Shoulder Exam/Eval - Special Tests Flashcards
4 tests for subacromial impingement
- Hawkins-Kennedy
- Neer impingement
- Painful Arc
- Yergason’s
impingement tests with highest spec (2)
Hawkins-Kennedy and Neer
3 tests for tendonitis
- empty can
- speed’s test
- Gerber lift-off
empty can is specific to which muscle?
supraspinatus
speeds test which muscle?>
biceps tendonitis
Gerber lift off which muscle?
subscapularis
tendonitis test with highest spec?
gerber lift off for subscapularis
6 tests for RTC injury
- Passive elevation
Hornblowers biased to which 2 muscles
infraspinatus and teres minor
drop arm for which muscle
supraspinatus
3 tests for labral tears
- active compression
- crank test
- biceps load test
tests for ACJ pathology
- palpation
- resisted extension
3 ??
2 tests for shoulder instability
- apprehension
2. relocation
shoulder instability test with highest spec
apprehension
tendonitis of the ___ and ___ can be caused by impingement
biceps and supraspinatus
Hawkins-Kennedy impingement test
- elbow and GHJ (shoulder) at 90 degrees flexion
- PT puts arm into IR (normal end feel is hard)
- positive if painful with IR
3 things potentialy invovled with positieve Hawkins-Kennedy impingement test
supraspinatus, biceps tendon, bursa
Neer impingement test
stabilize scapula, passively elevate humerus (arm) above head while arm is in IR to jam greater tuberosity into subacromial space
neer positive indicates what?
positive with pain, possible impingment of supraspinatus or bursa
painful arc test
Active motion! PT doesn’t do anything
positive if painful between 60-100
impingement test
positive could also be RTC tear
Yergason Test
- biceps impingement
- shoulder down, elbow at 90 degrees flexion, full forearm pronation
- therapist instructs pt to ER shoulder and supinate
- therapist applies resistance against ER ad supination
positive = pain in bicipital groove
classic symptom with biceps tendonitis
pain reaching across body
2 primary ways to diagnose tendonitis
- palpation
2. resisted contraction in a lengthened range
empty can is for what
tendonitis of supraspinatus
empty can test
patient actively elevates arm to 90 deg scaption and IR (thumb down)
therapist applies downward force
positive = pain or weakness
most painful motion if patient has biceps tendonitis
shoulder flexion
Speed’s test
- biceps tendonitis
- arms at 90 deg shoulder flexion, full elbow extension and forearm supination
therapist pushes down while palpating bicipital groove
positive = pain and tenderness in biciptal groove
gerber lift off test is for
subscapularis tendonitis
gerber lift off test
patient puts both hands behind back (ext and IR)
lift arms away from back
must hold position
tear = unable to lift arms away from body
subscap tear doesn’t happen often
lesion = painful
high specificity (.88)
hornblowers sign is for which muscles
infraspinatus and teres minor (RTC injury)
hornblowers sign
- 90 degrees scaption, patient ER against resistance into IR
positive = pain and or weakness
high sen and spec!!
drop arm test - which muscle
supraspinatus (RTC injury)
drop arm test
arm passively abducted to 90
patient attempts to slowly lower (or hold position)
positive= arm flops
can also apply downward force to see if pt is weak or painful
Active compression test is for?
labraltears
active compression test
- labral tear
- in sitting, pt puts arm into 90 flexion, elbow ext
- PT adducts arm 10 degrees with full IR
- PT applies downward force
- test repeated with arm in ER
- psoitive = less pain with ER. also click/pain with IR
positive active compression test
less pain with ER than IR
sen/spec of active compression test
both very high!!! good for labral tears
Bankart tear
anterior, inferior labral tear
often occurs with dislocations
crank test
- for slap or bankart lesion
- pt supine, arm at 160 scaption
- apply compression while IR and ER arm
positive = pain or click
high sen and spec
biceps load test is for
slap lesion
biceps load test
- slap lesion
- pt supine
- arm abducted to 90, elow at 90, forearm supinated!
- ER until apprehensive, then patient flexes elbow against PT’s resistance
positive = pain or apprehension
