Shoulder Tests Flashcards
Shoulder Passive Compression Test
Positioning: patient lying on side, bad shoulder up. flex elbow to 90 deg and abduct arm 30 deg. externally rotate arm to end of range.
Instruction:
Technique: compress by pressing in at the elbow and top of the shoulder. then flex and extend the shoulder.
Interpretation: +pain - extension is the stressor of the labrum
Know the 3 tests used for Cluster Diagnosis for Subacromial Impingement
- Hawkins-Kennedy
- Infraspinatus strength
- Painful Arc
Gerber’s Lift-off Test
Positioning: patient seated, stand behind
Instruction: bring the back of your hand to the small of your back…then lift it off and away.
Technique: observe for pain, can add resistance.
Interpretation: +weakness - subscapularis
Codman’s Drop Arm Test
Positioning: patient seated, stand behind. abduct the patient’s arm to 150 deg
Instruction: i’m going to let go of your arm, slowly bring it back down to your side
Technique: observe if it is smooth motion fully. at 60 degs, muscle changes from deltoid to supraspinatus.
Interpretation: +if control is lost when supraspinatus takes over.
Muscle Test for Subscapularis
Positioning: patient seated, stand in front. patient’s upper arms against body, elbows flexed to 90 deg so palms face
Instruction: resist when i push against your hands
Technique: push the patient’s hands out away each other (testing internal rotation).
Interpretation: +weakness forsubscapularis
Muscle Test for Infraspinatus/Teres Minor
Positioning: patient seated, stand in front. patient’s upper arms against body, elbows flexed to 90 deg so palms face
Instruction: resist when i push against your hands
Technique: push the patient’s hands in toward each other (testing external rotation).
Interpretation: +weakness for either infraspinatus/teres minor
Hawkin-Kennedy Test
Positioning: patient seated, stand in front. flex shoulder to 90 and elbow to 90.
Instruction: keep your arm relaxed
Technique: one hand supports under the upper arm just proximal to elbow; other hand at the wrist…pull the forearm down quickly to maximize internal rotation
Interpretation: +pain - supraspinatus impingement
What are the actions of the SITS muscles and their primary tests?
- Supraspinatus - abduction; empty can
- Teres minor/infraspinatus - external rotation; resisted motion
- Subscapularis - internal rotation; resisted motion, gerber’s
A/C Compression test (AKA O’Brian’s Test part 1)
Positioning: patient seated, stand in front and to side. bring the patient’s straight arm into 90 deg shoulder flexion and move it 15 deg toward midline.
Instruction: you’re going to resist my pressure.
Technique: internally rotate the arm maximally and then provide downward force proximal to the wrist.
Interpretation: +pain - SLAP lesion or AC joint issue
Speed’s Test
Positioning: patient seated, stand to the side facing. with inside hand locate bicipetal groove
Instruction: straighten your arm and turn palm up (want about 30-45 deg shoulder flexion)
Technique: other hand at patient’s wrist and resist as they attempt shoulder flexion (bringing the arm up straight ahead to verhead)
Interpretation: +pain - biceps tendonitis
Know the 3 tests used for Cluster Diagnosis for Acromioclavicular Pathology
- AC cross body
- AC resisted extension
- AC compression (O’briens pt 1)
A/C Crossbody Adduction Test
Positioning: patient seated, stand beside and front
Instruction: let me know if there’s pain
Technique: flex shoulder to 90 and elbow to 90. one hand on clavicel and the other hand on the elbow. push the arm across the body as far as it will go.
Interpretation: +pain - either AC or sternoclavicular joints
O’Brien’s Test (part 1 & 2)
Positioning: patient seated, stand in front and to side. bring the patient’s straight arm into 90 deg shoulder flexion and move it 15 deg toward midline.
Instruction: you’re going to resist my pressure.
Technique: internally rotate the arm maximally and then provide downward force proximal to the wrist (part 1). repeat with the arm in maximal external rotation/ overly supinate (part 2).
Interpretation: +pain - SLAP lesion or AC joint issue
Relocation Test
Positioning: patient supine, stand to side. set up cactus arm and push down on the head of the humerus
Instruction: let me know if there’s pain
Technique: like with apprehension test, externally rotate the arm by pressing wrist toward the floor.
Interpretation: +pain or apprehension gone - glenohumoral instability confirmed
Shoulder Apprehension Test
Positioning: patient seated, stand behind and laterally. put the arm in cactus position. one hand on the back of the shoulder and one hand at the wrist.
Instruction: let me know if you feel pain
Technique: press the humeral head forward while simultaneously pulling back on the wirst (externally rotating arm).
Interpretation: +pain/apprehension - labrum tear, rotator cuff tear
Modified Dynamic Labral Shear Test
Positioning: patient standing. stand behind and to side. flex elbow 90 deg and bring arm into abduction over 120 deg and in the scapular plane.
Instruction: let me know if there’s pain
Technique: holding the arm at the wrist, move it up and down bewteen 60 and 120 degrees
Interpretation: +pain - labral tear
Know the 3 tests used for Cluster Diagnosis for Full Thickness Rotator Cuff Tears
- Drop arm test
- Painful arc
- Infraspinatus strength test
Neer’s Test (part 1 & 2)
Positioning: patient seated, stand to the side. keep patient arm straight and maximally rotate the hand internally (part 1) or externally (part 2)
Instruction: don’t try to help
Technique: one hand on the scapula and the other at the wrist, maximally flex the shoulder by bringing the arm overhead
Interpretation: +pain - pinching against acromion
1 - supraspinatus impingement
2 - biceps impingement
Muscle Test for Supraspinatus (AKA Empty Can Test)
Positioning: patient standing, stand behind.
Instruction: you’re going to resist me pushing down on your arm
Technique: abduct arm to shoulder level, then move forward 30 deg into pane of the scapula. make thumbs up and internally rotate fully so thumb point down. press down into the hand.
Interpretation: +weakness - supraspinatus muscle/tendon injurt
Passive Distraction Test
Positioning: patient supine. stand to side. straight, supinated arm, abduct it to 150 deg. and stabilize shoulder by trying to press on head of humerus.
Instruction: let me know if there’s pain
Technique: pronate the patient’s forearm.
Interpretation: +pain - pronation pulls on biecps which pulls on labrum
