Shoulder tests Flashcards
What are the shoulder orthopedic tests?
Bicipital tendinopathy
– Speeds
– Yergason’s
Rotator cuff impingement:
– Hawkins Kennedy
– Neers
– Empty can
– painful arc
Labral lesion:
– O’briens
– clunk
– Kim’s
– Crank
Speeds
Looks for:
– bicipital tendinopathy, impingement syndrome, labral lesions
+VE:
– pain
—- increased tenderness in the bicipital groove especially with the arm supinated (indicative of bicipital tendinosis
How:
– pt forearm straight out, first supinated then pronated
– examiner resists forward flexion
– can also be performed when the shoulder is flexed to 90 degrees and extension is resisted by examiner
This test is more affective than Yergason’s:
– because the bone moves over more of the tendon during the speeds test
If profound weakness is found on resisted supination, a severe second or third degree (rupture) sprain of the distal biceps should be suspected
Yergason’s
Looks for:
– bicipital tendinopathy
– tendon slipping out of the groove- transverse humeral ligament pathology
– pain in shoulder- glenoid labrum pathology
+VE:
– tendon felt to ‘pop out’ of bicipital groove during test- if the transverse humeral ligament is torn
– tenderness of bicipital groove- bicipital tendinopathy
— pain over bicultural groove- bicipital tendinipathy
— pain over shoulder- glenoid labrum lesion
— tendon slipping out of groove- transverse numeral ligament pathology
How:
– elbow flexed 90 degrees and stabilised at elbow
– hold pt hand, pt hand starts pronated, want to do a ‘opening a door’ motion
– the hand should end up supinated
– palpate the pt’s bicipital groove
Hawkins Kennedy
Looks for:
– supraspinatus impingement or tendinoopathy
– subacromial impingement
+VE:
– pain
How:
– pt seated, arm abducted 90 degrees
– compress shoulder and internally rotate and horizontally abduct inside
– this will pinch the greater tuberosity of the humerus against the acromion (squeezing that supraspinatus muscle)
– can also be done in the scapula plain
Neers
Looks for:
– pain with int rot (hand down)- supraspinatus impingement, subacromial bursitis
– pain with ext rot (hand up)- biceps long head impingement
—- causes the greater tuberosity to arm against the anteroinferior border of the acromion
+VE:
– pain
How:
– pt seated, examiner takes pt through the passive range of motion at shoulder, with int rot of hand and ext rot of hand
Empty can
Looks for:
– injury or lesion to the supraspinatus muscle
– supraspinatus impingement
– neuropathy of the subscapular nerve
+VE:
– weakness or pain
How:
– pt arm abducted to 90 degrees, examiner provides resistance to abduction
– move shoulder in scapula plane and do the same, with thumbs up and thumbs down
O’briens
Looks for:
– pain with int rotation (thumb down)- SLAP lesion, labral lesion AC pathology
– pain with ext rotation (thumb up)- biceps long head tendinopathy
+VE:
– pain
— GH pain or crepitus with internal rotation that is eliminated with palm up- anterior labral tear/SLAP lesion
— palm up pain- biceps tendinopathy
How:
– pt seated, shoulder flexed 90 degrees and adducted 10-20 degrees
– internal rotation (thumb down) resistance
– external rotation (thumb up) resistance
Painful arc
Looks for:
— rotator cuff or AC pathology
+VE:
— shoulder pain 60-120 degrees- rotator cuff pathology
— shoulder pain 170-180 degrees- AC pathology
How:
Pt abducts
Crank test
Looks for:
– glenoid labral lesion
– may also be used to test the different glenohumeral ligaments
+VE:
– pain
How:
– completed with shoulder out to the side in ‘neutral’ - primarily the superior glenohumeral ligament and capsule are being tested
– if completed at 45 to 60 degrees abduction- middle glenohumeral ligament, coracohumeral ligament, inferior glenohumeral ligament (anterior band) and anterior capsule are being tested
– over 90 degrees abduction, the inferior glenohumeral ligament and anterior capsule are being tested
