The first and most important step to take when managing shoulder dysfunction is to make a specific diagnosis (Table 2).

Table 2
Problem Age group Symptoms Diagnosis
Instability 17-30 Dislocations History of dislocation Apprehension sign
Stiffness 40-60 Pain Loss of external rotation Pain at night Loss of movement
Impingement 30-60 Pain with overhead activities Pain at night Impingement signs
Rotator cuff tear 50+ Pain with overhead activities Pain at night Inability to perform overhead activities Impingement signs Weakness of external rotation Weakness of supraspinatus
AC joint pain 20-40 Localised AC joint pain Paxinos sign
Arthritis 70+ Pain Loss of movement Crepitus

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