Special Tests--Shoulder Flashcards
Drop Arm Test
Patient positioned in standing, arm is moved passively into abduction, patient is asked to slowly lower it back to side.
Indications: RTC Tear (specifically Supraspinatus)
Positive Test: Cannot return arm slowly or has severe pain when attempting
Speed’s Test
Patient is standing with elbow extended and forearm supinated, asked to resist a downward force
Indicated for Bicipital Tendinitis
Positive finding: Tenderness or pain in bicipital groove
Crank Test (Apprehension Test)
Patient is positioned in supine, patient’s arm is abducted to 90 degrees and ER. Place a hand under the GHF and apply a mild anterior force.
Indicated for Anterior Instability of the Shoulder
Positive Finding: Patient looks for feels apprehensive/alarmed.
Posterior Apprehension Test
Patient is positioned in supine or sitting
Indicated for Posterior Instability of the Shoulder
Positive Finding: Look of apprehension/alarm on patients face and resistance to move further
Hawkins Kennedy
Patient is in sitting or standing.
Indicated for shoulder impingement syndrome.
Positive finding: Pain indicating supraspinatus tendonitis or secondary impingement.
Yergason’s Test
Patient is in sitting position
Indicated for torn transverse humeral ligament, bicipital tendonitis/tendinosis
Positive finding is tenderness in the bicipital groove
Empty Can Test
Patient is in standing or sitting position
Indicated for supraspinatus tear or neuropathy of suprascapular nerve
Positive finding: Signs of weakness or pain
Neer Impingement Test
Patient is in sitting or standing
Indicated for overuse injury of supraspinatus muscle or biceps tendon
Positive finding: Reproduction of pain
Clunk Test
Patient is positioned in supine on table
Indicated for Glenoid labrum tear
Positive Findings: Clunk or Grinding sound
O’Brien Test
Patient positioned in standing
Indicated for SLAP lesions, type II or superior labral lesions
Positive Finding: Pain or painful clicking inside the shoulder in the first part of the test and eliminated or decreased in the second part
Biceps Load Test
Patient positioned in supine with arm at 90* abduction and maximum ER
Indicated for superior labrum lesion
Positive Finding: Apprehension is teh same or shoulder becomes more painful with bicep activatoin
Bicep Load Test II
Patient is positioned in supine with arm abducted to 120* and maximum ER
Indicated for SLAP Lesion
Positive Finding is deep pain with shoulder during contraction
Posterior Internal Impingement Test
Patient is in supine
Indicated for impingement between RTC and greater tuberosity
Positive finding: Reproduction of pain in posterior shoulder
ER Lag Sign
Patient standing with back to PT
Indicated for tear of supraspinatus or infraspinatus tendon
Positive Finding: Unable to maintain position once PT lets go
IR Lag Sign
Patient is seated with back to PT
Indicated for subscapularis tear
Positive finding: Unable to maintain position once PT lets go
Adson Maneuver
Patient is in sitting
Indicated for TOS secondary to a cervical rib or 1st thoracic rib syndrome
Positive: Disappearance of radial pulse
Roos Test
Patient is in standing
Indication: TOS secondary to neurovascular compromise
Positive Finding: Unable to keep the arms in the starting position for 3 minutes, ischemic pain, heaviness or profound weakness of the arm, N/T of the hand during 3 minutes
Allen’s Test
Patient is positioned in sitting
Indicated for patency of blood vessels supplying the hand.
Positive finding: Vascular filling time > 5 seconds.
Wright’s Test
Patient is sitting and then supine
Indicated for TOS secondary to compression of the costoclavicular space
Positive finding is an absent radial pulse
Costoclavicular Syndrome Test
Patient is sitting
Indicated for TOS secondary to compression in costoclavicular space
Positive finding is an absent radial pulse
Halstead Maneuver
Patient is in sitting
Indicated for TOS secondary to anterior scalene syndrome
Positive Finding: Absence or disappearance of the radial pulse when head is rotated away from the test side
Sulcus Sign
Patient is standing or sitting
Indicated for inferior instability or glenohumeral laxity
Positive finding: Depression more than a finger width between lateral acromion and the head of the humerus
Jobe Subluxation/Relocation
Patient is positioned in supine
Indicated for superior labral tear
Positive finding: Pain and apprehension
Load and Shift Test
Patient is sitting without stabilizing the upper trunk
Indicated for atraumatic instability of glenohumeral joint
Positive finding is a posterior translation of 25% or more of the humeral head diameter.
Posterior Drawer Test of Shoulder
Patient is in supine
Indicated for posterior translation of shoulder, labral tear, or slippage of humeral head over glenoid rim.
Positive finding is increased posterior translation of half or more of humeral head diameter.
Anterior Apprehension Test
Patient is in supine
Indicated for anterior instability of shoulder
Positive finding is apprehension or alarm from patient and resisting further motion.
Anterior Drawer Test of Shoulder
Patient is positioned in supine
Indicated for anterior translation or labral tear, slippage of humeral head over the glenoid rim.
Positive finding is movement with accompanying click, apprehension, or both. Increase in laxity and less firm end feel.
Acromioclavicular Shear Test
Patient is sitting or standing
Indicated for AC joint dysfunction such as arthritis or separation
Positive finding is abnormal movement of the AC joint
Crossover Impingement/Horizontal Adduction Test
Patient is in sitting
Indicated for AC Joint Dysfunction
Positive Findings: Local pain over the AC joint
Special Tests for Anterior Shoulder (Glenohumeral) Instability
Apprehension (Crank) Test
Jobe Relocation Test
Anterior Drawer Test
Load and Shift Test
Special Tests for Posterior Shoulder (Glenohumeral) Instability
Jerk (Jahnke) Test
Load and Shift Test
Posterior apprehension test
Special tests for inferior and multidirectional shoulder (GH) instability
Sulcus sign
Special tests for Anterior Shoulder Impingement
Coracoid impingement sign
Hawkins-Kennedy test
Neer test
Supine impingement
Yokum test
Special Tests for Labral Lesions
Active compression test of O’Brien
Kim Test I/Biceps Load Test II
Porcellini test?
