Shoulder Special Tests Flashcards
Impingement tests
Yocums test
Drop arm test
Hawkins kennedy test
Labral tests
Crank test
O’briens test
Tendon tests
Speeds test
Yergasons test
Empty can test
Lift off
Instability tests
Sulcus
Load and shift
Apprehension tests
Speeds test
Purpose = tests pathology in biceps tendon or superior labral tear Pt = standing/seated, shoulder flexed 60-90, elbow fully extended, forearm supinates PT = on affected side, one hand stabilises shoulder, other on anterior forearm Action = pt asked to maintain position whilst PT applies downward pressure through forearm
Weak clinical value
Yergasons test
Purpose = identifies pathology in biceps tendon or glenoid labrum Pt = standing/seated, arm in anatomical position, elbow flexed to 90, wrist pronated PT = on affected side, 1 hand palpates biceps tendon, other hand around distal forearm Action = pt supinates, PT resists Positive = P = biceps tendonosus/SLAP lesions, click often heard indicating laxity, biceps tendon pops out of groove = tear of transverse humeral ligament
Empty can test
Purpose = supraspinatus involvement/impingement Pt = standing/seated, shoulder flexed 40/70 degrees with full medial rotation, elbow and wrist extended PT = stand in front, apply downward pressure Positive = pain anterior, lateral aspect
Lift off test
Purpose = subscapularis integrity Pt = standing/seated, shoulder internally rotated behind back, dorsum of hand adjacent to Lx PT = on affected side/behind, assist medial rotation of arm, ensure hand does not make contact with Lx e.g. "lifted off" Action = ask pt to maintain position Positive = inability to maintain position, hand falls towards Lx
Hawkins Kennedy
Purpose = identify shoulder impingement Pt = standing/seated, shoulder flexed 90 degrees, medial rotation, elbow flexed 90 degrees PT = front of affected, 1 hand stabilises shoulder and supports elbow, other hand on wrist allowing downward medial rotation Action = PT passively takes into internal rotation (push down) Positive = P at end of rotation = rotator cuff pathology
Weak clinical value
Yocums test
Purpose = shoulder impingement, rotator cuff pathology Pt = standing/seated, places hand on opposite shoulder PT = front of affected side, 1 hand stabilises/supports scapula, other hand assists elbow Action = stabilising scapula, PT passively raises the elbow of pt Positive = P reproduced at subacromial space
Drop arm test
Purpose = shoulder impingement Pt = standing/seated, shoulder abducted 90degrees, elbow and wrist extended, wrist pronated PT = standing behind/side supporting when required Action = pt asked to slowly lower arm back down towards torso Positive = arm drops with lack of control = impingement, weakness to rotator cuff, inhibition
Moderate clinical value
Apprehension test
Purpose = ant. instability of GH joint Pt = supine, shoulder abducted 90 degrees, elbow flexed 90 degrees PT = to side of pt, support upper limb at elbow, one hand holding distal radius, watches pt response Action = passive lateral rotation applied to wrist, whilst maintaining arm position Positive = excessive rotation to 90 degrees, pt reports instability
Strong clinical value
Load and shift test
Purpose = anterior instability of GH joint Pt = standing/seated, arm relaxed by side PT = standing behind/side, one hand over shoulder fixing scapula, other hand gripping head of humerus Action = stabilising scapula, ant force applied through humeral head Positive = reproduce of symptoms, grades of laxity
G1 – Translation of Humeral head to glenoid rim, not over it
G2 – Translation of H/H over glenoid rim
G3 – Dislocation of H/H, not returning after movement
Sulcus test
Purpose = inferior instability of GH joint Pt = seated/standing, arms relaxed by side PT = stands by pt side, 1 hand stabilises scapula, other hand grips elbow Action = gradual inferior pull of humerus, down from glenoid fossa Positive = observation of dip under acromion aspect of shoulder
Crank test
Purpose = GH labrum tear Pt = sitting/supine, shoulder abducted to 90, elbow flexed 120 PT = standing on affected side, 1 hand supporting shoulder, other hand holds elbow applying medial force through axis of humerus Action = PT continues compression force whilst medially/laterally rotation shoulder at elbow Positive = reproduction of P, "click" = labrum tear
O’briens test
Purpose = labrum tear
Pt = seated/standing, shoulder flexed 90, adducted 10, full medial/lateral rotation (ask to rotate so palms face up/out to side)
PT = on affected side, 1 hand supports shoulder, other on wrist to apply downward force
Action = in both medial/lateral rotation, PT applies downward force and ask pt to resist
Positive = SLAP lesion = P deep inside shoulder internal rotation, eased by external rotation
ACJ disorder = P top of shoulder/click when internally rotated, eased by external rotation
Weak clinical value
