Special Tests - Shoulder Flashcards
What does the bear hug test for?
Damage or weakness in medial rotators (subscapularis)
What is a positive bear hug test?
weakness, or pain in shoulder over lesser tubercle. OR patient unable to maintain test position
How to perform bear hug test?
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’
what does the infraspinatus test for?
damage or weakness in lateral rotators (mainly infraspinatus)
what is a positive infraspinatus test?
weakness or pain in shoulder region (over greater tubercle) OR unable to hold test position OR early fatigue
How to perform infraspinatus test?
bend both elbows to 90 - arms by the side of body - with palms facing each other - apply pressure into medial rotation
what does the external rotation lag sign test for?
damage or weakness in lateral rotators (mainly infraspinatus)
what is a positive test in the external rotation lag sign?
excessive drop into medial rotation - difference between left and right
how to perform the external rotation lag sign test?
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
what does the sulcus test of rotator cuff integrity test for?
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
what is a positive sulcus test?
inferior gapping of more than 2cm OR difference between the two sides
how to perform a sulcus test?
passively flex elbow to 90 - palpate lateral tip of acromion - apply downwards gliding force on humerus - palpate for gapping at joint
what does the empty can test for subacromial impingement test for?
impingement of supraspainatus tendon, infraspinatus tendon or subacromial bursa.
what is a positive empty can test for subacromial impingement test?
reproduction of pain or symptoms over impinged area in shoulder
how to perform empty can test for subacromial impingement test?
ask if pain at any stage:
- arms by side
- abduct to 90
- horizontal adduct to 30
- empty can
- add resistance
why would empty can test for subacromial impingement reproduce pain?
by causing that movement - bringing greater tubercle closer to the coracaoacromial arch and compressing the structures within the space - reproducing the pain
what does the empty can test for coracoacromial impingement test for?
impingement of supraspinatus tendon, biceps tendon, or subscapularis
what is a positive test for coracoacromial impingement?
reproduction of pain or symptoms over impinged area in shoulder
how to perform empty can test for coracoacromial impingement test?
ask for pain at any stage
- arms at sides
- arms flex to 90
- empty cans
- apply pressure
why would empty can test for coracoacromial impingement test reproduce pain?
compression of lesser tubercle against corocoid process - trapping subscaplaris
compression of humeral head against coracoacromial arch -trapping supraspinatus and bursa
What is the Hawkins and Kennedy impingement test for?
Coracoacromial Impingement of supraspinatus
How might Hawkins and Kennedy impingement cause pain
greater tubercle to compress coracoacromial arch
What is a positive Hawkins and Kennedy test?
pain in the coracoacomial space or difference in the two sides
how to perform Hawkins and Kennedy test?
flex elbow and shoulder to 90 - medially rotate passively - observe for any pain
What is the Scarf test for?
Integrity of the ACJ - degeneration or ligament sprain
What is a positive scarf test?
pain over the ACJ
why may a scarf test cause pain?
protraction of the scapula compresses the acromion on the clavicle –> stresses the ligaments and capsule - compressing the joint surfaces
how to perform the scarf test?
ask patient to reach for opposite shoulder - ask if have any pain - if not, root over pressure over line of humerus
