The Shoulder

Preliminary examination

The resisted movements of the cervical spine and/ or the shoulder girdle are positive

Painless weakness of the neck usually points in the direction of a neurological lesion. Since muscular and tendinous lesions are extremely uncommon at the cervical spine, pain during muscular contracture is usually the result of transmitted stress.

Pain and /or weakness during the resisted examination of the cervical spine motivate to a thorough examination of this region .

Weakness of the elevation of the scapulae indicates a neurological lesion.

A lesion of the accessory nerve
or a C4 nerve root lesion

Pain during resisted elevation of the scapulae indicates either a muscular or tendinous pathology ( trapezius or levator scapulae) or 'transmitted stress'.
A thorough clinical examination of the shoulder girdle will usually settle the problem.