Practical 1 - Special Tests (indications & (+) ) Flashcards
anterior apprehension test
suspicion of ant shoulder subluxation or dislocation
(+) signs of apprehension or alarm on face
Jobe subluxation - relocation test
indicated if (+) ant apprehension test
(+) dec pain and inc ER
- confirm ant instability and findings in apprehension test
load and shift test
traumatic instability of GH joint (ant and post instability tested)
(+) reproduciton of sx
(+) excessive translation
- anterior shift: can grade the laxity 1-3
anterior drawer test
inc or dec translation of HOH to gleniod
(+) pain, clicking, or inc/dec in HOH translation
posterior apprehension test
test post GH laxity and/or post labrum
(+) reproduced sense of apprehension and inc ms guarding to prevent post shoulder dislocation
Feagin test
“inferior drawer test”, test instability anteroinferiorly
(+) inerior movement
(+) apprehension or discomfort
sulcus test
pt presents w inferior instability of GH
(+ sulcus sign) depression greater than a fingerbreadth bw lateral acromion and HOH
(+) reproduce sx
active compression (O’Briens) test
labral tear identification and AC joint abnormalities
(+) pain or painful clicking in first position and absent in second position
(+ labral involvement) deep pain
(+ AC joint implicated) pain on top of shoulder
biceps load 1 and 2
SLAP testing
(+) pain, clicking or popping
(+) apprehension unchanged or more painful
(+ SLAP lesion) deep pain during contraction
crank test
SLAP testing, good for identifying bucket handle (Type III and IV SLAPs)
(+) reproducing painful sx w ER, clicking and grinding may also be present
anterior slide test
SLAP testing
(+) pain localized to anterosuperior aspect of shoulder
(+) pop or click in anterosuperior region
(+) reproduces sx
speed’s test
bicipital involvement like tenopathy
(+) pain along biceps tendon
- d/t SLAP
- d/t inflammation of bicep tendon
yergason’s test
check ability of transverse humeral ligament to hold biceps in groove
(+) pain in bicipital groove
- if tendon displaced can indicate tear of transverse humeral ligament
neer test
impingement of rotator cuff on anterosuperior glenoid rim or coracoacromial ligament
(+)pain at end range of available ROM
hawkins kennedy test
should impingement, rotator cuff involvement, and subacromial bursitis
(+) reproduction of ant shoulder pain in subacromial space
- more medial position of humerus = RC tendons impinged at coracoacromial arch/process
crossover test
identify AC joint dysfunction/sprain and possible impingement of RC under AC joint
(+) pain reproduced in AC region
empty can test (jobe test)
determine integrity of supraspinatus tendon, partial or complete rupture of tendon
- will be more comfortable for impingement people than full can and less likely to result in ms weakness d/t pain provocation
(+ partial rupture) weak and painful test
(+ complete rupture) weak and painless test
full can test
alternate to empty can
integrity of supraspinatus tendon
(+) inc shoulder pain
(+) inc shoulder ms weakness
(+) inc both shoulder pain and ms weakness
lift-off test (gerber’s test)
assess subscap ms
induce pain secondary to subacromial impingement syndrome
(+) inability to lift dorsum of hand off back
belly press test
alternative to lift off tst
assess subscap ms
(+ subscap tear) elbow dropping behind body into ext
internal rotation lag sign
assess integrity of subscap tendon
(+ subscap tendon rupture) pt can’t hold position on their own
patte test (hornblowers sign)
evaluate integrity of teres minor ms
(+) pt can’t externally rotate shoulder in this position
drop arm test
test integrity of supraspinatus ms
test for complete tear of rotator cuff
(+) pt unable to slowly and smoothly lower his arm all the way down to side
- indicates complete rotator cuff tear
external rotation lag sign and dropping sign
assess integrity of infraspinatus and supraspinatus tendons
(+ lag) pt inability to maintain arm near full ER
- may indicate a supra/infra tear
(+ drop) inability to maintain the position and arm drops to neutral position of shoulder rotation
ROOS test (east test)
assess thoracic outlet syndrome
(+) reproduced sx of pain, numbness, heaviness, tingling, and fatigue in <3min
adson’s test
r/o neuro-vasculature compressions d/t abnormalities of scalene ms and/or cervical ribs
(+) pulse diminishes or disappears
(+) paresthesias induced
costoclavicular manuever (military test)
suspicion of thoracic outlet compromised causing compression of subclavian artery & brachial plexus where pass thru clavicle and 1st rib (dec volume of costoclavicular space)
(+) diminished pulse or paresthesia
wright’s test (hyper-ABD test)
determine if TOS compression is occurring as result of pec minor tightness/impingement
(+) diminished radial pulse and/or paresthesia
elbow flexion test
cubital tunnel syndrome and ulnar n. entrapment
- pain/numbness on 4th/5th digits
- difficulty separating fingers
- dec or loss of ability to grip, atrophy, and contracture
(+) tingling, numbness or tingling along ulnar n. distribution
pressure provocation test
cubital tunnel syndrome and ulnar n. entrapment
- pain/numbness on 4th/5th digits
- difficulty separating fingers
- dec or loss of ability to grip, atrophy, and contracture
(+) reproduction of sx along ulnar n. distribution
tinel’s test
progression of pressure provocation test
cubital tunnel syndrome and ulnar n. entrapment
- pain/numbness on 4th/5th digits
- difficulty separating fingers
- dec or loss of ability to grip, atrophy, and contracture
(+) tingling sensation in ulnar distribution, indicating ulna n. irritation
Cozen’s test
lateral epicondylalgia
(+) pain produced w provocation test
- usually secondary to inflammation/irritation of wrist extensors d/t overuse
(+ ECRL tendon irritation) pain above lat epicondyle
(+ ECRB origin irritation) pain localized to lateral epicondyle
mill’s test
lateral epicondylalgia
(+) pain in lateral epicondyle of elbow
maudsley test
lateral epicondylalgia
testing more for extensor digitorum communis
(+) reproduction of pain/sx at lateral epicondyle region
golfer’s elbow test
tenderness and/or pain slightly distal and ant to medial epicondyle
pain worsens w resisted wrist flex
pain worsens w passive stretch of wrist ext/sup
(+) pain in region of medial epicondyle
valgus stress test
testing MCL - specifically anterior band
checking for laxity/instability
(+) reproduction of pain and inc space at elbow
milking maneuver test
testing MCL - specifically posterior band
checking for laxity/instability
(+) reproduction of pain and inc space at elbow w valgus stress
moving valgus stress test
testing MCL
checking for laxity/instability
OH athlete not getting (+) tests w valgus stress test and milking maneuver
(+ chronic MCL tear) reproduction of medial elbow pain bw 120-70deg
varus stress test
testing LCL
checking for laxity/instability
(+) reproduction of pain and inc space at elbow w valgus stress
