Shoulder Special Tests Flashcards by Alex Stein

Yergason’s - Tests for

Integrity of transverse ligament
Subacromial impingement syndrome
Might identify bicipital tendonitis/tendinopathy

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Yergason’s - How to perform

Pt sitting
Shoulder in neutral (stabilized against trunk)
Elbow at 90 flexion with forearm pronated
Resist - supination of forearm and ER of shoulder

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Speed’s test - Tests for

Bicipital tendonitis/tendinopathy

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Speed’s test - How to perform

Pt sitting or standing
Upper limb in 90 shoulder flexion, full elbow extension and forearm supination (some scaption)
Resist shoulder flexion (apply force down into shoulder extension and palpate bicipital groove)

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Neer’s impingement test - Tests for

Subacromial impingement syndrome

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Neer’s - How to perform

Pt sitting

Shoulder passively IR, then fully abducted (textbook), Bush has passive IR and flexion

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Empty can test - Tests for

Supraspinatus tendonitis

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Empty can test - How to perform

Pt sitting
Pt actively elevates arms into 90 flexion with elbow extension and thumb down (empty can) (IR and 30 scaption)
Downward force applied by therapist (Resist abduction - text)

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Drop arm test - Tests for

RTC injury - supraspinatus biased

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Drop arm test - How to perform

Pt sitting
Shoulder passively abducted to 120 degrees
Pt instructed to slowly lower arm to side

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Posterior internal impingement test - Tests for

Impingement between the rotator cuff and greater tuberosity or posterior glenoid and labrum

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Posterior internal impingement test - How to perform

Pt supine

Move shoulder into 90 abduction, max ER, and 15-20 horizontal adduction

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Clunk test - Tests for

Glenoid labrum tear

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Clunk test - How to perform

Pt supine
Shoulder in full abduction
Push humeral head ant while ER humerus
Audible clunk when performing - positive

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Anterior apprehension sign - Tests for

Instability at GH joint - past hx of anterior dislocation

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Anterior apprehension sign - How to perform

Pt supine

Shoulder in 90 abduction, slowly take into ER

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Posterior apprehension sign - Tests for

Instability at GH joint - past hx of posterior dislocation

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Posterior apprehension sign - How to perform

Pt supine in 90 abduction, place posterior force through shoulder via force at elbow (so shoulder is kind of flexed) while moving shoulder into internal rotation and horizontal adduction

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Acromioclavicular shear test - Tests for

Dysfunction of AC joint

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AC shear test - How to perform

Pt sitting
Arm resting at side
Clasps hands with one at spine of scap and other at clavicle - squeeze hands together to cause compression of AC joint
Pain - positive

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Adson’s test - Tests for

Thoracic outlet syndrome - pathology of structures passing through thoracic inlet

Adson’s test - How to perform

Pt sitting
Find radial pulse
Rotate head toward extremity being tested
Extend elbow and ER arm while extending the head
Positive - disappearance of pulse or neuro sx

Costoclavicular Syndrome (military brace) Test - Tests for

Pathology of structures passing through thoracic inlet

Costoclavicular syndrome (military brace) test - How to perform

Pt sitting
Find radial pulse
Move involved shoulder down and back

Wright (hyperabduction) test - Tests for what

Pathology of structures passing through thoracic inlet

Wright (hyperabduction) test - How to perform

Pt sitting Find radial pulse Move shoulder into max abduction and ER Take deep breath and rotate head opposite side being tested

Roos elevated arm test - Tests for what

Pathology of structures passing through thoracic inlet

Roos elevated arm test - How to perform

Pt standing with shoulder fully ER , 90 abd | Elbow flexed to 90 and pt open and closes hands for 3 minutes

Upper limb tension tests - Tests for

Peripheral nerve compression

Hawkins Kennedy Impingement Test - Test for what

Subacromial impingement syndrome

Hawkins Kennedy Impingement Test - How to perform

Examiner places pt shoulder into 90 of shoulder flex with elbow flex to 90 PT then passively IR pt arm

Allen's maneuver - Tests for what

Presence of thoracic outlet syndrom

Allen's maneuver - How to perform

Pt sitting Arm to be tested in 90 abd and full ER, elbow in 90 flex Pt rotates head opposite side while palpating radial pulse

Active compression - Tests for what

Labral tear or AC lesion

Active compression - How to perform

Sitting or standing Pt instructed to place shoulder in 90 flex and 10 add (elbow ext) Arm actively IR so thumb is pointing down PT apply force into shoulder ext (downward) Then do it with ER (thumb up) Positive if decrease in pain with thumb up

Rent Sign - Tests for what

Torn RTC or RTC impingement

Rent Sign - How to perform

Pt seated with PT standing behind pt PT palpates anterior to anterior edge of acromion while holding the pt's flexed elbow with the other PT passively extends the shoulder while slowly rotated into IR and ER rotation Positive for tear if greater tuberosity prominent and depression of 1 finger width is felt

Crank Test - Tests for what

Used to evaluate different GH ligaments | Anterior shoulder instability

Crank Test - How to perform

Pt standing PT place hand on pt elbow and proximal humerus Passively elevate pt shoulder to 160 scaption Apply force against humerus while IR and ER the humerus (with your other hand)

Biceps load 2 test - Tests for what

GH labral tears - SLAP lesion

Biceps load 2 test - How to perform

Supine PT bring pt into 120 abduction, max ER, 90 elbow flex, forearm supination pt asked to perform elbow flexion against examiner resistance

Bear Hug Test - Tests for what

Subscapularis tear

Bear hug test - How to perform

Pt sitting or standing with hand on opp shoulder with elbow anterior to body PT applies ER force while patient attempts to maintain hand on the shoulder Positive - pt cannot hold hand against shoulder as therapist applies ER force

Belly compression test - Tests for what

Subscapularis lesion

Belly compression test - How to perform

Pt sitting or standing PT places hand on abdomen pt places hand of shoulder being tests on examiner hand and pushes hard as they can into stomach pt tries to bring elbow forward in scapular plane causing IR at shoulder

Horizontal adduction test - Tests for what

Presence of AC dysfunction or subacromial impingement

Horizontal adduction test - How to perform

PT stand behind pt on side being tested Grasp pt arm distal to elbow and passively flex pt shoulder to 90 - then maximally adduct shoulder to bring it across to other shoulder

Gerber lift off test - tests for what

Tendonitis | Subscapularis

Gerber lift off test - How to perform

pt stands with hand against back at waist level PT moves pt arm 5-10 away from back while keeping elbow flexion pt has to hold the position

Hornblowers sign - Tests for what

RTC injury - biased towards infraspinatus and teres minor

Hornblowers sign - How to perform

PT place pt arm in 90 scaption | pt asked to ER against resistance