The Shoulder

Basic Functional Examination

Endfeel

This term describes the sensation that the examiner experiences at the end of the passive movement.

It gives him information about the structure or condition that stops the movement and has therefore a high diagnostic value.
In addition it has therapeutic and prognostic consequences; see capsular pattern.

The normal endfeel for passive movements at the shoulder is the 'ligamentous' or 'elastic' endfeel: The feeling of a thick piece of leather being stretched via a lever.

The pathological end-feels at the shoulder are:

to hard: arthrosis, osteophytic outcrops or capsular contracture.
muscle spasm: an involuntary muscular contraction protects the inflamed tissues against further overstretching. It is present in severe and acute conditions - arthritis in the acute stage - see capsular pattern.
empty endfeel: The examiner does not feel any organic resistance but stops the movement because the perceived pain is too intense and further forcing would result in active and voluntary muscular contraction - see acute bursitis
double endfeel: The movement is conducted to a first stop whereafter the movement can be continued until a (second) soft endfeel is felt and the final stop is reached. This is typical for capsular instability.