MSK Special Tests: SHOULDER Flashcards
(Shoulder) Posterior internal impingement
A) IDs impingement between RTC and greater tuberosity of posterior glenoid and labrum
B) Supine: move shoulder into 90 abduction, max ER, 15-20 HADD
(+) pain in posterior shoulder
(Shoulder) Clunk Test
A) IDs glenoid labrum tear
B) Supine: shoulder full ABD, push humeral head anterior while rotating humerus ER
(+) Audible clunk
(Shoulder) Anterior apprehension
A) IDs past hx of anterior shoulder dislocation
B) Supine: shoulder 90 abduction, slowly take shoulder into ER
(+) Doesn’t allow or doesn’t like shoulder to move in that direction
(Shoulder) Posterior apprehension
A) IDs past hx of posterior shoulder dislocation
B) Supine: shoulder ABD 90, scap stabilized by table — place force through shoulder via force on pt’s elbow while simultaneously moving shoulder into IR and ADD
(+) Doesn’t allow or doesn’t like shoulder to move in that direction
(Shoulder) AC Shear
A) IDs AC dysfunction
B) Sitting, arm resting at side — examiner clasps hands, places heel of hand on spine of scap, heel of other hand on clavicle
C) Squeeze hands together causing AC jt compression
(+) AC joint pain
(Shoulder) Yergason
A) ID integrity of transverse humeral ligament, bicipital tendinopathy
B) seated, arm at side, elbow 90 flexed, forearm pronated
C) resist forearm supination, shoulder ER
(+) Biceps tendon pops out, pain in long head of biceps
(Shoulder) Speed’s
A) IDs bicipital tendinopathy
B) UE full extension, forearm supinated, resist shoulder flexion
OR
C) Shoulder in 90 flexion, resist into extension (eccentric biceps contraction)
(+) pain long head biceps
(Shoulder) Neer’s
A) Impingement of soft tissue structures of shoulder (long head biceps, supraspinatus)
B) sitting, shoulder passively IR, fully flexed)
(+)pain
(Shoulder) Empty Can/Supraspinatus
A) IDs tear/impingement of supraspinatus or suprascap N. Neuropathy
B) sitting- shoulder at 90 with no rotation, resist abduction
THEN
C) empty can: IR shoulder, HADD 30, resist
— differentiate between pain pre/post
(+) pain in supraspinatus tendon/weakness in empty can
(Shoulder) Drop Arm
A) Tear/full rupture of RTC
B) Sitting, shoulder passively abducted 120 then instruct pt to slowly lower
(+) unable to lower
(Shoulder) Active Compression (O’Brien)
A) IDs presence of AC tear or lesion
B) sitting or standing: pt places shoulder in 90 flexion, 10 adduction
C) active IR, thumb down, force applied down, first thumb down then repeat thumb up
(+) AC lesion: localized pain w/ thumb down, decreased pain thumb up
(+) Labral tear: painful clicking in jt with thumb down, reduced with thumb up
(Shoulder) Rent Sign
A) IDs torn RTC or RTC impingement
B) Pt seated, arm relaxed, PT behind — palpate anterior to anterior edge of acromion w/ 1 hand while holding pt’s elbow flexed with other
C) PT passively extends shoulder, slowly rotating shoulder into ER/IR
(+) greater tuberosity prominent with depression of 1 finger width felt if RTC tear present
(Shoulder) Crank test
A) Eval different GH ligaments or ID shoulder instability, labral tear
B) Pt standing, PT places distal hand on pt’s elbow, proximal on pt’s proximal humerus, then passively elevate shoulder to 160 in scap plane
C) distal hand applies load along long axis of humerus, prox hand ER/IR humerus
(+) pain with or without click
(Shoulder) Biceps Load 2
A) ID GH labral tear (SLAP)
B) supine, PT brings shoulder into 120 abduction, max ER, elbow flexion, forearm supination
C) PT holds pt’s wrist, stabilized elbow w/ other hand, pt flexes elbow against resistance
(+) increase symptoms against resistance
(Shoulder) Bear Hug Test
A) ID subsap tear
B) sitting/standing, hand on opp shoulder — PT applies ER force while pt tries to keep hand on shoulder
(+) pt can’t maintain
