Shoulder Flashcards
Scapular Load Test
Shoulder - Stand
Hands-on the hips, 90o, 120o, 150o (apply a force ant, post, sup and inf)
Testing: Test the stability of the scapula during GH mvt.
+ve: Excessive Laxity (beyond 1.5cm)
Punch Out Test
Shoulder - Stand
Forward flex to 90o and make a fist. The examier applies a backward force.
Testing: Serratus Anterior weakness
+ve: winging of the scapula, a difficulty raising their arm
Acromioclavicular Crossover Test
Shoulder - Sit
Examiner passively forward flexes the arm to 90o then adducts as far as possible.
Testing: AC or SC jt. dysfunction
+ve: pain over AC or SC jt
Jerk Test
Shoulder - Sit (arm IR + flex 90o)
Examiner grabs the elbow and axially loads which abducting the arm across the body
Testing: posterior instability of GH
+ve: sudden jerk of humeral head
Crank Test
Shoulder - Supine
Examiners abducts to 90o and laterally rotates w hand under GH jt
Testing: anterior shoulder dislocation
+ve: apprehension or posterior pain
Sulcus Sign
Shoulder - Standing
Examiner prabs patients forearm below the elbow and pulls down supporting the shoulder with the other hand.
Testing: Inferior Instability of the GH
+ve: Presence of sulcus sign (1+,2+,3+)
Neers Test
Shoulder - Standing
1. Examiner flexes and medially rotates the arm
2. Examiner flexes and laterally rotates the arm
Testing:
1. impingement of supraspinatus or bicep tendon
2. AC pathology
+ve: A disappearance of pain with the second part of the test is considered a positive sign for impingement. If the pain during the second part of the test usually indicative of AC joint pathology with Pain in the AC joint.
Hawkins-Kennedy Impingement Test
Shoulder - Standing
Examinar flexes arm to 90o and medially rotates the shoulder.
Testing: supraspinatus tendinosis or secondary impingement
+ve: pain in anterior GH
Empty Can
Shoulder - Standing
Full can: Abduct 90o & laterally rotate w downward resistance
Empty can: Abduct 90o, Adduct 30o, & medially rotate w downward resistance
Testing: supraspinatus tendon or muscle strain
+ve: weakness or pain in anterior GH
Drop Arm Test
Shoulder - Standing
Examiner abducts arm to 90o and asks the patient to lower the arm.
Testing: tear in rotator cuff complex
+ve: patient is unable to return the arm to the side slowly or has pain
Speeds Test
Shoulder - Standing
Resisted GH flex w/ sup
Resisted GH flex w/ pron
Elbow is straight – extension
Testing:
1. Bicipital paratenonitis or tendinosis
2. Also test for SLAP or 2nd or 3rd degree distal biceps strain if profoundly weak.
+ve: increased tenderness in the bicipital groove especially with the arm supinated and is indicative of bicipital paratenonitis or tendinosis
Yergason’s Test
Shoulder - Standing
EF 90 stabilized against thorax
Forearm pronated
Examiner resists supination/ER
Examiner palpates biceps tendon
Testing:
1. To assess for sprained coracohumeral ligament and the transverse humeral ligament.
2. bicipital paratenonitis/tendinosis
+ve
biceps tendon in the bicipital groove the tendon will be felt to “pop out” of the groove if the transverse humeral ligament is torn.
Tenderness in the bicipital groove alone without the dislocation may indicate
bicipital paratenonitis/tendinosis
Lift-Off Sign
Shoulder - Standing
1st The patient stands and places the dorsum of the hand against the midlumbar spine.
2nd The patient then lifts the hand away from the back.
3rd If the patient is able to take the hand away from the back, the examiner should
apply a load pushing the hand toward the back to test the strength of the subscapularis
Testing: Strain in Subscapularis muscle
+ve: An inability to do so indicates a lesion of the subscapularis muscle.
Abnormal motion in the scapula during the test may indicate scapular instability.
Active Compression test of O’Brien Test
Shoulder- Standing
Pt 1: GH flex 90˚, EE, Hor ADD 10-15, IR
MT resists from behind (thumbs down)
Pt 2: position as above w/ER, repeat resistance (thumbs up)
Testing: This test is designed to detect SLAP (type II) or superior labral lesion.
+ve: : If pain on the joint line or deep painful clicking is produced inside the shoulder (not over the AC joint) in the first part of the test and eliminated or decreased in the second part, the test is considered positive for labral abnormalities.
AC Joint Resting Position, Closed Packed Position and Capsular Pattern
Resting position: Arm resting by side in normal physiological
position
Close packed position: 90° abduction
Capsular pattern: Pain at extremes of range of motion, especially
horizontal adduction and full elevation
