Shoulder Special Tests: Impingement, Rotator Cuff, TOS Flashcards
Why are impingement tests performed?
PT suspects cluster of symptoms that include painful arc, impingement tests and ms weakness with shoulder ER
When is Neer’s test indicated?
impingement of RC on the anterosuperior glenoid rim or coracoacromial ligament
What is procedure of Neer’s?
pt seated and passively forced into elevation in scapular plane
over pressure is applied with GH in neutral, IR and ER
positive result is pain, ask pt where pain is
What is Hawkin’s Kennedy indicated?
may indicate shoulder impingement, RC involvement, and subacromial bursitis
What is procedure of Hawkin’s Kennedy?
pt is seated, PT moves arm into flexion at 90 degrees in scapula plane and then arm is forced into IR, other arm stabilizes scapula
What are results of HK?
pos test is characterized by reproduction of pts anterior shoulder pain in the sub acromial space, more medial humerus is could mean RC involvement
When is crossover impingement/horizontal adduction test indicated?
can be used to indentify A/C joint dysfunction and possible impingement of RC located under ac joint region
What is procedure for crossover?
pt is seated and PT passively moves arm into 90 degrees flexion and horizontal adduction and applies pressure
What is result of crossover?
positive if pain in AC region, and ask pt where pain is
When is empty can indicated?
performed to determine integrity of the supraspinatus tendon: partial or complete rupture
What is procedure of empty can?
pt arm in scap plane and felxed to 90 with shoulder IR then apply manual resistance
What is result of empty can?
a partial rupture of supraspinatus- painful and weak test
complete- painless and weak contraction
What is difference between empty and full can?
arm is ER, this is also more likely to show pain instead of muscle weakness
When is the Lift Off test (Gerber’s) indicated?
done to assess the subscapularis
What is procedure of Gerber’s?
patient is sitting or standing and back of hand is is put on pts lumbar region and asked to lift off and then resistance is provided
if pt cant lift off test is positive
What is Belly press test?
pt sits or stands and puts hand on belly and performs IR into stomach, PT can put hand on pts
if arm drops into extension it can indicate subscap tear
this is good test for alternative lift off if patient can’t get into that position
How is internal lag sign performed?
pt is put into position of hand behind back away from back, and asked to hold that position
pos sign if pt cannot hold the position likely indicative of rupture
What is Patte Test or Hornblowers sign?
performed to evaluate integrity of teres minor muscle
What is procedure of Patte?
pt can be sitting or standing with elbow flexed at 90 and pts arm supported at 90 abducted in scapular plane and pt ER rotates arm against PT resistance, if pt cant then it is positive
What is way to test infraspinatus using Patte’s?
same set up but arm is at side
When is the drop arm test indicated?
procedure is performed to test integrity of supraspinatus as well as complete tear of RC
How is drop arm test performed?
PT passively moves pt arm into 90 degrees of abduction and pt is asked to slowly lower arm by their side
What is a positive result of drop arm?
patient is unable to slowly and smoothly lower their arm, this is indicative of complete RC tear
When is external lag sign and dropping sign performed?
test is performed to assess integrity of the infraspinatus and supraspinatus
