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
