Special Tests

Question 1

Apprehension Test

Answer 1

Tests GH joint instability
Arm in throwing position (90 deg), hold holder and other hand imposes external rotation from wrist, attempt to ANTERIORLY dislocation humeral head

+ sign if pain or fear of dislocation on pt’s part

Question 2

Drop Arm Test

Answer 2

pt abducts shoulder 90 deg and slowly lowers arm back to side

+ sign if inability to smoothly lower arm or abrupt drop at last 10 to 15 deg, Rotator cuff injury esp. Supraspinatus

Question 3

Empty Can Test

Answer 3

Supraspinatus strength test
90 deg shoulder flexion, internal rotation w/ thumb pointing inferiorly (in scaption)
attempt to push arm inferiorly ask pt to resist

+ if pain indicative of rotator cuff tear esp Supraspinatus

Question 4

Neer Impingement Sign

Answer 4

Immobilize scapula, passively raise arm in sagittal plan flexion and internal rotation, compresses greater tuberosity of humerus against acromion

+ if pain, reflects overuse injury to supraspinatus

Question 5

Hawkin-Kennedy Impingement Sign

Answer 5

flex shoulder 90 deg, place one hand on distal end of humerus and one on wrist in pronation, internally rotate arm from wrist
compresses greater tuberosity against coracoacromial ligament

Alternate: can put hand on shoulder instead of humerus and other hand at elbow, limits motion of scapula

+ if pain, reflects over use injury to supraspinatus tendon

Question 6

Infraspinatus Test

Answer 6

pt has arms at sides flexed 90 deg w/ thumbs facing up, push on pt’s hands and have pt externally rotate against your resistance

+ if pain or weakness, indicates rotator cuff injury/tear esp. infraspinatus or teres minor (less common)

Question 7

Finkelstein Test: DeQuervain Tenosynovitis

Answer 7

involves extensor pollicis brevis (EPB) and abductor pollicis longus (APL)

flex MCP and IP joint of thumb while imposing ulnar deviation and palpating over snuff box (EPB and APL tendons)

+ if pain over that area

Question 8

Tinel Test: Carpal Tunnel Syndrome

Answer 8

tap over transverse carpal ligament region, irritating median n.

+ if there is numbness, tingling or pain following median n. distribution (thumb and next 3 digits)

Question 9

Phalen Test: Carpal Tunnel Syndrome

Answer 9

both wrists flexed by opposing dorsal surface of hand, maintain for 1-2 min.

+ if there is numbness, tingling or pain following median n. distribution (thumb and next 3 digits)

Question 10

Reverse Phalen Test: Carpal Tunnel Syndrome

Answer 10

wrist extension created and exaggerated for 1-2 min. to compress carpal tunnel and elicit radicular signs: numbness, tingling or generalized changes to sensation (paresthesia) and/or pain

+ if there are radicular signs