Orthopaedic & Musculoskeletal Tests - Shoulder

Question 1

What conditions of the GH joint can you test for?

Answer 1

Anterior Instability 
Rotator Cuff Tear - Infraspinatus tear 
Supraspinatus tendinopathy
Subscapularis tendinopathy
Subacromial Impingment 
Labral Tear

Question 2

What Osteopathic Test is used for anterior shoulder instability?

Answer 2

Apprenhension and Relocation Test.

Question 3

How do you perform the Apprehension and Relocation Test?

Answer 3

Apprehension -

1) Have the patient lie supine.
2) Flex the Forearm to 90,
3) Abduct the humerus to 90,
4) support Scapula and clavical with medial hand.
5) Slowly externally rotate the humerus, if the patient feels uncomfortable or weary stop. and do the Relocation. IF NO APPREHENSION TEST WAS NEG, NO NEED TO DO RELOCATION.

Relocation.

1) Same first 4 steps of apprehension.
2) with medial hand on GH joint apply posterior pressure, (push shoulder into table)
3) continue with external rotation and see if there is a difference in results.

TEST SHOULD NOT BE DONE ON CLIENTS WITH ANTERIOR SHOULDER DISLOCATIONS.

Question 4

When test for a rotator cuff test, what muscle are we testing

Answer 4

Infraspinatus.

Question 5

How do you test the infraspinatus muscle. what test do we use?

Answer 5

We use the infraspinatus muscle test.

1) Have the patient sitting on the edge of the table.
2) have them flex their elbow to 90.
3) support the forearm and medially rotate the humerus to 45
4) have the patient resist into your hand while trying to externally rotate the humerus.
5) positive result is pain/weakness on movement/around GH joint.

Question 6

how do you test for supraspinatus tendinopathy?

Answer 6

There are 3 test for supraspinatus tendinopathy.

1) Hawkins- Kennedy. which test for Supraspinatus tendon pushed against the anterior surface of the coracoacromial ligament and coracoid process

2) Neer’s Impingment Test- Supraspinatus tendon
Jams the greater tuberosity against the anteroinferior acromion

3) Empty can test - Tests the supraspinatus muscle/tendon for inflammation or injury

Question 7

How to preform the Hawkins- Kennedy Test and what is it testing for

Answer 7

it is testing to see if the supraspinatus tendon is pushing against the coroacromial ligament and coracoid process)

1) Have the patient seated.
2) flex the humerus to 90.
3) support the elbow while holding the wrist.
4) forcibly medially rotate the wrist

Question 8

how to preform the Neers’s impingment test? and what is it testing for?

Answer 8

Neer’s impingment test is pushing the greater tuberosity against the anterioinferior acromion.

1) have the patient seated.
2) flex elbow to 90.
3) pronate the the forearm and extend the elbow
4) while the forearm arm is pronated, and elbow flexed, vertical flex the humerus.

If pain or weakness posititive result

Question 9

how to preform the empty can test, and what is it testing for

Answer 9

the empty can test, is testing the supraspinatus tendon for inflammation or injury.

1) patient is seated.
2) patient activly abducts the arm to 90
3) patient then horizontal flexs the arm to 30- 40
4) patient then “empties the can” (pronate forearm)
5) practitionar pushed down on patients arm.

Pain or weakness positive result.

Question 10

what is test is used to test for a disfunctional subscapularis?

Answer 10

The push off test.

Question 11

How is the push off test done?

Answer 11

1) patient is seated
2) you have the patient medially rotate the humerus.
3) have patient put medially rotated arm behind back. (pain or struggle is positive.)
4) if they have no issue, place you palm on theirs and get them to try and push your hand backwards/away from body. (positive test if pain/weakness)