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Using a goniometer to assess shoulder horizontal adduction

This is an excerpt from Principles of Goniometry and Manual Muscle Testing by Abigail Shelley.

Patient position: Sitting with the arm abducted to 90° with the elbow flexed and the shoulder in neutral rotation (a)

Clinician position: Standing above the patient, looking down at the top of the shoulder

Goniometer

• Fulcrum: Placed over the acromion
• Proximal arm: Aligned parallel to the acromion
• Distal arm: Aligned with the midline of the humerus

Stabilization

• Glenohumeral horizontal adduction: Place a hand on the scapula to prevent protraction.
• Shoulder complex horizontal adduction: Place a hand on the ribs to stabilize the trunk and maintain a neutral position of the spine.

Test motion

• Glenohumeral horizontal adduction: Horizontally adduct the shoulder by bringing the elbow anteriorly while the shoulder maintains the 90° abducted position. Maintain the neutral rotation position throughout the motion. Use the stabilizing hand to feel for scapular protraction (b).
• Shoulder complex horizontal adduction: Horizontally adduct the shoulder while observing the trunk and ribs. Note the end of shoulder complex flexion when there is resistance in the shoulder and the patient begins to flex through their spine, causing motion of the ribs (c).

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