Special tests

Question 1

Allen’s test

Answer 1

Blood flow to the hands
Supinated, therapist thumbs on both sides of wrist, pt opens/closes hands several times, then clenches fist. Pt open hands, therapist releases one artery at a time and watches for flushing
Positive: absence of blood flow return

Question 2

Finklestein’s test

Answer 2

De Quervain’s tenosynovitis
Pt makes a fist while closing thumb within fingers, move wrist into ulnar deviation
Positive: pain over lateral wrist

Question 3

Phalen’s test

Answer 3

Carpal tunnel
Dorsal sides of hands together, hold for 1 min
Reverse: praying, hold for 1 min
Positive: numbness and tingling

Question 4

Tinel’s

Answer 4

Carpal tunnel
Tap for 1 min
Positive: numbness tingling

Question 5

Froment’s

Answer 5

Ulnar nerve palsy/strength of adductor pollicis in thumb
Paper between thumb and index finger (lateral pinch), tell them to hold it tightly and you try to yank it out
Positive: flex DIP joint because it’s weak (normal is if they keep their thumb straight)

Question 6

Speed’s

Answer 6

Bicipital tendinitis
Flex shoulder to 60 deg with elbow slightly flexed and forearm supinated. Resist shoulder flexion at distal forearm (and stabilize on shoulder)
Positive: pain in bicipital groove

Question 7

Yeargason’s

Answer 7

Bicipital tendinitis
(resist SOUP)
Stabilize elbow against trunk held in 90 deg flex, resist supination from pronation (and stabilize on shoulder)
to resist sup, put your hand on the back of forearm
Positive: pain in bicipital groove

Question 8

Drop arm test

Answer 8

Supraspinatus tear
Arms in abduction up to their ears (backs of hands touching at top), slowy lower
Positive: limb drops uncontrollably, pain

Question 9

Jobe’s

Answer 9

Supraspinatus tear/shoulder impingement
Shoulder 90 deg of abduction, internal rotation, and 30 deg scaption, resist shoulder abduction (pushing down as they go up) - stabilize shoulder, resist distal forearm
Positive: pain or weakness

Question 10

Neer

Answer 10

Shoulder impingement - bicep tendon
Passively and forcibly flex shoulder backward up to their ear
Can stabilize opposite shoulder
Positive: pain

Question 11

Hawkin’s & Kennedy

Answer 11

Supraspinatus impingement
Shoulder and elbow flexed to 90, forcibly internally rotate the shoulder - not resisting; you’re pushing - stabilize shoulder and distal forearm
Positive: pain

Question 12

Addson’s maneuver

Answer 12

Thoracic outlet syndrome
Pt seated with head extended and rotated towards side being tested. Therapist palpates radial pulse at wrist while extending and externally rotating shoulder
(dramatic greek sculpture)
Positive: decrease or diminish of radial pulse

Question 13

Roo’s (elevated arm stress test)

Answer 13

Thoracic outlet syndrome
Pt stand with both shoulders abducted to 90, externally rotated with elbows flexed to 90
Pt open and close hands for 3 min
Positive: unable to maintain position, pain numbness or tingling

Question 14

upper limb tension test

Answer 14

Thoracic outlet syndrome
Pt supine, supination, elbow/wrist/fingers extended, therapist abducts and externally rotates shoulder, then subject bends head to opposite side
Positive: pain, numbness, tingling

Question 15

anterior apprehension

Answer 15

Anterior shoulder instability/sublux (*feel for a sublux)
Pt in supine, shoulder passively abducted to 90 and elbow at 90, and forced into external rotation
(cock back motion)
Positive: pain, resistance to further motion

Question 16

valgus stress

Answer 16

Stability of MCL
Elbow slightly flexed, supinated, push MEDIALLY on upper arm so that their lower arm goes outwards
Positive: pain or gapping

Question 17

varus stress

Answer 17

Stability of LCL
Elbow slightly flexed, supinated, push LATERALLY on upper arm so lower arm goes inwards
Positive: pain or gapping

Question 18

pronator teres syndrome

Answer 18

Entrapment of median nerve by PT
Seated, elbow flexed to 90, resist pronation while you bring them out into extension
Stabilize shoulder
“Turn your palm over and I’m going to resist and pull your arm out”
Positive: tingling or numbness in median nerve distribution (thumb, index, middle, ½ ring)

Question 19

lateral epicondylitis (cozens)

Answer 19

Forearm pronated, elbow slightly flexed, resist wrist and finger extension
Stabilize at lat epi
Positive: pain in lat epic

Question 20

medial epicondylitis (mills)

Answer 20

Elbow slight flexion, supinated, therapist resists wrist flexion
Stabilize at med epi
Positive: pain in med epic

Question 21

collateral ligament test

Answer 21

MCP thumb instability
Stabilize distal thumb metacarpal on both sides. Other thumb/index finger on phalanx. Give valgus and varus force
Positive: pain or gapping

Question 22

oblique retinacular ligament test

Answer 22

ORL tightness - any digit, but if it says L hand do all except thumb
See how much they can flex their DIP when you block them into extension. then repeat while PIP is held in flexion
Positive: more flexion at DIP when PIP is in flexion

Question 23

intrinsic tightness

Answer 23

Therapist positions MCP joint in extension, PIP is flexed and ROM noted. Then, MCP is flexed. PIP flexed again
(claw, fist)
Positive: ability to move PIP into full flexion while MCP is flexed

Question 24

extrinsic flexor tightness

Answer 24

Digit extension with wrist flexed, then extended

Positive: less finger extension with wrist extended than with wrist flexed

Question 25

extrinsic extensor tightness

Answer 25

Digit flexion with wrist extended, then flexed (fist)

Positive: less flexion when wrist is flexed