shoulder orthos detailed how to

Question 1

Jerk Test

Answer 1

Sit with arm medially rotated & 90 forward flexed
Grasp elbow and axially load humerus proximally
stabilize scap with other hand
move arm into horizontal adduction
+ve: sudden jerk or clunk

Question 2

Load and shift test

Answer 2

Patient seated.
Humerus centred in glenoid
Shift humerus anterior and posterior looking for degree of translation
Normal 25% and 50%

Question 3

Jobe Apprehension and relocation

Answer 3

Abduct shoulder 90 degrees.
stabilize elbow and wrist.
Externally rotate shoulder.
Stop at point of pain or apprehension.
(+ve pain or apprehension)
Apply anterior pressure over humeral head (+ve dec pain)

Question 4

Obrien’s (Active compression test)

Answer 4

Arm flex fwd 90 & elbow extended
Adduct arm 10 - 15 deg & IR (thumb down)
Stabilize shoulder & apply downward pressure
Repeated with ER (thumb up)
+ve: painful clicking deep in shoulder or no pain in ER

Question 5

Kim

Answer 5

Patient sitting
Abduct arm 90 in scapular plane
Support elbow 90 flexion
Push through elbow with compressive force; pull posterior and inferior.
+ve: posterior shoulder pain and click

Question 6

Resisted supination in external rotation

Answer 6

Supine
support elbow and wrist in 90 90.
Place palm on hand
resist patient’s supination
ER shoulder to end range

Question 7

Speeds Test

Answer 7

Arm flex fwd 90 &
supinated
asked to resist down ward pressure
pronate resist downward pressure:
+ve pain in supination (bicep tendon suspension cable from insertion in superior labrum to arm. inc tension + inflammation = pain)
no pain in pronation

Question 8

Neers

Answer 8

Examiner IR rotate arm.
Passively & fully elevate in forward flexion in scapular plane while stabilizing scapular.

Passive stress causes humerus tuberosity to jam agst antero-inferior border of acromion.

If painful with ER think AC joint