Principles of Physical Examination

Overhead athletes can perform their desired and specific tasks because of utilization of the kinetic chain. Alterations in the kinetic chain, either anatomical injuries and/or physical impairments, have been associated with shoulder injury. This relationship between injury and kinetic chain dysfunction/deficiency suggests that an evaluation approach that goes beyond the assessment of the site of symptoms is necessary to correctly identify the root cause(s) that may be creating symptoms. Due to the complexity of the throwing motion and the reliance on the kinetic chain segments working optimally as a unit, a comprehensive evaluation program that assesses anatomical segments proximal and distal to the site of symptoms is necessary to evaluate the thrower. A comprehensive but efficient clinical examination should include elements from three anatomic areas: the core (legs, hips, and trunk), the scapula, and the shoulder/arm.