Special Tests

Question 1

Ludingtons Test

Answer 1

Sitting 
*Clasp both hands behind head 
*Repeatedly contract & relax biceps muscle
\+ : absent movement in biceps tendon
Ind: ruptured long head of biceps 

*** LuD = Long-heaD

Question 2

Speed’s Test

Answer 2

Sitting or standing
*Elbow extended; forearm supinated
**PT - one hand on bicipital groove, other hand on volar surface of forearm
**PT resists ACTIVE shoulder flexion
+ : pain or tenderness in bicipital groove region
Ind: bicipital tendonitis

Question 3

Yergasons test

Answer 3

Sitting
*Humerus stabilized against thorax; with 90 deg elbow flexion + forearm pronated
**PT: one hand on bicipital groove, other on pt’s forearm
*Pt instructed to ACTIVELY supinate and ER, against resistance
+ : pain or tenderness in bicipital groove
Ind: bicipital tendonitis

Question 4

Hawkins-Kennedy Impingement sign

Answer 4

Sit or Stand
*Flex arm to 90deg & IR
+ : pain
Ind: shoulder impingement of supraspinatus tendon, subacromial bursitis, RCT

Question 5

Yocum

Answer 5

Sit or Stand
*Pt asked to place a hand on their opposite shoulder, then raise elbow twds their nose
+ : pain
Ind: subacromial impingement

Question 6

Neer Impingement Test

Answer 6

Sit or Stand
**PT places one hand on posterior scapula (to stabilize/depress), other hand stabilizes elbow
** PT elevates pt’s arm through full flexion
+ : pain; facial grimace
Ind: subacromial impingement, subacromial bursitis, RCP

Question 7

Empty Can (Supraspinatus Test)

Answer 7

Standing
*Arm in scapular plane; thumbs point down
**Resists downward force from PT
+ : weakness, pain
Ind: supraspinatus tear, impingement, suprascapular n involvement

Question 8

Full Can

Answer 8

Standing
*Arm in scapular plane; thumbs point up
**Resists downward force from PT
Ind: Rotator cuff tear; Impingement syndrome

Question 9

Infraspinatus Test

Answer 9

Elbow flexed 90deg, 45 deg IR
Resists medially directed force to arm
+ : pain, weakness
Ind: infraspinatus strain/tear

Question 10

Lateral Rotation Lag Sign

Answer 10

20 deg scaption, end range ER
Pt asked to hold that position
+ : failure to hold the position
Ind: infraspinatus or supraspinatus pathology

Question 11

Lift off sign (medial rotation lag sign)

Answer 11

Dorsum of hand on low back
Asked to move hand away
If unable - PT moves hand away and see if they're able to hold the position 
\+ : inability to hold the position 
Ind: subscapularis lesion

Question 12

O’Briens active compression test

Answer 12

1: Patient stands with -
90deg shoulder flex, 10-15deg H. add; MR (thumb down)

2: PT puts downward resistance on arm
3: ER arm (palm up), same down force applied

+ : pain in IR, reduced with ER
Inds: superior labral tear

Question 13

Thoracic Outlet Syndrome Tests:

Answer 13

• Adson
• Allen Test
• Costoclavicular syndrome test
• Roos
• Wright (hyperabduction test)

Question 14

Acromioclavicular Crossover Test

Answer 14

PT moves pt’s arm to:
90deg shoulder flexion, full H. add

+ : pain over AC joint
Ind: AC joint inj

Question 15

Jerk Test

Answer 15

1: Patient’s sitting
Shoulder flexed to 90deg, elbow bent, IR, and H add

2: PT stands behind pt – applies an axial compression force through elbow

+ : sudden clunk or jerk (H.H. subluxing posteriorly)
Ind’s: posterior instability; pain could also indicate a posterior labral lesion

Note* a 2nd clunk/jerk may be felt when returning to starting as HH reduces

Question 16

Apprehension test for posterior dislocation

Answer 16

1: pt supine, arm in 90deg flex & medial rotation
2: PT apply compression through humerus

+: look of ‘apprehension’ or grimacing

Question 17

Sulcus Sign

Answer 17

Pt with 20-50 deg of abduction* in standing
PT pull arm inferiorly from elbow

+ for inferior instability = depression between acromion and HH seen

Grades:
1+ : < 1 cm
2+ : 1-2 cm
3+ : >2 cm