SHOULDER Flashcards
EMPTY CAN
Pt stood or seated
Arm out horizontally with thumb up
Pronate hand so thumb is down
Movement so it looks like pt is ‘emptying a can’
EMPTY CAN - WHAT DOES IT TEST?
Impingement
Injury/lesion to supraspinatous
EMPTY CAN - POSITIVE TEST
Irritation
Pain
May be due to an injury to the muscle that produces internal rotation (pec major, ant deltoid, lats)
PAINFUL ARC
Pt stood
Normal active abduction
Open palms all the way up
PAINFUL ARC - WHAT DOES IT TEST?
Sub-acromion impingement
PAINFUL ARC - POSITIVE SIGN
Local pain in the region of 60-120 = subacromial/rotator cuff
Local pain in the region of 170-180 = pathology to AC
NEER’S
Pt seated
Depress scapula
Pronate arm (so palm is facing away from body), bring to maximal flexion
Repeat with internal rotation
NEER’S - WHAT DOES IT TEST?
External rotation - biceps long head impingement
Internal rotation - Supraspinatous impingement, subacromial bursitis
NEER’S - POSITIVE TEST
External rotation = pain
Internal rotation = pain
CRANK
Pt seated
Abduct and externally rotate elbow at 90
Apply pressure into elbow
Rotate pt arm into internal and external rotation so they look like they are ‘brushing their hair’
CRANK - WHAT DOES IT TEST?
Glenoid labral lesion
Can also be used to test the different glenohumeral ligaments
CRANK - POSITIVE TEST
Pain
Crepitus
If pain is over AC its a negative result
OBRIEN’S
Pt seated
Shoulder flexed 90, arm adducted
Pt attempts to maintain position whilst you apply force to forearm
1. Arm is internally rotated, thumb down
2. Arm is externally rotated, thumb up
OBRIEN’S - WHAT DOES IT TEST?
INTERNAL ROTATION - Labral tears, SLAP lesions, A/C pathology
EXTERNAL ROTATION - Biceps long head impingement
OBRIEN’S - POSITIVE TEST
Pain in internal rotation (labral tears, SLAP lesions, A/C pathology)
Pain in external rotation (biceps long head impingement)
CLUNK
Pt supine
One hand under GH
Other hand supporting above pt elbow
Apply translation under the GH, while other hand is externally rotating the humerus
CLUNK - WHAT DOES IT TEST?
Glenoid labral lesions
CLUNK - POSITIVE TEST
Clunk or grinding noise/feeling
Due to the trapping of the torn labrum between the glenoid and humeral head
KIM
Pt seated
Support pt back with your body (stand close)
Arm abducted 90
One hand holding pt elbow
Other hand on deltoid
Apply force through the elbow while stabilising around their deltoid
Adduct arm while applying this pressure
KIM - WHAT DOES IT TEST?
Posterioinferior labral lesion
KIM - POSITIVE TEST
Pain
Clicking
Posterior shoulder pain
SPEED’S
Pt seated or standing
Pt has arm straight out in front of them with elbow fully extended and arm supinated (palm up)
Examiner places contact just superior to pt wrist and applies a downward force on arm
Pt resists the downward pressure
SPEED’S - WHAT DOES IT TEST?
Bicipital tendinitis
Impingement syndrome
Labral lesion or bursitis
SPEED’S - POSITIVE TEST
Pain
YERGASON
Pt stood or seated
Pt has elbow flexed 90 and forearm fully pronated
One hand palpating the bicipital groove
Other hand holding pt wrist
Ask pt to supinate arm and you resist this movement
YERGASON - WHAT DOES IT TEST?
Biceps tendinopathy
Transverse humeral ligament pathology
Glenoid labrum pathology
YERGASON - POSITIVE TEST
Pain in bicipital groove (biceps tendinopathy)
Tendon slipping out of groove (transverse humeral ligament pathology)
Pain in shoulder (glenoid labrum pathology)
HAWKINS KENNEDY
Pt seated
Forward flexion 90 (arm straight out)
Elbow flexed 90
Examiner stabilises pt shoulder with other hand round pt wrist
Examiner internally rotates pt arm
HAWKINS KENNEDY - WHAT DOES IT TEST?
Supraspinatus impingement
HAWKINS KENNEDY - POSITIVE TEST
Increased local pain in the anterior lateral G/H
