ch 15 skills Flashcards
Drop Arm test
tests for- rotator cuff pathology
evaluation- have the patient put arm up to ear (humerus fully abducted) & have patient slowly lower arm to their side
positive test- arm falls uncontrollably from a position of approx. 90 degrees abduction to their side
Gerber Lift-off test
tests for- subscapularis pathology
evaluation- have patient actively lift the hand off the spine while keeping humerus in extension
positive test- inability to lift the hand off the back
Scapular Retraction test
tests for- scapular dysfuntion/diskinesis
evaluation- empty can MMT, then stabilize scapula with forearm and repeat the empty can test applying downward pressure on the elbow
positive test- supraspinatus strength is increased or symptoms diminished with manual stabilization
Acromioclavicular Compression test
tests for- AC joint & coraclavicular ligament laxity / sprain of AC joint
evaluation- one hand over posterior acromion and the other over the anterior acromion, squeeze hands together to compress the AC joint
positive test- pain at the AC joint or excursion of the clavicle over the acromion process
Apprehension and Relocation tests
tests for- anterior glenohumeral laxity / instability
evaluation- apprehension: GH joint abducted to 90 and the elbow flexed to 90, support the humerus at 90 abduction & passively externally rotate the GH joint by slowly applying pressure to the anterior forearm
relocation: same position, apply a posterior force to the head of the humerus and externally rotate humerus at same time
positive test- patient displays apprehension that the shoulder may dislocate and resists further movement, pain centered in anterior capsule of GH joint
Cross Body Adduction (Scarf) test
tests for- AC ligament pathology
evaluation- patient has arm flexed to 90 degrees and maximally horizontally adducted, examiner pushes arm into further horizontal adduction, compressing the AC joint (mimics throwing scarf over shoulder)
positive test- pain at the AC joint
Posterior Apprehension test
tests for- posterior glenohumeral instability
evaluation- patient laying on back, apply a longitudinal force to the humeral shaft when shoulder & elbow are flexed to 90, forcing the humeral head to move posteriorly on the glenoid fossa
positive test- patient displays apprehension & produces muscle guarding to prevent the shoulder from subluxing posteriorly
Jerk (posterior stress) test
tests for- labral tears, posterior GH instability
evaluation- patient supine with arm at 90 degrees flexion & internal rotation and apply an axial load to the humerus, horizontally adduct the affected arm while maintaining the axial load to the humerus
positive test- cluck that may or may not be painful
Sulcus Sign
tests for- inferior glenohumeral instability / laxity
evaluation- patient sitting with arm hanging at side, grip the arm distal to the elbow and apply a downward force (inferior) traction force to the arm while stabilizing the scapula
positive test- an indention appears beneath the acromion process
how do you differentiate sulcus sign versus AC traction test?
in sulcus sign, the movement of the humeral head is away from the scapula and clavicle while in the AC traction test, the humerus and scapula move away from the clavicle
Neer Impingement test
tests for- rotator cuff impingement
evaluation- arm up by ear, one hand stabilizes the scapula the other grabs the patient’s wrist, place the humerus in internal rotation and pronate the forearm. move the GH joint through forward flexion while stabilizing the scapula
positive test- pain in anterior or lateral shoulder in the range of 90 degrees to full elevation
Hawkins-Kennedy test
tests for- rotator cuff impingement
evaluation- elbow is flexed & GH joint is elevated to 90 in scapular plane, internally rotate humerus until pain or scapular rotation is felt or observed
positive test- pain with motion, especially near the end ROM
Empty Can test
tests for- supraspinatous pathology / weakness (impingement or muscle tear)
evaluation- GH joint abducted to 90 in scapular plane, elbow extended, humerus internally rotated, & forearm pronated so thumb is pointed downward. Place one hand on the superior portion of mid forearm to resist the motion of abduction in the scapular plane
positive test- weakness and/or pain accompanying the movement
Yergason’s test
tests for- LHBT pathology, SLAP lesion, bicipital tendinopathy
evaluation- GH joint in anatomical, elbow flexed to 90 one hand on shoulder palpating bicipital groove while other grabs forearm to resist supination and external rotation of humerus
positive test- pain or snapping in bicipital groove, pain at the superior GH joint (SLAP lesion)
Speed’s test
tests for- long head of biceps brachii tendinopathy
evaluation- stabilize shoulder, resist flexion of GH joint while palpating for tenderness over the bicipital groove. allow the patient to move through flexion ROM
positive test- pain along the long head of the biceps brachii tendon, especially in the bicipital groove or at the superior shoulder
