Shoulder problem that attach the shoulder muscles to bone and assist the muscles in moving the shoulder. Ligaments attach shoulder bones to each other, providing stability. For example, the front of the joint capsule is anchored by three glenohumeral ligaments. The rotator cuff is a structure composed of tendons that, with associated muscles, holds the ball at the top of the humerus in the glenoid socket and provides mobility and strength to the shoulder joint. Four filmy sac-like structures called bursa permit smooth gliding between bone, muscle, and tendon. They cushion and protect the rotator cuff from the bony arch of the
Rotator cuff tear single physical examination test distinguishes reliably between bursitis, partial-thickness, and full-thickness tears. On the contrary, a combination of tests seems to provide the most accurate diagnosis. For impingement, these tests include the Hawkins-Kennedy impingement sign in which the examiner medially rotates the patient's flexed arm, forcing the supraspinatus tendon against the coracoacromial ligament and so producing pain if the test is positive a positive painful arc sign, and weakness in external rotation with the arm at the side. For the diagnosis of full-thickness rotator cuff tear, the best combination appears to include once more the painful arc and weakness in