Shoulder Special Tests (CE3)

Question 1

general rotator cuff tear test cluster

Answer 1

• drop arm sign
• external rotation lag sign
• lift off / belly press

Question 2

full-thickness rotator cuff tear cluster

Answer 2

• drop arm sign
• painful arc sign
• infraspinatus MMT

Question 3

subacromial impingement cluster

Answer 3

• hawkins kennedy
• neer test
• painful arc sign
• empty can
• resisted shoulder ER

Question 4

cluster of tests for subacromial impingement dx

Answer 4

2 or more (+):
- painful arc
- empty can
- resisted ER

Question 5

cluster of tests for r/o subacromial impingement

Answer 5

both are (-):
- painful arc
- resisted ER

Question 6

what are 3 anterior instability tests

Answer 6

apprehension test
load and shift test (anterior)
anterior drawer

Question 7

apprehension test

Answer 7

passive 90 deg ABD + slow ER

pain w/o apprehension can indicate posterior impingement RC pathology

Question 8

modified jobe subluxation-relocation

Answer 8

apply posterior force at proximal-anterior humerus at onset of apprehension

(+) decreased pain and/or increased ER available

Question 9

anterior drawer test

Answer 9

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

Question 10

what are 2 posterior instability tests

Answer 10

load and shift (posterior)
posterior apprehension test

Question 11

posterior apprehension test

Answer 11

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

Question 12

what are 2 general instability tests

Answer 12

feagin test
sulcus test

Question 13

feagin test

Answer 13

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)

Question 14

sulcus test

Answer 14

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

Question 15

what are 4 tests for labral tears

Answer 15

active compression (O’Briens)
biceps load I and II
crank test
anterior slide

Question 16

active compression (O’Briens) test

Answer 16

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

Question 17

what is problematic about active compression (O’Briens) test

ie what special tests are in the same position

Answer 17

empty and full can

Question 18

biceps load I and II

Answer 18

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

Question 19

crank test

Answer 19

supine, arm elevated 160 deg scaption, elbow flexed
apply longitudinal compression thru elbow and rotate arm into ER

(+) SLAP III & IV tears (bucket handle)

Question 20

anterior slide test

Answer 20

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

Question 21

what are 2 biceps tendon tests

Answer 21

speed’s test
yergason’s test

Question 22

speed’s test

Answer 22

flex shoulder 70-80 deg, elbow extended, ER and supinated
resist shoulder flexion at ventral forearm

dynamic speed’s test = shoulder + elbow flexion

Question 23

why is speed’s test problematic

ie what special test is in the same position

Answer 23

full can

Question 24

yergason’s test

Answer 24

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