{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T23:27:52Z","timestamp":1788305272683,"version":"build-2803163510"},"reference-count":46,"publisher":"The Ewha Medical Journal, Ewha Womans University College of Medicine","issue":"1","license":[{"start":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T00:00:00Z","timestamp":1738281600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":["www.e-emj.org"],"crossmark-restriction":true},"short-container-title":["Ewha Med J"],"abstract":"<jats:p>\n                Shoulder pain is a common complaint in primary care settings. The prevalence of\n                    shoulder pain is on the rise, especially in societies with aging populations.\n                    Like other joint-related conditions, shoulder pain is predominantly caused by\n                    degenerative diseases. These degenerative changes typically affect bones,\n                    tendons, and cartilage, with common conditions including degenerative rotator\n                    cuff tears, impingement syndrome, and osteoarthritis. Diagnosing these\n                    degenerative diseases in older adults requires a thorough understanding of basic\n                    anatomy, general physical examination techniques, and specific diagnostic tests.\n                    This review aims to outline the fundamental physical examination methods for\n                    diagnosing shoulder pain in older adult patients in primary care. The\n                    shoulder's complex anatomy and its broad range of motion underscore the\n                    need for a systematic approach to evaluation. Routine inspection and palpation\n                    can identify signs such as muscle atrophy, bony protrusions, or indications of\n                    degenerative changes. Assessing range of motion, and distinguishing between\n                    active and passive deficits, is crucial for differentiating conditions like\n                    frozen shoulder from rotator cuff tears. Targeted strength tests, such as the\n                    empty can, external rotation lag, liftoff, and belly press tests, are\n                    instrumental in isolating specific rotator cuff muscles. Additionally,\n                    impingement tests, including Neer\u2019s and Hawkins\u2019 signs, are useful\n                    for detecting subacromial impingement. A comprehensive understanding of shoulder\n                    anatomy and a systematic physical examination are vital for accurately\n                    diagnosing shoulder pain in older adults. When properly executed and interpreted\n                    in the clinical context, these maneuvers help differentiate between various\n                    conditions, ranging from degenerative changes to rotator cuff pathology.\n            <\/jats:p>","DOI":"10.12771\/emj.2025.e8","type":"journal-article","created":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T09:20:41Z","timestamp":1740388841000},"update-policy":"https:\/\/doi.org\/10.12771\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Physical examinations for older adults with shoulder pain: a\n                    narrative review"],"prefix":"10.12771","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4573-3210","authenticated-orcid":false,"given":"Sangwoo","family":"Kang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0883-2461","authenticated-orcid":false,"given":"Suk-Woong","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4998","published-online":{"date-parts":[[2025,1,31]]},"reference":[{"issue":"11","key":"key2.0250224102027e+13_B1","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1136\/ard.57.11.649","article-title":"Estimating the burden of musculoskeletal disorders in the\n                        community: the comparative prevalence of symptoms at different anatomical\n                        sites, and the relation to social deprivation","volume":"57","author":"Urwin","year":"1998","journal-title":"Ann Rheum Dis"},{"issue":"1","key":"key2.0250224102027e+13_B2","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1186\/s12891-022-05973-8","article-title":"A systematic review of the global prevalence and incidence of\n                        shoulder pain","volume":"23","author":"Lucas","year":"2022","journal-title":"BMC Musculoskelet Disord"},{"issue":"1","key":"key2.0250224102027e+13_B3","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/s40945-021-00119-w","article-title":"Shoulder pain prevalence by age and within occupational groups: a\n                        systematic review","volume":"11","author":"Hodgetts","year":"2021","journal-title":"Arch Physiother"},{"issue":"11","key":"key2.0250224102027e+13_B4","doi-asserted-by":"crossref","first-page":"687","DOI":"10.5124\/jkma.2022.65.11.687","article-title":"Epidemiology and etiology of shoulder pain based on health\n                        statistics data from Healthcare Bigdata Hub in Korea","volume":"65","author":"Jung","year":"2022","journal-title":"J Korean Med Assoc"},{"issue":"3","key":"key2.0250224102027e+13_B5","doi-asserted-by":"crossref","first-page":"125","DOI":"10.5397\/cise.2020.00178","article-title":"Prevalence of rotator cuff diseases in adults older than 40 years\n                        in or near Chuncheon city, Korea","volume":"23","author":"Kim","year":"2020","journal-title":"Clin Shoulder Elb"},{"issue":"2","key":"key2.0250224102027e+13_B6","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1097\/00005373-196703000-00002","article-title":"Recurrent anterior dislocation of the shoulder. II. A comparative\n                        study","volume":"7","author":"McLaughlin","year":"1967","journal-title":"J Trauma Acute Care Surg"},{"issue":"3","key":"key2.0250224102027e+13_B7","doi-asserted-by":"crossref","first-page":"345","DOI":"10.5397\/cise.2024.00283","article-title":"Factors associated with patient satisfaction after arthroscopic\n                        rotator cuff repair: do they differ by age?","volume":"27","author":"Kim","year":"2024","journal-title":"Clin Shoulder Elb"},{"issue":"5","key":"key2.0250224102027e+13_B8","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1016\/j.jse.2011.01.021","article-title":"The prevalence of shoulder osteoarthritis in the elderly Korean\n                        population: association with risk factors and function","volume":"20","author":"Oh","year":"2011","journal-title":"J Shoulder Elb Surg"},{"issue":"7","key":"key2.0250224102027e+13_B9","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.2106\/00004623-200107000-00013","article-title":"Effects of the glenoid labrum and glenohumeral abduction on\n                        stability of the shoulder joint through concavity-compression: an in vitro\n                        study","volume":"83","author":"Halder","year":"2001","journal-title":"J Bone Joint Surg Am"},{"issue":"1","key":"key2.0250224102027e+13_B10","doi-asserted-by":"crossref","first-page":"46","DOI":"10.2106\/00004623-199274010-00007","article-title":"Anatomy, histology, and vascularity of the glenoid labrum. An\n                        anatomical study","volume":"74","author":"Cooper","year":"1992","journal-title":"J Bone Joint Surg Am"},{"issue":"10","key":"key2.0250224102027e+13_B11","doi-asserted-by":"crossref","first-page":"2119","DOI":"10.1016\/j.jbiomech.2006.10.016","article-title":"Shoulder function: the perfect compromise between mobility and\n                        stability","volume":"40","author":"Veeger","year":"2007","journal-title":"J Biomech"},{"issue":"5","key":"key2.0250224102027e+13_B12","doi-asserted-by":"crossref","first-page":"713","DOI":"10.2106\/00004623-199274050-00010","article-title":"Tendons, ligaments, and capsule of the rotator cuff. Gross and\n                        microscopic anatomy","volume":"74","author":"Clark","year":"1992","journal-title":"J Bone Joint Surg Am"},{"issue":"4","key":"key2.0250224102027e+13_B13","doi-asserted-by":"crossref","first-page":"437","DOI":"10.5397\/cise.2024.00521","article-title":"The impact of supraspinatus tear on subscapularis muscle atrophy\n                        and fatty infiltration","volume":"27","author":"Kim","year":"2024","journal-title":"Clin Shoulder Elb"},{"issue":"11","key":"key2.0250224102027e+13_B14","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1097\/SMJ.0b013e3181f5e85f","article-title":"Evaluation and management of shoulder pain in primary care\n                        clinics","volume":"103","author":"House","year":"2010","journal-title":"South Med J"},{"issue":"4","key":"key2.0250224102027e+13_B15","doi-asserted-by":"crossref","first-page":"640","DOI":"10.3390\/medicina60040640","article-title":"Socioeconomic and other risk factors for retear after\n                        arthroscopic surgery for nontraumatic rotator cuff tear","volume":"60","author":"Lee","year":"2024","journal-title":"Medicina"},{"issue":"6","key":"key2.0250224102027e+13_B16","first-page":"216","article-title":"Identifying shoulder pain in older patients: the history,\n                        physical examination, and testing","volume":"26","author":"Tobola","year":"2009","journal-title":"J Musculoskeletal"},{"issue":"5","key":"key2.0250224102027e+13_B17","doi-asserted-by":"crossref","first-page":"447","DOI":"10.3928\/01477447-20060501-09","article-title":"Isolated teres minor atrophy: manifestation of quadrilateral\n                        space syndrome or traction injury to the axillary nerve?","volume":"29","author":"Wilson","year":"2006","journal-title":"Orthopedics"},{"issue":"3","key":"key2.0250224102027e+13_B18","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1007\/s00276-009-0605-9","article-title":"Teres minor innervation in the context of isolated muscle\n                        atrophy","volume":"32","author":"Friend","year":"2010","journal-title":"Surg Radiol Anat"},{"issue":"4","key":"key2.0250224102027e+13_B19","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/S1058-2746(96)80051-6","article-title":"Role of the long head of the biceps brachii in glenohumeral\n                        stability: a biomechanical study in cadavera","volume":"5","author":"Pagnani","year":"1996","journal-title":"J Shoulder Elb Surg"},{"issue":"11","key":"key2.0250224102027e+13_B20","doi-asserted-by":"crossref","first-page":"2684","DOI":"10.1177\/0363546513485359","article-title":"Degenerative joint disease of the acromioclavicular joint: a\n                        review","volume":"41","author":"Mall","year":"2013","journal-title":"Am J Sports Med"},{"key":"key2.0250224102027e+13_B21","first-page":"1055","article-title":"Osteoarthritis of the sternoclavicular joint","volume-title":"The shoulder","author":"Rockwood","year":"1998","edition":"2nd ed"},{"issue":"4","key":"key2.0250224102027e+13_B22","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1016\/j.pop.2013.08.006","article-title":"The evaluation and treatment of rotator cuff\n                        pathology","volume":"40","author":"Bishay","year":"2013","journal-title":"Prim Care Clin Office Pract"},{"issue":"5","key":"key2.0250224102027e+13_B23","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1136\/bjsm.2009.058834","article-title":"Current concepts: scapular dyskinesis","volume":"44","author":"Kibler","year":"2010","journal-title":"Br J Sports Med"},{"issue":"1","key":"key2.0250224102027e+13_B24","doi-asserted-by":"crossref","first-page":"79","DOI":"10.5397\/cise.2022.01417","article-title":"Partial-thickness rotator cuff tears: a review of current\n                        literature on evaluation and management","volume":"27","author":"Radhakrishnan","year":"2024","journal-title":"Clin Shoulder Elb"},{"issue":"1","key":"key2.0250224102027e+13_B25","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1148\/radiol.11101082","article-title":"Shoulder US: anatomy, technique, and scanning\n                        pitfalls","volume":"260","author":"Jacobson","year":"2011","journal-title":"Radiology"},{"issue":"5","key":"key2.0250224102027e+13_B26","doi-asserted-by":"crossref","first-page":"353","DOI":"10.5435\/00124635-200509000-00009","article-title":"Subscapularis tendon tears","volume":"13","author":"Lyons","year":"2005","journal-title":"J Am Acad Orthop Surg"},{"issue":"11","key":"key2.0250224102027e+13_B27","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1589\/jpts.32.760","article-title":"Accuracy of long head of the biceps tendon palpation by physical\n                        therapists; an ultrasonographic study","volume":"32","author":"McDevitt","year":"2020","journal-title":"J Phys Ther Sci"},{"issue":"6","key":"key2.0250224102027e+13_B28","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0129398","article-title":"Measurement of shoulder range of motion in patients with adhesive\n                        capsulitis using a Kinect","volume":"10","author":"Lee","year":"2015","journal-title":"PLoS One"},{"issue":"2","key":"key2.0250224102027e+13_B29","doi-asserted-by":"crossref","first-page":"2293","DOI":"10.21037\/apm-20-1808","article-title":"Understanding the physical examination of the shoulder: a\n                        narrative review","volume":"10","author":"Yang","year":"2021","journal-title":"Ann Palliat Med"},{"issue":"1","key":"key2.0250224102027e+13_B30","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1177\/03635465990270011901","article-title":"Which is more useful, the \"full can test\" or the\n                        \"empty can test,\" in detecting the torn supraspinatus\n                        tendon?","volume":"27","author":"Itoi","year":"1999","journal-title":"Am J Sports Med"},{"issue":"1","key":"key2.0250224102027e+13_B31","doi-asserted-by":"crossref","first-page":"13","DOI":"10.5397\/CiSE.2008.11.1.013","article-title":"Physical examinations of rotator cuff tear","volume":"11","author":"Kim","year":"2008","journal-title":"Clin Shoulder Elb"},{"issue":"4","key":"key2.0250224102027e+13_B32","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/S1058-2746(96)80058-9","article-title":"Lag signs in the diagnosis of rotator cuff\n                        rupture","volume":"5","author":"Hertel","year":"1996","journal-title":"J Shoulder Elb Surg"},{"issue":"10","key":"key2.0250224102027e+13_B33","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1016\/j.arthro.2006.05.005","article-title":"The bear-hug test: a new and sensitive test for diagnosing a\n                        subscapularis tear","volume":"22","author":"Barth","year":"2006","journal-title":"Arthroscopy"},{"issue":"14","key":"key2.0250224102027e+13_B34","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1136\/bjsports-2012-091066","article-title":"Which physical examination tests provide clinicians with the most\n                        value when examining the shoulder? Update of a systematic review with\n                        meta-analysis of individual tests","volume":"46","author":"Hegedus","year":"2012","journal-title":"Br J Sports Med"},{"key":"key2.0250224102027e+13_B35","volume-title":"Shoulder impingement syndrome [Internet]","author":"Creech","year":"2023"},{"issue":"8","key":"key2.0250224102027e+13_B36","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1136\/bjsm.2008.048074","article-title":"Screening the athlete's shoulder for impingement symptoms:\n                        a clinical reasoning algorithm for early detection of shoulder\n                        pathology","volume":"42","author":"Cools","year":"2008","journal-title":"Br J Sports Med"},{"issue":"45","key":"key2.0250224102027e+13_B37","first-page":"765","article-title":"Impingement syndrome of the shoulder","volume":"114","author":"Garving","year":"2017","journal-title":"Dtsch Arztebl Int"},{"issue":"2","key":"key2.0250224102027e+13_B38","doi-asserted-by":"crossref","first-page":"350","DOI":"10.2307\/3349884","article-title":"Epidemiology of disability in the oldest old: methodologic issues\n                        and preliminary findings","volume":"63","author":"Cornoni-Huntley","year":"1985","journal-title":"Milbank Mem Fund Q Health Soc"},{"issue":"10","key":"key2.0250224102027e+13_B39","doi-asserted-by":"crossref","first-page":"3307","DOI":"10.1007\/s11999-015-4450-3","article-title":"Prevalence and risk factors of spine, shoulder, hand, hip, and\n                        knee osteoarthritis in community-dwelling Koreans older than age 65\n                        years","volume":"473","author":"Cho","year":"2015","journal-title":"Clin Orthop Relat Res"},{"issue":"45","key":"key2.0250224102027e+13_B40","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000031431","article-title":"Inpatients with shoulder osteoarthritis who received integrative\n                        Korean medicine treatment: long-term follow-up of an observation\n                        study","volume":"101","author":"Choi","year":"2022","journal-title":"Medicine"},{"issue":"2","key":"key2.0250224102027e+13_B41","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.jajs.2018.05.001","article-title":"Acromioclavicular arthritis: a review","volume":"5","author":"Vaishya","year":"2018","journal-title":"J Arthrosc Jt Surg"},{"issue":"2","key":"key2.0250224102027e+13_B42","doi-asserted-by":"crossref","first-page":"107","DOI":"10.5397\/cise.2023.00311","article-title":"Isolated acromioclavicular osteoarthritis and steroid\n                        injection","volume":"26","author":"Yi","year":"2023","journal-title":"Clin Shoulder Elb"},{"issue":"2","key":"key2.0250224102027e+13_B43","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1177\/0363546506298022","article-title":"Evaluation and treatment of acromioclavicular joint\n                        injuries","volume":"35","author":"Mazzocca","year":"2007","journal-title":"Am J Sports Med"},{"issue":"3","key":"key2.0250224102027e+13_B44","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1177\/0363546503261723","article-title":"Diagnostic value of physical tests for isolated chronic\n                        acromioclavicular lesions","volume":"32","author":"Chronopoulos","year":"2004","journal-title":"Am J Sports Med"},{"issue":"3","key":"key2.0250224102027e+13_B45","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/S0004-9514(08)70022-9","article-title":"Most clinical tests cannot accurately diagnose rotator cuff\n                        pathology: a systematic review","volume":"54","author":"Hughes","year":"2008","journal-title":"Aust J Physiother"},{"issue":"4","key":"key2.0250224102027e+13_B46","doi-asserted-by":"crossref","first-page":"807","DOI":"10.2106\/00004623-200404000-00021","article-title":"Diagnostic values of tests for acromioclavicular joint\n                        pain","volume":"86","author":"Walton","year":"2004","journal-title":"J Bone Joint Surg Am"}],"container-title":["The Ewha Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.e-emj.org\/download\/download_pdf?doi=10.12771\/emj.2025.e8","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/www.e-emj.org\/download\/download_pdf?doi=10.12771\/emj.2025.e8","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T02:09:57Z","timestamp":1741226997000},"score":1,"resource":{"primary":{"URL":"https:\/\/e-emj.org\/journal\/view.php?doi=10.12771\/emj.2025.e8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,31]]},"references-count":46,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,31]]}},"alternative-id":["10.12771\/emj.2025.e8"],"URL":"https:\/\/doi.org\/10.12771\/emj.2025.e8","relation":{},"ISSN":["2234-2591"],"issn-type":[{"value":"2234-2591","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,31]]},"assertion":[{"value":"2024-11-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e8"}}