Shoulder Special Tests Flashcards
Apprehension Test
Patient lying supine with elbow flexed to 90 degrees.
Therapist stands next to patient on affected side; one and holds forearm, other placed over patient’s GH joint.
Slowly abduct the patient’s shoulder to 90 degrees; slowly externally rotate the patient’s arm.
Posterior force can be applied at the end of the test (posterior glide)
Positive Apprehension Test
Patient feels apprehensive,
Muscle spasm response,
Patient tenses to avoid the movement
Symptoms ease with posterior glide
Why is the Apprehension Test used?
Detect instability of the glenohumeral joint
Load and Shift Test
Patient sitting with hand resting on the thigh, therapist stand behind the affected side.
Therapist uses one hand to fix patient’s scapula and clavicle, other hand takes hold of the humeral head.
Humeral head hand generates a load by pushing the humerus into the glenoid.
‘Shift’ is an anterior and posterior translation of the humerus.
Positive Load and Shift Test
Replication of patient’s symptoms
More movement compared to the other side
Why is the Load and Shift Test used?
Detect anterior and posterior instability of the glenohumeral joint
Scarf Test
Patient sitting or standing, therapist standing facing the patient on the affected side with their hand around the patient’s back to stabilise the opposite shoulder.
Patient’s arm should be in 90 degrees of elbow and shoulder flexion, palm facing the floor.
Therapist should then adduct the patient’s arm across their body by pushing on the patient’s elbow until end range.
Scarf Test Positive Test
Pain over the ACJ line
Why is the Scarf Test used?
Assesses for Acromioclavicular joint lesions
Shear Test
Patient sitting with their arm resting on their lap in a neutral position, therapist stood on the affected side.
Therapist should place the heel of one hand over the spine of scapula and the other over the clavicle with fingers interlocked.
Therapist gently squeeze their hands together to apply a shear stress to the ACJ
Positive Shear Test
Pain over the ACJ or,
Increased movement compared to the other side
Why is the Shear Test used?
Assesses for ACJ pathology or injury
Painful Arc
Can be picked up during AROM section.
Ask patient to report pain occurrence but continue moving (if possible).
Where is the painful arc usually?
Between 60-120 degrees of abduction, with a reduction in pain outside of this range.
Scapulohumeral Rhythm (Scapula Dyskinesia)
This is the relationship between the GHJ and the STJ, the clavicle is also involved.
During abduction, watch from different angles.
Always watch the downwards movement as well as this is when there is more likely to be a disruption to the rhythm.
Looking for smoothness of the movement of the scapula.
