As soft tissues, osseous tissue and cartilaginous tissues are all in motion, active tests are considered to give general but useful information about the severity of the injury and the nature of the movement that causes discomfort. This avoids irritating the condition with an overly strong provocation test. Active range of motion tests are comparatively safe as the client performs the movement and they are instructed to stop as soon as discomfort is felt. Once this unlikely culprit has been assessed we can rule it out as a suspect. Range of motion, muscle resistance and orthopaedic testing can narrow the field further.Ī useful first step in assessing SIS is to have a client actively abduct the arm. With only 9% of the population having a type III acromion, it is not the primary factor responsible for the 65% of anterior-lateral shoulder pain seen in clinic. Some cases of a type III acromion may warrant a surgical intervention (figure 1.2). ![]() It is estimated that 43.3% of the population has a type I flat acromion, 47.7% have a type II curved acromion and only 9% have a type III hooked acromion. ![]() Angling or hooking of the acromion is graded from I to III. Initial investigation by a medical practitioner will usually involve physical examination and an x-ray to rule out degenerative arthritic changes in the humeral head or congenital hooking of the acromion.
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