G-H Special Tests

Question 1

What are the 10 special tests of the glenohumeral joint?

Answer 1

1. ANTERIOR INSTABILITY TEST - APPREHENSION
2. ANTERIOR DRAWER TEST OF THE SHOULDER
3. INFERIOR INSTABILITY TEST (SULCUS SIGN)
4. POSTERIOR INSTABILITY TEST (JERK TEST)
   ANTERIOR IMPINGEMENT TESTS:
5. HAWKINS-KENNEDY IMPINGEMENT TEST
6. NEER IMPINGEMENT TEST
   +
7. LABRAL TEAR TEST (CLUNK TEST)
   ACROMIALCLAVICULAR JOINT PATHOLOGY TESTS:
8. HORIZONTAL ADDUCTION / CROSSOVER
9. ACROMIALCLAVICULAR SHEAR TEST
   +
10. ELLMAN’S COMPRESSION ROTATION TEST

Question 2

Name the first 6 special tests of the glenohumeral joint?

Answer 2

1. ANTERIOR INSTABILITY TEST - APPREHENSION
2. ANTERIOR DRAWER TEST OF THE SHOULDER
3. INFERIOR INSTABILITY TEST (SULCUS SIGN)
4. POSTERIOR INSTABILITY TEST (JERK TEST)
   ANTERIOR IMPINGEMENT TESTS:
5. HAWKINS-KENNEDY IMPINGEMENT TEST
6. NEER IMPINGEMENT TEST

Question 3

Name the final 4 special tests of the glenohumeral joint? (7 - 10)

Answer 3

7.  LABRAL TEAR TEST (CLUNK TEST)
\+
ACROMIALCLAVICULAR JOINT PATHOLOGY TESTS:
8.  HORIZONTAL ADDUCTION / CROSSOVER
9.  ACROMIALCLAVICULAR SHEAR TEST
\+
10.  ELLMAN'S COMPRESSION ROTATION TEST

Question 4

How would you perform the Apprehension Test?

Answer 4

DONE SLOWLY
\+
ABDUCT PATIENTS ARM TO 90°
\+
LATERALLY ROTATE SHOULDER

+ = patient looks/feels alarmed, resists further motion

Question 5

How would you perform the Anterior Drawer Test of the shoulder?

Answer 5

ABDUCT PATIENTS ARM TO 90°
+
SLIGHTLY FWD FLEX and EXT ROTATE
+
PLACE ONE HAND ON AXILLA, RESTING PATIENT HAND IN ELBOW
+
PLACE OTHER HAND ON SCAPULA with THUMB on CORACOID PROCESS
+
USE HAND IN AXILLA TO DRAW HUMERUS FORWARD

+ = click, apprehension, excessive movement

Question 6

How would you perform the Inferior Instability test known as Sulcus Sign?

Answer 6

Px STANDING, ARMS AT SIDES, SHOULDER RELAXED
+
THERAPIST GRASPS Px FOREARM below elbow and PULLS DISTALLY
+
REPEAT AT 20° and 50° ABDUCTION

+ = sulcus sign (step deformity appearance)

Question 7

How would you perform the Posterior Instability “Jerk Test”?

Answer 7

Px SITS, ARM MEDIALLY ROTATED and FLEXED 90°
\+
Tx GRASPS Px ELBOW and AXIALLY LOADS ARM
(pushing towards shoulder)
\+
MAINTAINING AXIAL LOAD, HORIZONTALLY ADDUCT
\+
RETURN ARM TO START

+ = sudden clunk / jerk as arm subluxes, may be 2nd clunk as returned to start

Question 8

Name the 2 anterior impingement tests of the shoulder?

Answer 8

5. HAWKINS-KENNEDY IMPINGEMENT TEST

6. NEER IMPINGEMENT TEST

Question 9

How would you apply the Hawkins-Kennedy Impingement Test for supraspinatus tendinosis or impingement?

Answer 9

Tx FLEXES Px ARM TO 90° (BEND ELBOW TOO)
+
FORCIBLY INTERNALLY ROTATE while HORIZONTALLY ADDUCTING

+ = local pain

Question 10

How would you apply the Neer Impingement Test for supraspinatus (or sometimes biceps) overuse injury?

Answer 10

Tx MEDIALLY ROTATES THE PATIENTS ARM
then
FULLY ELEVATES IN SCAPTION

+ = local pain

Question 11

How would you apply the Clunk Test, for labral tears?

Speed’s also tests for labral tears

Answer 11

Tx PLACES ONE HAND OVER Px POST SHOULDER, HUMERAL HEAD
+
Tx OTHER HAND HOLDS HUMERUS ABOVE THE ELBOW
+
Tx FULLY ABDUCTS ARM THEN PUSHES ANTERIORLY WITH OTHER HAND while EXT ROTATING ARM

+ = clunk or grinding sound

Question 12

What is the positive for the simple “Horizontal Adduction” test, which can be done active free or passively?

Answer 12

A-C pain indicating injury / pathology

Question 13

How is the Acromioclavicular Shear test performed?

Answer 13

Px SEATED
\+
Tx CUPS HANDS OVER CLAVICLE / SCAPULAR SPINE
\+
Tx SQUEEZES HEELS OF HANDS TOGETHER

+ = excessive movement of A/C joint, pain possible

Question 14

How would you perform Ellman’s Compression Rotation Test for arthritic changes / problems at the G-H joint?

Answer 14

Px SIDELYING
+
Tx COMPRESSES HUMERAL HEAD INTO GLENOID FOSSA
while
Px INTERNALLY / EXTERNALLY ROTATES THE SHOULDER

+ = reproduction s / s