Shoulder / GH Joint Flashcards
Neers Impingement
o Pt seated → examiner stabilises elbow and scapula and passively flexes the arm in IR.
o Pain and reproduction of SSx indicates subacromial impingement
Hawkins-Kennedy Impingement
o Pt seated → passive shoulder flexion to 90 deg with elbow flexion to 90, examiner stabilises at elbow and introduces internal rotation
o Pain and reproduction of SSx indicates subacromial impingement (syndrome).
Open + Empty Can Test
o Pt seated → active abduction of arm to 90 deg with ~ 30 deg forward flexion. Examiner applies superior force to distal arm → Pt resists
o Examiner then introduces IR (thumb to ground) and applies superior force to distal arm → Pt resists
o Familiar pain implicates involvement of supraspinatus Mm and tendon
Drop Arm Test
o Pt seated. Passive abduction of arm to 90 deg with subsequent rapid removal of support.
o Pt inability to maintain position at 90 deg indicates tear / rupture of RC
Infraspinatus Test
o Pt seated. Active adduction of arm with 90 deg elbow flexion. Examiner resists Pt efforts (distal forearm) to introduce ER.
o Familiar pain and SSx implicates involvement of infraspinatus Mm and tendon
Press Belly Test
o Pt seated. Examiner places dorsal aspect of hand on PT belly, asks Pt to place hand on Pt hand and press into belly.
o Familiar pain/SSx or weakness (wrt opposite side) indicates subscapularis tear / involvement.
o → cf. Lift Off Test (preferable because of minimized involvement of pecs and lats)
Biceps Load II Test
o Pt supine. Active abduction of shoulder to ~ 120 deg with ER. Active elbow flexion to 90 deg after which examiner provides resistance.
o Familiar pain / SSx deep in GH Jt indicate presence of SLAP (superior labral tear antr → postr) lesion.
Resisted Supination External Rotation Test
o Pt supine. Active shoulder abduction to ~ 90 deg with ~70 deg elbow flexion. Examiner introduces ER and provides active resistance to PT efforts to supinate forearm
o Familiar pain / SSx deep in GH Jt indicate presence of SLAP (superior labral tear antr → postr) lesion
Speeds Test
o Pt seated. Active shoulder flexion to ~60 with elbow extended and supinated. Examiner provides active resistance to forearm flexion.
o Familiar pain in anterior GH / bicipital groove indicates pathology of biceps tendon.
o → also possible SLAP lesion.
Yergasons Test
o Pt seated. Active elbow flexion to 90 deg, Pt asked to actively supinate and ER against examiner resistance.
o Familiar pain in anterior GH / bicipital groove indicates pathology of biceps tendon Apprehension Test
Apprehension Test
o Pt supine. Passive shoulder abduction to 90 deg with elbow flexion 90 deg → examiner takes arm into rapid ER
o Any Pt guarding / resistance or pain indicates shoulder instability (with possible Hx of subluxation / dislocation).
O’Briens AC Compression
o Pt sitting. Active shoulder flexion to 90 deg with ~ 15 deg adduction → IR and pronation of forearm.
o Examiner stabilises distally and resists Pt upwards force.
o Repeat with neutral shoulder and forearm positions.
o Pain / clicking in first position and reduced / absent in second indicates AC involvement (if superficial pain) or labral pathology (if deep pain).
