3 Expert-Backed Tips to Strengthen your Shoulder Assessment

Shoulders, shoulders, shoulders. As physios, we either love treating them or we don’t. But like it or not, the bottom line is that most of us see plenty of shoulder cases in our day-to-day, so it’s essential to feel confident in how we assess them.

Thankfully, we’ve got experts like consultant physio Anju Jaggi to guide us. With years of experience and deep expertise in shoulder pain, she’s distilled her knowledge into her Shoulder Assessment Practical. Here are three key takeaways from her Practical that I think every physio should bring into their daily clinical work:

If you’d like to see exactly how expert physio Anju Jaggi assess shoulders, watch her full Practical HERE. With Practicals, you can be a fly on the wall and see exactly how top experts assess and treat specific conditions – so you can become a better clinician, faster. Learn more HERE.

1 – Think in categories, not diagnoses

When it comes to shoulder pain, trying to pin down a specific diagnosis with clinical tests can be confusing, and often unreliable. Instead, Anju suggests a simpler, more practical approach: think in categories. Ask yourself – does my patient have a shoulder that is:

• Painful and stiff? (e.g., frozen shoulder, glenohumeral osteoarthritis)
• Painful and weak? (e.g., rotator cuff-related pain)
• Painful and unstable? (e.g., shoulder instability)

These categories can help cut through the diagnostic noise, prioritise your objective assessment, and focus on what matters most.

Anju also points out that you can often start forming a working hypothesis based on the subjective history alone, especially when considering the patient’s age. For example, as a general rule:

• A younger patient? Think painful and unstable (potential shoulder instability)
• Someone aged between 40–65? More likely to be rotator cuff-related issues (painful and weak), or potentially frozen shoulder (painful and stiff).
• 65+? Consider glenohumeral osteoarthritis.

By shifting your mindset from diagnosis to pattern recognition, you’ll build more effective, patient-centered management plans, without getting stuck in the weeds of clinical testing.

2 – Prioritise the sequence to streamline your assessment

Once you’ve completed your subjective assessment and observation of the patient, it’s time to start narrowing things down. Anju aligns her assessment with her goal, that is: to categorise the shoulder pain.

When it comes to active range of motion (AROM) and strength testing, Anju always starts with external rotation, this is because it gives her an early clue about what she’s dealing with; whether the shoulder is more painful and stiff or painful and weak. That insight helps to save time by guiding what to assess next. See her explain in this short clip from her Practical:

Additionally, if you’re dealing with a painful and weak shoulder, then getting a true understanding of cuff strength is integral. See Anju demonstrate how she does this with her patient in lying in this excerpt from her Practical:

3 – Don’t forget the biopsychosocial side

With years of clinical experience behind her, Anju is a strong advocate for taking a biopsychosocial approach to shoulder assessment and management. She highlights that understanding your patient’s beliefs, expectations, and self-efficacy from the very beginning is arguably one of the most important parts in setting them up for success.

Simple questions like:“Do you think physiotherapy can help your condition?”, or “Do you feel confident in your ability to follow the rehab plan?” can give you insight into how your patient might respond to treatment, and where you may need to offer more support, education, or reassurance.

The Getting it Right: Assessing Shoulder Pain (GRASP) trial backs this up. It found that when clinicians take the time to do a thorough initial assessment that includes understanding patient beliefs, addressing concerns, and providing education, a single session can be just as effective as up to six sessions of progressive exercise for many patients (1).

Wrapping up

Regardless of whether you’re a physio who loves treating shoulder pain or not, it makes up a big chunk of what most physios see day-to-day, and getting the assessment right is the first step in effective management.

Shoulder assessment doesn’t have to be complicated. Hopefully, these simple, expert-backed insights from Anju Jaggi help you cut through the noise, build clinical confidence, bring more clarity to your shoulder assessments, and identify what’s actually meaningful to the patient in front of you.

Want to see how Anju Jaggi assesses shoulder pain in the clinic? Watch her full Practical HERE.