Shoulder tests

Question 1

Cross arm test
+?
indicates?

Answer 1

passively adduct patient’s arm across their chest and rest patient’s hand on their opposite shoulder
+ pain in AC joint with end range adduction
indicates: AC joint pathology

Question 2

Apley scratch test
+?
indication?
What to make note of?

Answer 2

patient abducts arm placing palm of hand behind their neck with palm facing down toward the body. patient should attempt to scratch the lowest possible vertebrae (external rotation and abduction).
patient places arm behind their back with palm facing outward and dorsum of hand resting on their mid-back. patient should attempt to scratch highest possible vertebrae (internal rotation and adduction)
+ pain
indicates: rotator cuff disorder or adhesive capsulitis
note how far pt can reach

Question 3

Painful arc test
+?
indicates?

Answer 3

pt abducts arm starting at their side from 0 to 180
+ shoulder pain from 60 to 120
indicates subacromial impingement and/or rotator cuff injury

Question 4

Neer impingement
+?
indicates?

Answer 4

stabilize patient’s shoulder (scapula). passively flex patient’s arm with the other hand.
+ pain
indicates subacromial bursa or rotator cuff impingement

Question 5

Hawkins test
+?
indicates?

Answer 5

flex shoulder and elbow to 90. passively rotate the humerus into internal rotation.
+ pain
indicates rotator cuff tendinitis or supraspinatus impingement

Question 6

Lift off test
+?
indicates?

Answer 6

place patient’s arm into internal rotation and extension (behind back). pt pushes arm into further internal rotation as physician resists.
+ weakness (inability to resist)
indicates subscapularis weakness

Question 7

Drop-arm test
+?
indicates?

Answer 7

pt abducts arm to 90 degrees (shoulder level) then slowly lowers it. physician gently taps wrist.
+ arm drop or gentle tap on wrist will cause arm to drop
indicates full thickness tear of supraspinatus

Question 8

Apprehension test
+?
indicates?

Answer 8

pt seated or supine. shoulder abducted and elbow flexed to 90. stabilize shoulder to block linkage and force arm into external rotation.
+ pt apprehensive of repeat dislocation
indicates glenohumeral instability

Question 9

Sulcus sign
+?
indicates?

Answer 9

grasp patient’s elbow and apply inferior traction
+ indention in area beneath acromion
indicates glenohumeral instability

Question 10

Yergason’s test
+?
indicates?

Answer 10

patient’s arm at side with elbow flexed to 90. physician uses 1 hand to palpate bicipital groove and monitors there, while the other hand grasps the patient’s wrist. have pt supinate and externally rotate against physician’s resistance.
+ pain and/or tendon subluxation
indicates unstable bicipital

Question 11

Speed’s test
+?
indicates?

Answer 11

patient’s arm flexed (50-90) at the shoulder with hand supinated. slightly flex patient’s elbow. resist at forearm while pt flexes shoulder.
+ pain in bicipital groove
indicates bicipital tendonitis or longhead biceps

Question 12

Empty can test
+?
indicates?

Answer 12

flex patient’s shoulders to 90 while horizontally abducting to 45. internally rotate both arms so thumbs are pointing down. press down on forearms while pt resists.
+ pain or weakness
indicates rotator cuff pathology (supraspinatus)