Also, include evaluation of the cervical spine and upper extremity. Inspect for scars, color, edema, deformities, muscle atrophy, and asymmetry. Palpate the bony and soft-tissue structures, noting any areas of tenderness. The subdeltoid and subacromial bursae can be palpated anteriorly under the acromion, and laterally with the deltoid muscle and the arm in extension. The supraspinatus is palpated anteriorly when the arm is externally rotated and flexed.
Hyperextension permits the palpation of the infraspinatus.
Assess active and passive range of motion. Note any pain elicited and loss of motion. Determine muscle strength. If there is drooping of this position, full thickness rotator cuff tears are suggested. The subscapularis may be tested with the arm at the side with internal rotation resistance.