1. Is your shoulder comfortable with your arm at rest by your side?

2. Does your shoulder allow you to sleep comfortably?

3. Can you reach the small of your back to tuck in your shirt with your hand?

4. Can you place your hand behind your head with the elbow straight out to the side?

5. Can you place a coin on a shelf at the level of your shoulder without bending your elbow?

6. Can you lift one pound (a full pint container) to the level of your shoulder without bending your elbow?

7. Can you lift eight pounds (a full gallon container) to the level of the top of your head without bending your elbow?

8. Can you carry 20 pounds at your side with the affected extremity?

9. Do you think you can toss a softball underhand 10 yards with the affected extremity?

10. Do you think you can throw a softball overhand 20 yards with the affected extremity?

11. Can you wash the back of your opposite shoulder with the affected extremity?

12. Would your shoulder allow you to work full-time at your usual job?