Shoulder Flashcards
What does Speeds test
Bicep tendinopathy, impingement syndrome, labral lesion, bursitis, SLAP lesion
Speeds technique
Pt seated
Forearm ext + sup, arm at side
Stabilise shoulder + wrist
Pt flexes arm to 120 (swing forward)
Resist
Whilst palpating bicipital groove (deltoid contraction will hide bicipital tendon)
+ve Speeds
P
Specificity of Speeds
11-100
Sensitivity of Speeds
4-100
What does Yergasons test
Bicep tendinopathy, glenoid labrum pathology, torn trans humeral lig
Yergasons test
Palpation over bicipital groove
Pt seated, elbow flex to 90
Forearm pronated + gripped
Door handle + open
Resist movement
+ve Yergasons
P in bicipital groove- bicep tendinopathy
P in shoulder- glenoid labrum pathology
Tendon slipping out of groove- torn transverse humeral ligament
Specificity of Yergasons
Bicep- 88
SLAP- 87
Sensitivity of Yergasons
Bicep- 32
SLAP- 12
What does Hawkins-Kennedy test
Supraspinatous impingement/lesion
Hawkins-Kennedy techniques
Pt seated
Put hand on hip, move hand off hip
Apply force through elbow, move forward + back
+ve Hawkins-Kennedy
Increased local P- ant-lat GH
Crepitus may be OA
Specificity of HK
59
Sensitivity of HK
79
What does empty can test
Injury/lesion to supraspinatous
Empty can technique
Pt standing or seated
Actively raises straight arm (palm up) to 120 in scapula plane
At the top- PT IR arm (thumb down= empty can)
Then lowers arm IR slwoly to body
+ve Empty can
Irritation + P- may be injury to muscle which produces IR (pec major, ant delt, lats)
Empty can spens/sens
Sens- 44-89
Spec- 50-90
What does painful arc test
Sub-acromion impingement
Rotator cuff or AC patio
Painful arc technqiue
Normal active abduction
+ve Painful arc
60-120 local P to subacromial/rotator cuff
170-180 pathology to AC
Painful arc sens/spec
Sens- 33-98
Spec- 10-81
What does Nears test
ER- bicep long head impingement
IR- supraspinatous impingement, subacromial bursitis
Nears technique
Depress scapula
ER arm, bring to maximal flex
Repeat for IR
+ve Nears
ER- P
IR- P
Specificity of Nears
60
Sensitivity of Nears
72
What does Cranks test
Labral tears
Cranks test technique
Pt seated
Abd + ER elbow at 90
Apply pressure into elbow
‘Brush hair’
Rotate humerus int/ext
+ve Cranks
If P is over AC test is
-ve
Shoulder P and crepitus- labral
Specificity of Cranks
93
Sensitivity of Cranks
46-91
What does Obriens test
Labral tears, SLAP lesions, Ac pathology, bicep long head tendinopathy
Obriens technique
Pt seated
Shoulder flexed to 90, arm add (10-20)
Pt attempts to maintain position whilst you apply force on forearm
1. Arm IR, thumb down
2. Arm ER, thumb up
Apply downward pressure ask Pt to resist
+ve Obriens
IR- P- labral or SLAP lesion, AC pathology
ER- bicep long head tendinopathy
Specificity of Obriens
98
Sensitivity of Obriens
90
What does Clunks test for
Labral lesion
Clunks techniques
Pt supine
One hand under GH, other supporting above elbow
Shoulder abducted to 150
Apply translation under GH, other hand ER humerus
+ve Clunks
Clunk or grinding sound- trapping of torn labrum between glenoid + humeral head
Clunks spec/sens
Spec- 69
Sens- 44
What does Kims test for
Labral lesion (posterior glenoid)
Ant instability
Kims technique
Pt seated
Back support ]stand on injured side
Abd to 90
Apply force through shoulder
Other hand on deltoid
Elevate their arm upwards, whilst apply downward force
+ve Kim
P (in post shoulder) + clicking
Specificity of Kims
94
Sensitivity of Kims
80
AC Shear technique
Pt seated, examiner cups hands over clavicle and spine of scar
Apply compressive force
+ve AC Shear
P or abnormal movement –> AC Jt patio, AC ligament sprain
Ant Apprehension Test
Pt seated or supine
Shoulder abducted to 90, elbow flexed 90
Examiner applies P-A pressure over the humerus
Observe for signs of apprehension or discomfort
Ant Apprehension test- for?
Ant GH instability
Ant apprehnsion test +ve
Excessive ant translation, dislocation or Pt apprehension
Ant drawer procedure
Pt supine
Examiner grasps the Pts arm with one hand and palpates with other hand over coracoid process and post scapula (trying to stabilise)
Examiner applies long axis distraction to humerus
What does Ant drawer test
Ant GH instability - inc motion or apprehension
Rotator cuff ligament damage - local P
Ant slide test procedure
Pt seated and supine
Hands on hips so thumb is posterior
Examiner stabilises shoulder
Applies an ant-sup force to ipsilateral olecranon + asks Pt to resist action
What does ant slide test
SLAP lesion - ant shoulder P
GH OA - crepitus
Ant slide sensitivity/specificity
8-78
84-93
Apleys procedure
Pt seated or standing
Examiner instructs Pt to place hand behind back and touch mid back inferiorly then superiorly (over shoulder)
What does Apleys test
Rot cuff patho (bicipital or supraspin tendonitis)- P and inability to perform motion
Ext GH rotator tightness or patho
Labral pathology
AC arthritis
Capsular/muscle contracture
Bicep load test
Pt supine or seated
Shoulder abducted- 120 and flexed to 90
Examiner fully ER shoulder then asks Pt to flex elbow while resisting action
What does bicep load test
SLAP lesion- if ant shoulder P
Bicep load validity
High validity for testing SLAP
- bicep tendon attaches to superior labrum
- when resistive force to elbow flexion, biceps contracts and pulls on injured labrum
Specificity- 97
Sensitivity- 90
Arm drop test procedure
Pt seated
Examiner passively abducts shoulders to 90
suddenly let go and ask Pt to catch themselves
What does arm drop test
Bursitis, rotator cuff strain or tear, tendonitis/impingement- P/weakness or ‘racheting’ movement
Grade 3 cuff strain= unable tp catch themselves, less than 3/5 muscle strength
Drop arm sens/spec
Sens- 8-27
Spec- 88-100
Full can procedure
Pt seated
Actively raises straight arm (palm up) to 120 in scapular plane
At top examiner applies downward pressure and notes Pt strength
Full can interpretation
P or weakness- injury or lesion of supraspinatus
Full can spec/sens
Sen- 86
Spec- 57
Post apprehension procedure
Pt supine
Shoulders flexed 90 + IR
Elbow flexed 90
Examiner applies A-P pressure voer elbow while palapting GH
Post apprehension interpretation
Post GH instability- apprehension/inc motion
Rotator cuff ligament/tendon damage- local P
