Special Tests

Question 1

Pt is in supine with arm in 90 deg of abduction, the therapist laterally rotates the pt’s shoulder. A positive is indicated by a look of apprehension or a facial grimace prior to reaching an end point.

Answer 1

Apprehension test for “anterior” shoulder dislocation

Question 2

Pt is positioned in supine with shoulder at 90 deg of flexion and medial rotation. The therapist applies a posterior force through the long axis of the humerus. A positive test is indicated be the look of apprehension or a facial grimace prior to reaching an end point

Answer 2

Apprehension test for “posterior” shoulder dislocation

Question 3

The patient is positioned in sitting/standing. Shoulder flexed to 90 with elbow extended and forearm supinated. The therapist places one hand over the bicipital groove and the other hand over the volar surface of the forearm. The therapist resists active shoulder flexion. A positive test is indicated by pain or tenderness in the bicipital groove region. May be indicative of bicipital tendonitis

Answer 3

Speed’s Test for biceps tendon pathology

Question 4

Pt is seated with elbow flexed to 90 deg with forearm pronated. One hand is placed on the forearm and one on the bicipital groove. Pt is directed to actively supinate and laterally rotate against resistance. Positive test is indicated by pain or tenderness in the bicipital groove.

Answer 4

Yergason’s test, for bicipital pathology

Question 5

Pt is positioned in sitting or standing with arm in 90 deg of abduction. The patient is asked to slowly lower arm to their side. A positive test is indicated by failing to slowly lower arm to side or by the presence of severe pain.

Answer 5

Drop arm test, for rotator cuff tear.

Question 6

Pt is positioned in sitting or standing. The therapist flexes the pt’s shoulder to 90 deg and then horizontally adducts and medially rotates the arm. Positive test is indicated by pain is indicated by pain. May be indicative of shoulder impingement.

Answer 6

Hawkins-Kennedy impingement test, for supraspinatus tendon.

Question 7

Pt is positioned in sitting or standing. The therapist positions one hand on the posterior aspect of the pt’s scapula and the other hand stabilizing the elbow. The therapist then elevates the pt’s arm through flexion. Positive is indicated by facial grimace or pain in the subacromial area.

Answer 7

Neer’s impingement test, for supraspinatus tendon. (remember “Neer the ear”)

Question 8

Pt is positioned in sitting or standing. with arm in 90 deg of scaption. The therapist resists the patients attempt to move through scaption. A positive test is indicated by weakness or pain in the superior shoulder area.

Answer 8

Supraspinatus test.

Question 9

The pt is positioned in sitting or standing. The therapist monitors the radial pulse and asks the pat to rotate his/her head to face the tested shoulder. The pt is then asked to extend his/her head while the therapist laterally rotates and extends the pt’s shoulder. A positive test is indicated by an absent or diminished radial pulse.

Answer 9

Adson maneuver, for thoracic outlet

Question 10

The pt is positioned in sitting or standing with the test arm is in 90 deg of abduction, lateral rotation and elbow flexion. The pt is asked to rotate the head away from the test shoulder while the therapist monitors the radial pulse. A positive test is indicated by an absent or diminished pulse when the head is rotated away from the test shoulder.

Answer 10

Allens test, for thoracic outlet

Question 11

The pt is positioned in sitting or standing with arms positioned in 90 deg of abduction, lateral rotation, and elbow flexion. The pt is asked to open and close fist for 3 minutes. A positive test is indicated by the inability to maintain the test position, weakness of the arms, sensory loss or ischemic pain.

Answer 11

Roos test, for thoracic outlet

Question 12

The pt is positioned in sitting with elbow in slight flexion. The therapist places his/her thumb on the pt’s lateral epicondyle while stabilizing the elbow joint . The pt is asked to make a fist, pronate the forearm, radially deviate, and extend the wrist against resistance. A positive test is indicated by pain in the lateral epicondyle region or muscle weakness.

Answer 12

Cozen’s test, for lateral epicondylitis

Question 13

The pt is positioned in sitting. The therapist stabilizes the elbow with one hand and places the other hand on the dorsal aspect of the pt’s hand distal to the proximal interphalangeal joint. The pt is asked to extend the third digit against resistance. A positive test is indicated by pain in the lateral epicondyle region or muscle weakness.

Answer 13

Lateral epicondylitis test

Question 14

Pt is positioned in sitting. The therapist palpates the medial epicondyle and supinates the pt’s forearm, extends the wrist, and extends the elbow. A positive test is indicated by pain in the medial epicondyle.

Answer 14

Medial epicondylitis test

Question 15

The pt is positioned in sitting with the elbow in slight flexion. The therapist taps between the olecranon process and the medial epicondyle. A positive test is indicated by a tingling sensation in the ulnar nerve distribution of the forearm, hand, and fingers.

Answer 15

Tinel’s sign, for ulnar nerve compression or compromise.

Question 16

Pt is positioned in sitting or standing. The pt is asked to open & close the hand several times in succession and then maintain the hand in a closed position. The therapist compresses the radial and ulnar arteries. The pt then relaxes hand and the therapist releases the pressure on one of the arteries while observing the color of the hand and fingers. A positive indicated by delayed or absent flushing in the hand from the released artery.

Answer 16

Allen test, for vascular insufficiency

Question 17

The pt is positioned in sitting or standing. The therapist flexes the pt’s wrist maximally and asks the pt to hold the position for 60 seconds. A positive test is indicated by tingling in the thumb, index finger, middle finger, and lateral half of the ring finger.

Answer 17

Phalen’s test, for carpal tunnel syndrome (median nerve compression)

Question 18

Pt is positioned in prone while the therapist passively flexes the pt’s knee. A positive test is indicated by spontaneous hip flexion occurring simultaneously with knee flexion.

Answer 18

Ely’s test, for rectus femoris contracture

Question 19

Pt is positioned in sidelying with the lower leg flexed at the hip & knee. The therapist moves the test leg into hip extension and abduction and then attempts to slowly lower the test leg. A positive test is indicated by an inability of the test leg to adduct and touch the table.

Answer 19

Ober’s test, for tensor fasciae latae contracture

Question 20

Pt is in sidelying with the test leg positioned toward the ceiling and the hip flexed at 60 deg. While stabilizing the pelvis the therapist applies a downward force (adduction) to the knee. A positive is indicated by pain or tightness in lateral hip area.

Answer 20

Piriformis test, for tight piriformis or sciatic nerve compression.

Question 21

Pt is positioned in supine. Pt is asked to bring one of his/her knees to their chest, in order to flatten the lumbar spine. The therapist observes the position of the contralateral hip. A positive is indicated by the contralateral leg raising from the table.

Answer 21

Thomas test, for hip flexor contracture

Question 22

Pt is in supine and is asked to stabilize the hips at 90 deg of flexion with the knees relaxed. The therapist instructs the pt to alternately extend each knee as much as possible while maintaining the hips at 90 deg. A positive test is indicated by the knee remaining in 20 deg of flexion or more.

Answer 22

90-90 straight leg raise test, for hamstring tightness

Question 23

Pt is in prone with the knee flexed to 90 deg. The therapist palpates the posterior aspect of the greater trochanter and medially or laterally rotates the hip until the greater trochanter is parallel with the table. The degree of femoral anteversion/retroversion is measured by angle of the lower leg perpendicular to the table.

Answer 23

Craig’s test, for femoral anteversion/retroversion. (normal is 8-15 deg of anteversion)

Question 24

Pt is positioned in supine with test leg flexed, abducted and laterally rotated at the hip onto the opposite leg (figure 4) The therapist slowly lowers the test left through abduction toward the table. Positive is indicated by failure of the test leg to abduct below the level of the opposite leg.

Answer 24

Patrick’s test (Faber’s test), for iliopsoas, sacroiliac, por hip joint abnormalities

Question 25

Pt is in supine with knee flexed to 90 deg and hip at 45 deg. The therapist stabilized the lower leg by sitting on the forefoot. The therapist grasps the proximal tibia with two hands, places their thumbs on the tibial plateau, and administers an anterior directed force. A positive is indicated by excessive anterior translation of the tibia witha diminished or absent end-point.

Answer 25

Anterior drawer test, for ACL injury

Question 26

Pt is in supine with knee flexed at 90 deg and hip at 45 deg. The therapist stabilizes the lower leg by sitting on the forefoot. The therapist applies a posterior directed force to the proximal tibia. A positive is indicated by excessive posterior translation of the tibia on the femur and a diminished or absent end-feel.

Answer 26

Posterior drawer test, for PCL injury

Question 27

Pt is positioned in supine with knee flexed to 20-30 deg. The therapist stabilizes the femur with one hand and places the other hand on the proximal tibia. The therapist applies an anterior directed force on the tibia. A positive is indicated by excessive anterior translation of the tibia on the femur with a diminished or absent end-feel.

Answer 27

Lachman’s test, for ACL injury

Question 28

Posterior sag sign

Answer 28

Pt is positioned in supine with knee flexed at 90 deg and hip at 45 deg. A positive test is indicated by the tibia sagging back on the femur. May be indicate PCL injury.

Question 29

The pt is positioned in prone with the feet extended over the edge of the table. The therapist asks the patient to relax and proceeds to squeeze the muscle belly of the gastrocs/soleus. A positive is indicated by the absence of plantar flexion.

Answer 29

“Thompson” test, for achilles tendon rupture.

Question 30

The pt is positioned in prone with knee flexed at 90 deg. The therapist stabilizes the the femur using one hand and places the other hand on the pt’s heel. The therapist medially and laterally rotates the tibia while applying a compressive force through the tibia. A positive is indicated by pain or clicking in the knee.

Answer 30

Apley’s test, for meniscal pathology

Question 31

Pt is positioned in supine. The therapist grasps the distal leg with one hand and palpates the knee joint line with the other. With the knee fully flexed the therapist medially rotates the tibia while fully extending the leg, and repeats the movement rotating laterally. A positive is indicated by a a click or pronounced crepitation felt over the joint line.

Answer 31

McMurray test, for posterior meniscal pathology