Shoulder tests Flashcards
O’Brien sign
shoulder @ 90, internal rotation, and adduction @15 (cross chest). push downward against resistance, repeat with arm supinated
- deep pain is labrum tear
- superficial pain is AC joint problem
Anterior slide test
pt puts hand on hip, stabilze the ant clavicle and contact olecranon. slide femoral head anterior and superior, then have patient push it back to place
-popping, cracking, or crepitus, is noticed with pain on the antero-superior aspect of the shoulder indicates superior or anterior glenoid labrum tear
Anterior Apprehension with Relocation
aka Jobe relocation test
pt lying supine with shoulder and elbow at 90, if this position reproduces the apprehension then,
place hand on anterior GH joint
-if this causes a relief upon relocation it confirms anterior instability of GH joint (rules out tendinitis as false positive)
Painful arc test
pt standing, have them abduction the arm entirely 180d slowely
- -pain worse between 70-110d indicates impingement syndrome with supraspinatus pathology
- -pain worse at 160d or above indicates AC joint involvement
Neer Test
pts shoulder is placed into passive forward flexion to end range, stabilize posterior scapula, thumb pointed down
–end range pain as the greater tuberosity jams the anterior border of acromion indicates impingement with overuse injury of supraspinatus or biceps tendon
Hawkin- Kennedy test
shoulder at 90 and elbow bent at 90 in front of body. take your arm and go under/over their arm. then passively internally rotate
–the supraspinatus tendon is jammed against the anterior coraco-acromial ligament due to narrowing of subacromial space. posterior pain implicates stretch of the teres minor and infraspinatus tendons
–local pain indicates supraspinatus tendinitis and impingement. anterior pain is anterior impingement syndrome, posterior pain is posterior impingement syndrome
Patte test aka?
aka Hornblower sign
shoulder and elbow at 90. stabilize elbow. ask patient to externally rotate. then add resistance
–pain or inability to actively externally rotate against resistance due to weakness indicates infraspinatus or teres minor tendinopathy
Empty can test
arm straight out and abducted about 40 d. maximum internal rotation with thumb pointed down. pt pushes up and out while dr pushes down and in
-resistance to the abduction and downward pressure stresses the supraspinatus muscle and tendon insertion. indicates tear, rupture to the supraspinatus muscle or tendon with possibly suprascapular neuropathy
Lift off test
Patient puts hand in the small of the back and lifts off, one at a time
-inability to actively left the hand off or away from the back indicates subscapularis tendinopathy
Sulcus sign
pt elbow flexed to 90d. and shoulder in neutral position. grasp the wrist and with other hand place downward traction
–this motion attempts to dislocate the shoulder inferiorly. a sulcus that appears on the antero-lateral will indicate shoulder instability and is graded.
-inferior shoulder instability and possible inferior dislocation. +1 sulcus indicates >1cm, +2 indicates 1-2cms, and +3 indicates more than 3cms
Mazion shoulder
place hand on opposite shoulder and try to bring elbow to face
-inability to actively raise the elbow to the forehead due to pain /stiffness indicates early stage adhesive capsulitis or non-inflammatory capsular adhesions
Maximum elbow flexion test
maximum elbow flexion with hand resting on ipsilateral shoulder for up to 3 min to close the cubital tunnel
-reproduction of parathesia into the ulnar nerve distribution with possible weakness on handshake (power grip) indicates cubital tunnel syndrome (ulnar nerve entrapment)
Valgus overload test
valgus stress (L-M) on the elbow while dymanically extending the elbow
-pain in the posterior elbow with a reproduction of a locking or catching senstation or an inability to fully extend due to pain indicates posterior elbow impingement syndrome
Reverse Mils test
the elbow is extended and forearm supinated, wrist is then passively extended
-reproduction of pain in the medial elbow indicates medial epicondylitis or golfers
froment paper sign
paper between thumb and index finger
-patient is seen to flex the thumb thereby recruiting the median nerve to compensate indicating weakness or palsy of adductor pollicus muscle innervated by ulnar nerve