Shoulder Flashcards
Special tests
*** Always test unaffected side first some tests can do both shoulders at the same time
1) Subacromial Pain Syndrome tests
‘Empty can’ test for subacromial pain syndrome
2) ‘Empty can’ test for coracoacromial pain syndrome
3) Hawkins and Kennedy= Subacromial pain syndrome and acromioclavicular pathology
4) Scarf=Subacromial pain syndrome and acromioclavicular pathology
5) Rotator Cuff- Sulcus test for rotator cuff integrity
6) Rotator Cuff- External rotation lag sign
7) Rotator Cuff- Infraspinatus muscle test (IFMT)
8) Rotator Cuff- Bear hug
Subacromial Pain Syndrome tests
1) ‘Empty can’ test for subacromial pain syndrome
Patient standing
1) Abduct the shoulders to 90 degrees- Any pain
2) Horizontally adduct to 30 degrees from the midline-Any pain
3) Fully internally rotate-Any pain
4) Maintain this position while therapist applies a
downwards pressure on the arms towards the floor-Any pain
Positive test: Reproduction of symptoms and/or weakness
Confirm findings by palpating the supraspinatus and infraspinatus tendons, and the subacromial bursa.
Subacromial Pain Syndrome tests
2) ‘Empty can’ test for coracoacromial pain syndrome
Patient standing
1) Flex the shoulders to 90 degrees- Any pain
2) Fully internally rotate- Any pain
3) Maintain this position while therapist applies a
downwards pressure on the arms towards the floor and slightly outwards- Any pain
Positive test: Reproduction of symptoms and/or weakness
Confirm findings by palpating the long head of biceps, the subscapularis insertion and the supraspinatus tendon.
3) Hawkins and Kennedy= Subacromial pain syndrome and acromioclavicular pathology
Patient standing
Therapist places the model’s shoulder in 90 degrees of flexion with the elbow flexed to 90 degrees.
The arm is passively internally rotated.
Positive test= pain is reproduced. Pain indicates general sensitivity of the structures in the subacromial space to
compression.
4) Scarf=Subacromial pain syndrome and acromioclavicular pathology
Patient standing
Model asked to reach horizontally across body towards opposite shoulder.
Therapist applies over pressure to the arm.
Positive test= model’s pain is reproduced in the region of the acromio clavicular joint (this manoeuvre
increases stress at the AC joint and may indicate AC joint dysfunction e.g. degeneration, ligament sprain).
5) Rotator Cuff- Sulcus test for rotator cuff integrity
patient sitting shoulder neutral elbow flexed to 90 degrees
Ensure shoulder muscle are relaxed
Therapist hand positioned superiorly over shoulder joint with a finger tip palpating the subacromial space, the therapist uses the other hand to grasp around lower arm just above the elbow joint and applies an inferior traction force.
palpate for widening subacromial space between later hboarder of acromion and humeral head indicating that humeral head has displaced inferiorly
Inferior displacement of 2cm = positive test
= a lesion of the rotator cuff muscles and/or injury to the superior ligament
complex.
6) Rotator Cuff- External rotation lag sign
Patient sitting on edge of plinth therapist behind arm to be tested
Elbow passively flexed to 90° and shoulder abducted 20°(in plane of scapula} held 5° off maximal external rotation (to avoid elastic recoil of the joint capsule).
The model asked to maintain this position actively while the therapist gently releases the wrist, maintaining support through the elbow
Positive test= Inability to maintain position (lag)= tear of rotator cuff(particularly infraspinatus).
Magnitude of lag= recorded in degrees to the nearest 5°.
7) Rotator Cuff- Infraspinatus muscle test (IFMT)
Model standing therapist facing model
Elbows flexed to 90°with the shoulders in neutral rotation.The therapist applies pressure in a medial direction on forearms and model has to resist bubble
Positive test= pain and/ or weakness (indicates damage to infraspinatus).
8) Rotator Cuff- Bear hug
Patient sitting on plinth
model presses their hand onto their opposite shoulder while
maintaining the elbow in a raised position. Therapist tries to lift the hand off the shoulder by pulling on the wrist, while supporting the elbow.
Positive test= unable to maintain position of arm due to painor weakness and shows problems with subscapularis
