Tendon Tests

Question 0

What is a positive empty/full can test?

Answer 0

Reproduction of the patient’s pain with or without weakness

Question 1

How do you perform the empty can test?

Answer 1

Patient: Standing or Sitting
Clinician: Standing on the affected side facing patient
Action: shoulder passively elevated to 90o and taken into full external rotation (thumb facing ground). Stabilise scapula and place hand on forearm and apply downward pressure and get patient to maintain position

Question 2

What is indicated by a positive empty/full can test?

Answer 2

Pain only: supraspinatus impingement or tendonopathy

Painful weakness: partial or complete tear of supraspinatus

Question 3

How do you perform a full can test?

Answer 3

same as empty can but thumb pointing to the ceiling.

Arm is elevated to 90o and full external rotation (thumb pointing upwards)

Question 4

How do you perform a lift off sign test?

Answer 4

Patient: Standing or sitting
Clinician: Standing behind the patient
Action: Put patient’s arm behind their back, hand is passively lifted away from lumbar spine and patient is asked to maintain the position

Question 5

What is a positive lift off sign?

Answer 5

Inability to maintain the position

Question 6

What does a positive lift off sign indicate?

Answer 6

Complete tear of subscapularis tendon

Question 7

How do you perform an external rotation lag sign test?

Answer 7

Patient: Sitting or standing, arm out to the side elbow flexed to 90o thumb up
Clinician: Standing adjacent to the affected side, one hand supporting the elbow, one hand on wrist.
Action: Shoulder elevated to 20o and taken to about 5o short of full external rotation. Patient asked to maintain the position

Question 8

What is a positive external rotation lag sign?

Answer 8

Patient unable to maintain rotated position and there is a lag or spring back of the arm

Question 9

What does a positive external rotation lag sign indicate?

Answer 9

Lag of 5-10o: complete tear of infraspinatus or supraspinatus
Lag of 10-15o: tear of both tendons

Question 10

How do you perform Speed’s Test?

Answer 10

Patient: Sitting or standing, shoulder in 60-90o of forward flexion, elbow fully extended and palm up (supinated)
Clinician: standing on affected side, one hand stabilising shoulder, other hand on lower forearm
Action: Patient is asked to maintain the position and downward pressure is applied to the forearm

Question 11

What is a positive Speed’s Test?

Answer 11

Reproduction of the patient’s pain. Need to ask position as may be localised or deep

Question 12

What does a positive Speed’s Test indicate?

Answer 12

Pain localised to bicipital groove: tendonopathy or tendosynovitis of long head of biceps
Deeper pain: biceps or labral complex injury