Shoulder Special Tests Flashcards
Yergason’s - Tests for
Integrity of transverse ligament
Subacromial impingement syndrome
Might identify bicipital tendonitis/tendinopathy
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
Speed’s test - Tests for
Bicipital tendonitis/tendinopathy
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)
Neer’s impingement test - Tests for
Subacromial impingement syndrome
Neer’s - How to perform
Pt sitting
Shoulder passively IR, then fully abducted (textbook), Bush has passive IR and flexion
Empty can test - Tests for
Supraspinatus tendonitis
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)
Drop arm test - Tests for
RTC injury - supraspinatus biased
Drop arm test - How to perform
Pt sitting
Shoulder passively abducted to 120 degrees
Pt instructed to slowly lower arm to side
Posterior internal impingement test - Tests for
Impingement between the rotator cuff and greater tuberosity or posterior glenoid and labrum
Posterior internal impingement test - How to perform
Pt supine
Move shoulder into 90 abduction, max ER, and 15-20 horizontal adduction
Clunk test - Tests for
Glenoid labrum tear
Clunk test - How to perform
Pt supine
Shoulder in full abduction
Push humeral head ant while ER humerus
Audible clunk when performing - positive
Anterior apprehension sign - Tests for
Instability at GH joint - past hx of anterior dislocation
Anterior apprehension sign - How to perform
Pt supine
Shoulder in 90 abduction, slowly take into ER
Posterior apprehension sign - Tests for
Instability at GH joint - past hx of posterior dislocation
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
Acromioclavicular shear test - Tests for
Dysfunction of AC joint
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
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
