Shoulder Special Tests (CE3) Flashcards
general rotator cuff tear test cluster
- drop arm sign
- external rotation lag sign
- lift off / belly press
full-thickness rotator cuff tear cluster
- drop arm sign
- painful arc sign
- infraspinatus MMT
subacromial impingement cluster
- hawkins kennedy
- neer test
- painful arc sign
- empty can
- resisted shoulder ER
cluster of tests for subacromial impingement dx
2 or more (+):
- painful arc
- empty can
- resisted ER
cluster of tests for r/o subacromial impingement
both are (-):
- painful arc
- resisted ER
what are 3 anterior instability tests
apprehension test
load and shift test (anterior)
anterior drawer
apprehension test
passive 90 deg ABD + slow ER
pain w/o apprehension can indicate posterior impingement RC pathology
modified jobe subluxation-relocation
apply posterior force at proximal-anterior humerus at onset of apprehension
(+) decreased pain and/or increased ER available
anterior drawer test
stabilize at scap - pin it down to the table
mobilize upper arm with anterior force
0 deg ABD = SGHL
45 deg = MGHL
90 deg = anterior band of IGHL
what are 2 posterior instability tests
load and shift (posterior)
posterior apprehension test
posterior apprehension test
arm in 90 deg flexion, neutral rotation, 100-105 deg H-ADD
stabilize at scap, axial force thru humerus applied at elbow
assesses posterior GH laxity and/or posterior labrum
can also perform in no H-ADD, pt should feel apprehension from arm just falling onto table
modification: increase ADD or IR
what are 2 general instability tests
feagin test
sulcus test
feagin test
seated, shoulder ABD 90 deg, elbow extended on PT’s shoulder
mobilizing force at proximal humerus over deltoid, inferior force
assesses anterior-inferior instability (SGHL)
sulcus test
seated, arm 20-50 deg ABD
apply inferior force and palpate sulcus
assesses inferior instability (superior ligament complex)
(+ sulcus sign) = depression > 1 finger breadth b/w lateral acromion and HOH
what are 4 tests for labral tears
active compression (O’Briens)
biceps load I and II
crank test
anterior slide
active compression (O’Briens) test
shoulder flexed 90 deg, elbow ext, H-ADD 10-15 deg
stabilize scap and clavicle, apply force into shoulder extension with arm positiones:
1. arm IR
2. arm ER
for labral tear and AC joint abnormalities
(+ labral tear) = arm IR
(+ AC joint abnormal) = top shoulder pain
what is problematic about active compression (O’Briens) test
ie what special tests are in the same position
empty and full can
biceps load I and II
supine, arm supinated and ABD 90 deg (I) or 120 deg (II)
perform anterior apprehension test
- stop ER at point of apprehension
- have pt flex elbow in this amount of ER, apply resistance
crank test
supine, arm elevated 160 deg scaption, elbow flexed
apply longitudinal compression thru elbow and rotate arm into ER
(+) SLAP III & IV tears (bucket handle)
anterior slide test
standing w hands on hips (thumb posterior)
stabilize scapula and apply force anterior / superior from behind elbow
best test for superior glenoid vs SLAP tear
what are 2 biceps tendon tests
speed’s test
yergason’s test
speed’s test
flex shoulder 70-80 deg, elbow extended, ER and supinated
resist shoulder flexion at ventral forearm
dynamic speed’s test = shoulder + elbow flexion
why is speed’s test problematic
ie what special test is in the same position
full can
yergason’s test
elbow against trunk, elbow flex 90 deg, forearm pronated
resist supination at forearm or hand
looks at transverse humeral lig integrity
modified yerg’s = supination + ER
