There are currently no standard examination positions for the shoulder. During movements of the gleno-humeral joint there are always relative movements within the scapulo-thoracic junction. These are usually described as fitting a set of established normal patterns. These must be considered when testing the shoulder. When testing or exercising the shoulder it is vital that the patient has sufficient warm up before performing any movements.
These movements can be performed in either the standing or seated position. In either position the alignment of the instantaneous axis of rotation should be a point roughly 2-3 cms below the inferior lip of the acromial arch. But it has been shown by Walmsley (1993) that the gleno-humeral joint as a whole (never mind its instantaneous axis of rotation) moves by an average of 8cm through range so the need for accuracy must be questioned.
Standing
In the standing position (see below) stabilization is difficult if not impossible (and probably undesirable). Testing in this position is more functional than that in the seated position.
Seated
Alignment is the same as that for the standing position but stabilization usually involves thoracic strapping (see below). Although this position is not as functional it is used during testing and for research purposes.
As velocities in some sports (any involving throwing an object) are known to reach thousands of degrees/second (Pappas et al., 1985) testing using a dynamometer will never be functional. (Even if this speed could be achieved it is over such a small arc that the results gained would be fruitless.) Generally it is accepted that speeds of 60 degrees/second and multiples of this should be used. Speeds over 300 degrees/second have been found to be difficult to achieve by even baseball pitchers (Cook et al., 1987).
