Special Tests - Shoulder

Question 1

What does the bear hug test for?

Answer 1

Damage or weakness in medial rotators (subscapularis)

Question 2

What is a positive bear hug test?

Answer 2

weakness, or pain in shoulder over lesser tubercle. OR patient unable to maintain test position

Question 3

How to perform bear hug test?

Answer 3

ask patient to put opposite hand on opposite shoulder and keep it there.

grasp their wrist and lift hand into LR - ‘don’t let me move you’

Question 4

what does the infraspinatus test for?

Answer 4

damage or weakness in lateral rotators (mainly infraspinatus)

Question 5

what is a positive infraspinatus test?

Answer 5

weakness or pain in shoulder region (over greater tubercle) OR unable to hold test position OR early fatigue

Question 6

How to perform infraspinatus test?

Answer 6

bend both elbows to 90 - arms by the side of body - with palms facing each other - apply pressure into medial rotation

Question 7

what does the external rotation lag sign test for?

Answer 7

damage or weakness in lateral rotators (mainly infraspinatus)

Question 8

what is a positive test in the external rotation lag sign?

Answer 8

excessive drop into medial rotation - difference between left and right

Question 9

how to perform the external rotation lag sign test?

Answer 9

passively flex elbow to 90, abduct to 20 in line of scapula, ask patient to hold that position and let go.

if patient can’t hold this position then positive sign

Question 10

what does the sulcus test of rotator cuff integrity test for?

Answer 10

Damage or weakness in the rotator cuff muscles - as they act as elastic ligaments to hold the head of humerus in the glenoid OR because they have a v lax capsule

Question 11

what is a positive sulcus test?

Answer 11

inferior gapping of more than 2cm OR difference between the two sides

Question 12

how to perform a sulcus test?

Answer 12

passively flex elbow to 90 - palpate lateral tip of acromion - apply downwards gliding force on humerus - palpate for gapping at joint

Question 13

what does the empty can test for subacromial impingement test for?

Answer 13

impingement of supraspainatus tendon, infraspinatus tendon or subacromial bursa.

Question 14

what is a positive empty can test for subacromial impingement test?

Answer 14

reproduction of pain or symptoms over impinged area in shoulder

Question 15

how to perform empty can test for subacromial impingement test?

Answer 15

ask if pain at any stage:

1. arms by side
2. abduct to 90
3. horizontal adduct to 30
4. empty can
5. add resistance

Question 16

why would empty can test for subacromial impingement reproduce pain?

Answer 16

by causing that movement - bringing greater tubercle closer to the coracaoacromial arch and compressing the structures within the space - reproducing the pain

Question 17

what does the empty can test for coracoacromial impingement test for?

Answer 17

impingement of supraspinatus tendon, biceps tendon, or subscapularis

Question 18

what is a positive test for coracoacromial impingement?

Answer 18

reproduction of pain or symptoms over impinged area in shoulder

Question 19

how to perform empty can test for coracoacromial impingement test?

Answer 19

ask for pain at any stage

1. arms at sides
2. arms flex to 90
3. empty cans
4. apply pressure

Question 20

why would empty can test for coracoacromial impingement test reproduce pain?

Answer 20

compression of lesser tubercle against corocoid process - trapping subscaplaris
compression of humeral head against coracoacromial arch -trapping supraspinatus and bursa

Question 21

What is the Hawkins and Kennedy impingement test for?

Answer 21

Coracoacromial Impingement of supraspinatus

Question 22

How might Hawkins and Kennedy impingement cause pain

Answer 22

greater tubercle to compress coracoacromial arch

Question 23

What is a positive Hawkins and Kennedy test?

Answer 23

pain in the coracoacomial space or difference in the two sides

Question 24

how to perform Hawkins and Kennedy test?

Answer 24

flex elbow and shoulder to 90 - medially rotate passively - observe for any pain

Question 25

What is the Scarf test for?

Answer 25

Integrity of the ACJ - degeneration or ligament sprain

Question 26

What is a positive scarf test?

Answer 26

pain over the ACJ

Question 27

why may a scarf test cause pain?

Answer 27

protraction of the scapula compresses the acromion on the clavicle –> stresses the ligaments and capsule - compressing the joint surfaces

Question 28

how to perform the scarf test?

Answer 28

ask patient to reach for opposite shoulder - ask if have any pain - if not, root over pressure over line of humerus