out to your side then lower your arm slowly. Is this painful when you lower the arm?*
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  • 14. Place your hand across your body and pull it close to your body with your free hand. Is this painful?*
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  • 15. Press on your belly. Is this painful?*
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  • 16. Stand with your back to a wall and place the back of your hand on your lower back and then press backwards against the wall. Is this painful?*
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  • 17. Hold your arm straight in front of you as if you were holding a platter and try not to let this hand move. Gently press down on your arm with your other hand. Is this painful?*

  • For the next section we will ask you to perform a few movements whilst resisting them with your free hand. All of these should be performed with your arm (elbow) at your side, your elbow bent to 90 degrees and your thumb pointing up.
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  • 18. Place your hands together and press them together. Does your shoulder feel weak? Is this painful?*
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  • 19. Place your free hand on the back of your hand and then try to move your affected hand outward. Does your shoulder feel weak? Is this painful?*
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  • 20. Hook your free hand around your elbow and try to push your elbow away from your body. Does your shoulder feel weak? Is this painful?*

  • Thank you for filling out this assessment tool. Please check your answers above and when you're happy select 'submit' below to email this to your Physio
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