Shoulder Special Tests Flashcards
1
Q
Impingement tests
A
Yocums test
Drop arm test
Hawkins kennedy test
2
Q
Labral tests
A
Crank test
O’briens test
3
Q
Tendon tests
A
Speeds test
Yergasons test
Empty can test
Lift off
4
Q
Instability tests
A
Sulcus
Load and shift
Apprehension tests
5
Q
Speeds test
A
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
6
Q
Yergasons test
A
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
7
Q
Empty can test
A
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
8
Q
Lift off test
A
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
9
Q
Hawkins Kennedy
A
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
10
Q
Yocums test
A
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
11
Q
Drop arm test
A
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
12
Q
Apprehension test
A
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
13
Q
Load and shift test
A
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
14
Q
Sulcus test
A
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
15
Q
Crank test
A
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
