Special Tests: Shoulder Flashcards
Apprehension Test (anterior shoulder instability)
With Pt supine, passive abduction to 90 and ER to end range. (+) if Pt c/o pain or instability.
Relocation Test (anterior shoulder instability)
With Pt supine, GH at edge of table - 90 abduction and ER - force is applied by clinician on head of humerus, posteriorly. If pain, apprehension diminish, (+).
Bony Apprehension Test (anterior shoulder instability)
With Pt seated/standing, abduction to 45, then 45 or less of ER. (+) if Pt appears apprehensive.
Anterior Drawer Test (anterior shoulder instability)
With pt supine, arm at 60-80 abduction, neutral rotation - humeral head is then translated anteriorly (quick motion). (+) of pt reports pain or comparable sign.
Load and Shift (anterior shoulder instability AND posterior shoulder instability))
With pt in sitting, Pinch head of humerus with thumb posterior. (+) if excessive translation (typically anteriorly >25%).
Posterior Drawer Test (Posterior shoulder instability)
With pt supine, arm is abducted to 80-100, Must identify joint line first. Then AP force is applied to humerus (quickly).
Sulcus Sign (Inferior instability)
With pt standing/sitting, Stabilize at shoulder. Ided mnferior force is exerted on the humerus, proximal to elbow - presence of “sulcus” indicates inferior laxity.
Crank Test (Labrum)
With pt supine, attain 160 abduction / elbow 90 - first, compression is applied to GH (palm into olecranon), then humerus is repeatedly rotated in small IR / ER arc of motion in attempt to pinch or catch a torn labrum. (+) if pain reproduced and “click” experienced.
Compression Rotation Test (Labrum)
With pt supine, attain abduction 90, elbow 90 - compressive force is applied to humerus (use thigh, stop before shoulder shrugs up), then rotation back and forth between IR/ER is performed (switch stances). Larger arc of motion than crank test. (typically start with this before progressing to crank test).
Active Compression (O’Brien Test) (Labrum)
With pt standing, shoulder flexed to 90, h. adduction 10 (thumb in front of sternum), max IR - pt then resists downward force - then repeated in max ER (palm up), 10 horiz. abduction. (+) if pain is worse in IR vs ER
Yergason (Labrum)
HandshakeWith pt seated / standing, elbow flexed to 90 and forearm pronated - pt is then instructed to supinate while clinician resists at wrist. (+) if pain is localized to bicipital groove (palpate with hand).
Biceps Load Test I (Labrum) - NOT ON SKILL CHECK
With pt supine, 90 abduction, forearm neutral/slight supination - then passively move to end range ER - pt is then asked to flex elbow while clinician resists. (+) if reproduction of pain.
Biceps Load Test II (Labrum)
With pt supine, 120 abduction, forearm supination and end-range ER. Use thigh to support elbow. Pt is asked to flex elbow while examiner resists. (+) if no change in apprehension or pain that is worsened with resisted elbow flexion.
AC Shear Test (AC joint)
With pt seated, clinician cups hand over clavicle and spine of scapula, then proceeds to apply compressive force through AC joint. (+) if pain is reproduced.
Biceps Speed Test (Biceps tendinits)
With pt standing , full elbow extension and full supination - clinician resists from 0-60 of shoulder flexion. (+) if pain is reproduced concordant to bicipital groove.