Special Tests of Shoulder

Question 1

Impingement sign?

Answer 1

Forward flexion >90 degrees = pain indicates impingement

Question 2

Hawkins test?

Answer 2

FF 90 degrees, then IR = pain indicates impingement syndrome

Question 3

Supraspinatus/Jobe empty can?

Answer 3

Pronate arm, resisted FF in scapular plane = pain/weakness indicates supraspinatus tear

Question 4

Drop arm?

Answer 4

FF >90 degrees, try to maintain it = arm drops indicates supraspinatus tear

Question 5

ER lag sign?

Answer 5

ER shoulder, patient holds it = inability to maintain ER indicates infraspinatus tear

Question 6

Horn blower’s?

Answer 6

Resisted ER in slight abduction = weakness indicates rotator cuff tear involving infraspinatus

Question 7

Lift off?

Answer 7

Hand behind back, push backward = weakness indicates subscapularis tear

Question 8

Lift off lag sign?

Answer 8

Lift hand off back, patient holds it = inability to hold hand off of low back indicates subcapularis tear

Question 9

Belly press?

Answer 9

Hand on belly, push toward belly = weakness indicates subscapularis tear

Question 10

Active compression (O’Brien’s)?

Answer 10

FF 90 degrees, adduct 10 degrees, resisted flexion; in pronation, then supination = pain with resisted flexion, greater in pronation indicates SLAP tear; may also suggest AC joint pathology

Question 11

Crank?

Answer 11

Abduct 90, axial load, rotate = pain indicates a SLAP tear

Question 12

Speed’s test?

Answer 12

Resisted flexion in scapular plane = pain indicates biceps lesion or tendinitis

Question 13

Yergason’s test?

Answer 13

Elbow 90 degrees, resisted supination = pain indicates biceps tendinitis

Question 14

Apprehension test?

Answer 14

Abduct, externally rotate = pain or apprehension of indicates anterior instability

Question 15

Relocation?

Answer 15

Abduct, ER, posterior force to arm = relief of pain/apprehension indicates anterior instability

Question 16

Load and shift?

Answer 16

Axial load, ant/post translation = increased translation indicates anterior OR posterior instability

Question 17

Jerk test?

Answer 17

Supine, adduct, FF 90 degrees, push posterior = pain/apprehension/translation indicates posterior instability

Question 18

Sulcus sign?

Answer 18

Pull down on adducted arm = sulcus under lateral acromion indicates inferior instability

Question 19

X-body adduction?

Answer 19

Adduct arm across body = pain at AC joint indicates AC joint pathology (e.g. arthrosis)

Question 20

Scapular winging?

Answer 20

Push against a wall = winging of scapula indicates nerve palsy or muscle weakness

Question 21

Adson’s test?

Answer 21

Palpate pulse, rotate neck = numbness or tingling suggestive of TOS

Question 22

Wright’s test?

Answer 22

Extend arm, rotate neck away = numbness or tingling suggestive of TOS

Question 23

Spurling’s test?

Answer 23

Lateral flex/axially compress neck = reproduction of symptoms indicates cervical neck pathology