The Shoulder Tests Flashcards
What is the test for AC joint injury?
Horizontal adduction test & O’Briens (use to differentiate between AC and labral)
How is the horizontal adduction test completed ie what position? What resistance is applied and where? What is a positive test?
Seated. Patient full horizontally adducts arm. Apply overpressure at the humerus (NOT RESISTANCE) ie passively horizontally adduct their arm.
Positive = reproduction of pain and/or symptoms at the AC Joint
What are the tests for RC tear? What do they assess the integrity of?
Belly press = subscapularis function
Gerber’s lift off = subscapularis function (pain/ weakness)
Lag sign = supraspinatus & infraspinatus
How is the lag sign test conducted and what is considered a positive?
Seated
Elbow flexed to 90 degrees
Maximal ER (-5 degrees)
20 degrees abduction & hold
Positive test = unable to maintain positon –> arm may spring forward anteriorly
How is the belly press conducted? What is a positive?
Hand to belly and press (bring elbow slightly forward to ensure internal rotation of the shoulder - positive if pain, weakness or compensate through wrist flexion, shoulder adduction and extension
What are the tests for subacromial impingement? What is a positive for each of these?
Neers = pain
Hawkin-Kennedy = pain
Painful arc = pain 60-120 degrees abd (reduces > 120)
Empty can = pain or weakness (tests supraspinatus)
Resisted external rotation = pain or weakness (tests infra/teres minor)
3 out of 5 = positive for SAI
What are the tests for shoulder instability/dislocation? What is a positive?
Apprehension –> ask them if they can let you know what they are feeling. Sign of apprehension = positive, no apprehension when pressure applied at GH j
Sulcus sign (palpate subacromial space) hold humeral condyles. Positive = indent (1.5cm-2 = moderate & severe > 3cm
Load and shift. Stabilise scapula. Compress the HOH into the glenoid and glide the HOH anteriorly and posteriorly parallel to the glenoid fossa. Amount and direction of HOH translation indicates level of instability.
What are the tests for a SLAP?
O’Briens
Biceps II load test
Jerk
Passive compressive test
How is the passive compressive test conducted?
Side lying
- Externally rotate
- 30 deg abduction
- One hand stabilises at scapula & compress at the elbow with the other hand
- Extend backwards
How is the jerk test conducted?
Patient seated.
90 degrees abduction
Apply force down just around/distal to elbow
Move into horizontal adduction
What is a positive for the jerk test?
Pain or a clunk as the humeral head slides off the back of the glenoid (a second clunk may be felt as the arm is brought back to its resting position)
