SPECIAL TESTS FOR THE SHOULDER COMPLEX Flashcards
Yergason’s - REF: Rattray (1078)
What does this test for? Stability of biceps tendon in bicipital groove
What is the position and
procedure?
PT: Elbow flexed to 90, forearm pronated.
Ther. stabilizes elbow against thorax & applies resistance
while PT. actively supinates, extends elbow & ext rots
humerus
What is a positive
test/sign?
Positive: Pain & sensation of tendon popping out of bicipital
groove, due to loss of integrity of transverse humeral
ligament
Differential diagnosis
tool:
If pain presents at biceps T, cont’ to Speed’s Test
Speed’s test - REF: Rattray (1078), Magee (277)
What does this test for?
Bicipital Tendonitis
What is the position and procedure?
PT: elbow extended, forearm supinated & shoulder flexed to 90 deg.
Ther: RROM to shoulder FLX via pressure at wrist.
What is a positive test/sign?
Positive: Pain in bicipital groove
Empty can test (aka Supraspinatus strength test)
- REF: Rattray (1077), Magee (278)
What does this test for?
Supraspinatus Tendonitis, strain, or weakness
What is the position and procedure?
PT: seated. Arm abducted to 90, horiz adduct to 30, full Int Rot
Ther: RROM into adduction, via pressure at the wrist.
What is a positive test/sign?
Positive: Pain along supraspinatus or weakness
Drop Arm test - REF: Rattray (1077), Magee (279)
What does this test for? Rotator Cuff Tear, esp. Supraspinatus What is the position and procedure? Ther: PROM Abduct PTs arm to 90. Pt: slowly adducts arm to starting point What is a positive test/sign? Positive: Unable to move arm smoothly & slowly due to pain Differential diagnosis tool: MMT SITS group
Lift Off Sign - REF: Magee (279)
What does this test for?
Subscapularis Lesion
What is the position and procedure?
Pt: stands & places dorsum of hand on mid-lumbar spine. Pt lifts hand away from back.
Ther: pushes hand toward back to test mm strength
What is a positive test/sign?
Positive: Inability to lift hand off back or resist Ther’s pressure, due to weakness in subscapularis
Pectoralis Major Contracture - REF: Magee (284)
What does this test for?
Pectoralis Major Hypertonicity
What is the position and procedure?
PT: supine, hands clasped behind head, lowers elbows toward table.
Ther: applies gentle pressure at elbows, attempting to bring elbows to the table.
What is a positive test/sign?
Positive: Elbows do not reach table
Acromioclavicular Shear Test - REF: Rattray (1076), Magee (275)
What does this test for?
Integrity of AC joint
What is the position and procedure?
PT: seated; arms resting at side.
Ther: Place cupped hands over the client’s shoulder, fingers interlaced, one palm on the clavicle & other on spine of scapula. Slowly squeeze heels of hands together
What is a positive test/sign?
Pain, excessive movement of joint, indicating joint sprain or pathology.
Rockwood - REF: Magee ( 252)
What does this test for?
Anterior Instability of GH joint
What is the position and procedure?
PT: seated, arms resting at side, elbow FLX
Ther: stands behind PT, PROM ext rot of GH jt. @ 0, 45, 90 & 120 degrees ABD.
What is a positive test/sign?
Positive: marked apprehension & posterior pain at 90.
At 45 & 120* Pt shows some uneasiness & some pain
At 0* there is rarely apprehension
Feagin - REF: Magee (260)
What does this test for?
Inferior Instability
What is the position and procedure?
PT: ABD arm to 90*
Ther: supports PTs arm via wrist resting on Ther’s shoulder. Ther clasps hands over upper humerus, pushes down & forward
What is a positive test/sign?
Positive: Sulcus above coracoid process, Apprehension. Due to instability of inferior GH ligament
Push-pull - REF: Magee (256)
What does this test for?
Posterior Instability of GH joint
What is the position and procedure?
PT: supine.
Ther: holds PT arm at wrist, abduct to 90. Forward flex to 30. Place other hand over humeral head. Pull up on wrist while pushing down on humerus.
What is a positive test/sign?
Positive: excess movement (more than 50%), pain, or apprehension
Neer Impingement - REF: Rattray (1074), Magee (263)
What does this test for?
Overuse injury to Supraspinatus, sometimes Biceps T
What is the position and procedure?
Ther: PROM arm into full flexion (through scapular plane) and medial rotated; forcibly take limb to end range, jamming greater tuberosity against acromion process
What is a positive test/sign?
Positive: Face shows pain, grimace. Inflammed supraspinatus or biceps tendon is being pinched under the acromion process
Hawkin’s-Kennedy - REF: Rattray (1074), Magee (263)
What does this test for?
Overuse injury to Supraspinatus
What is the position and procedure?
PT: seated or standing
Ther: PROM FLX arm 90*, full med rot. If no pain, cont to full horizontal ADD of humerus
What is a positive test/sign?
Positive: Pain due to compression of supraspinatus tendon against coracoid process
Adhesive Capsulitis Abduction Test
- REF: Rattray (1076)
What does this test for?
Restricted motion of shoulder due to fibrosis/adhesion of axillary fold of inf. GH joint capsule
What is the position and procedure?
Pt: standing or seated.
Ther: stands behind. Palpate inf angle of scapula. Other hand prox to Pt elbow. Slow PROM GH ABD. Observe and note when inf angle begins to move.
What is a positive test/sign?
Painful, leathery end feel anywhere before 90* abduction. The scapula begins to move before 90* ABD (axillary fold is fibrosed).
Adson’s Test - REF: Rattray (1071), Magee (288)
What does this test for?
TOS- Anterior Scalene
What is the position and procedure?
Pt: seated.
Ther: stands behind. EXT & lat rots clients arm at affected side, monitoring radial pulse. Pt IPSI Rotates head, lifts chin and holds a deep breath for 15 seconds.
What is a positive test/sign?
Positive: Diminished radial pulse or recreation of symptoms.
This action elevates first rib, compressing VAN against tight anterior scalene.
Ligament stress test RAFI
Rockwood 0,45,90(M/C),120
Anterior (instability)
Feagan
Inferior
