Assessing Shoulder Pain: Clinical Reasoning and Cervical Spine Factors

Your patient presents with shoulder pain, and straight away you need to identify:

Is it rotator cuff related shoulder pain, frozen shoulder, instability, or something else entirely?

• Is it rotator cuff related shoulder pain, frozen shoulder, instability, or something else entirely?
• Is the pain actually coming from the shoulder?
• Could it be the cervical spine?
• Is there a tear that needs urgent referral?
• Should you order imaging? Refer to a surgeon? Or confidently continue with rehab?

In this podcast, Jo Gibson (Upper Limb Rehabilitation Specialist Physio) guides you through a simple, evidence-informed clinical reasoning framework to help you confidently assess and treat patients with shoulder pain.

Drawing on decades of clinical experience and the latest research, Jo breaks down four essential questions you need to ask in every shoulder assessment—helping you identify red flags, tailor your treatment plan, and avoid common diagnostic pitfalls.

In this episode, you’ll discover:

• How to distinguish shoulder pain from cervical spine referral
• Key subjective clues that guide your diagnosis and treatment decisions
• Whether it’s “torn”—and how to know if a surgical referral is appropriate
• Clinical signs that help differentiate frozen shoulder from other causes of stiffness
• Why pain irritability matters—and how it impacts your rehab approach
• When to use (and when to avoid) imaging
• How to identify instability and assess the likelihood of recurrence
• What assessment tests to perform in your objective examination
• The real value—and limitations—of special tests like the Hawkins-Kennedy, drop arm, Hornblower’s, and more.
• How to modify testing to better isolate rotator cuff contributions
• Why symptom modification tests are useful—and what they tell you
• How to help your patient overcome fear, regain confidence, and move again
• What research says about exercise prescription, and how many exercises you should give patients

Listen in to strengthen your clinical reasoning and give your shoulder assessments a clear structure that helps you feel more confident—and gets better outcomes for your patients.

Chapters:

• 00:00 - Intro
• 03:12 - Subjective clues that guide diagnosis
• 04:33 - What to call shoulder pain? RCRSP or SAP?
• 06:04 - 4 key questions to ask
• 06:29 - Cervical spine driven shoulder pain
• 10:03 - Is it torn and does it matter?
• 11:29 - Traumatic dislocations
• 12:37 - Special tests in the "Is it torn" group
• 15:56 - Is it stiff?
• 17:36 - Is it irritable?
• 20:38 - Can I change it?
• 23:05 - Summary

Click on an image below to access these free resources from Jo Gibson and Clinical Edge

The handout for this podcast consists of a transcript associated with this podcast.

Shoulder: Steps to Success online course with Jo Gibson

Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess

Free trial Clinical Edge membership

Use a fresh approach to your musculoskeletal and sports injury treatment with a free trial Clinical Edge membership at clinicaledge.co/freetrial

Links associated with this episode:

• Free video series - How to be a shoulder detective: Solving acute shoulder pain with Jo Gibson
• Get your access to the free video series “Frozen shoulder assessment & treatment” with Jo Gibson
• Improve your shoulder assessment & treatment with the Shoulder: Steps to Success online course with Jo Gibson
• Improve your confidence and clinical reasoning with a free trial Clinical Edge membership
• Join Jo Gibson live on Facebook & ask your shoulder related questions every Monday
• Download and subscribe to the podcast on iTunes
• Download the podcast now using the best podcast app currently in existence - Overcast
• Listen to the podcast on Spotify
• Jo Gibson on Twitter
• Let David know what you liked about this podcast on Twitter
• Review the podcast on iTunes
• Infographics by Clinical Edge

Chapters:

• 00:00:00 - Intro
• 00:03:12 - Subjective clues that guide diagnosis
• 00:04:33 - What to call shoulder pain? RCRSP or SAP?
• 00:06:04 - 4 key questions to ask
• 00:06:29 - Cervical spine driven shoulder pain
• 00:10:03 - Is it torn and does it matter?
• 00:11:29 - Traumatic dislocations
• 00:12:37 - Special tests in the "Is it torn" group
• 00:15:56 - Is it stiff?
• 00:17:36 - Is it irritable?
• 00:20:38 - Can I change it?
• 00:23:05 - Summary