Shoulder

Question 1

What is the Apprehension test for and how do you perform it?

Answer 1

Testing for previous dislocation. Supine. Put them in bent elbow external rotation (pitching position). Ask them to tell you if it’s uncomfortable or painful. You’re looking for apprehension – watch their face and they may tense arm/ shoulder to stop you. Positive can be pain or worry/ apprehension

Question 2

What is the load and shift test for and how do you do it?

Answer 2

Testing for instability. Patient sits on bed with feet on floor with their hand in their lap. Hold upper arm (if they have a lot of muscle mass, hold just below where deltoids insert because if you go too high up you’re just moving muscle mass around. If they have a smaller arm, you can hold higher if you can get your hand around their arm). Other hand stabilises over top of shoulder to try and prevent scapula moving. Lift the humerus up and try to move it forwards and backwards. Positive result is more movement than the other side

Question 3

What is the sulcus sign test for and how do you do it?

Answer 3

Testing for instability. Patient sits on bed. You hold above their elbow with their arm bent – their forearm is resting on yours. Pull straight down. Positive result is a sulcus ie a dip appearing above the acromion. May or may not be pain

Question 4

What is Neer’s test for and how do you do it?

Answer 4

Testing for impingement. Standing. Ask them to int rot arm. One hand on top of shoulder, then with other hand hold above their elbow and you passively flex their shoulder. Positive result is pain

Question 5

What is the empty can test for and how do you do it?

Answer 5

Testing for impingement. Patient standing with arms out wide and a little forwards. They internally rotate arms like they were emptying a can they were holding in each hand. Ask for pain. You then apply a little downward pressure and again ask for pain. Positive result is pain

Question 6

What is the drop arm test for and how do you do it?

Answer 6

Testing for impingement. Patient standing with arms out wide and a little forwards, and with palms facing floor. First see if they can hold that position and ask for pain. Then you tap downwards on their arm a few times and ask for pain. Then you ask them to slowly lower their arms down and ask for pain. Positive result is pain

Question 7

What is the lift off test for and how do you do it?

Answer 7

Muscle test for subscap. They stand with elbow bent and back of hand in small of back. First ask them to try and lift their hand away from their back and ask for pain. Then you gently push their hand towards their back and they resist and ask for pain. Positive result is pain

Question 8

What is the Hawkins-Kennedy test for and how do you do it?

Answer 8

Testing for impingement. Standing or sitting with elbow bent 90 degrees and elbow in front of their shoulder. They passively let their arm internally rotate and ask for pain. Positive result is pain

Question 9

What is O’Brien’s test for and how do you do it?

Answer 9

[To remember think a thumbs up sign is like a b for O’Brien] Testing AC joint and labrum tear. Patient makes a thumbs down sign and holds in front and slightly medially. You press down and ask for pain. Then they have arm in same position but with thumb facing up. You press down and ask for pain. Positive result is pain that appears with thumb down but disappears with thumb up

Question 10

What is the scarf test for and how do you do it?

Answer 10

Testing AC ligament or joint problems. Wrap their arm around their neck like a scarf. You press on their elbow. Positive result is anterior pain around AC joint/ ligament