UE Special Tests Flashcards
Yergason’s Test
Purpose: integrity of transverse ligament
Position: sitting, 90 elbow flexion, forearm pronation, arm stabilized against thorax
Test: resist supination of forearm and ER of shoulder
+ tendon of long head of biceps will pop out of groove
+ tenderness in bicipital groove (without dislocation) – bicipital tendinosis
Speed’s test
Purpose: bicipital tendinosis
Position: full extension of arm, forearm supination OR 90 deg of flexion (push into extension)
Test: resist shoulder flexion
+ pain in long head of biceps tendon
Neer’s impingement test
Purpose: impingement of supraspinatus and biceps tendon
Position: passive arm elevation (in scapular plane), passive medial rotation
+ pain in shoulder
Empty can (Jobe) test
Purpose: impingement/tear of supraspinatus tendon or suprascapular neuropathy
Position: 90 abd, neutral rotation
Test: resisted abduction, passive medial rotation, angled 30 deg forward (thumbs pointing to the floor in scapular plane)
+ pain in supraspinatus tendon or weakness in empty can position
Drop arm test
Purpose: tear/full rupture of RC
Position: 90 abd
Test: patient slowly lowers arm
+ unable to return arm to side slowly, or has severe pain
Posterior Internal Impingement Test
Purpose: impingement between RC and greater tuberosity or posterior glenoid and labrum
Position: supine
Test: passive abduction to 90, 110, with 15-20 deg of extension and max ER
+ reproduction of posterior shoulder pain
Hawkin’s Kennedy Impingment Test
Purpose: subacromial impingement
Position: passive flexion to 90 deg in scapular plane, forearm forced into IR
+ pain
Horn Blower’s Sign
Purpose: detect RC tears involving teres minor
Position: sitting/standing, arm supported at 90 deg abd in scapular plane, 90 deg elbow flexion
Test: pt asked to rotate the forearm externally against resistance
+ unable to ER
O’brien Active Compression
Purpose: SLAP lesion or superior labral lesion
Position: standing, 90 deg flexion, 10 deg horizontal add, max IR, elbow extension. Resists downward force on distal arm. Test is repeated with max ER
+ pain on the joint line, painful clicking inside shoulder with first position and eliminated with second position
Biceps Load Test
Purpose: superior labral integrity
Position: supine or seated, 120 deg abduction, ER, 90 deg elbow flexion, forearm supination
Test: passively fully laterally rotate arm, hold position if apprehension occurs. Patient is asked to flex elbow against resistance.
- Decreased apprehension
+ Apprehension remains the same or shoulder pain increases
Lateral Rotation Lag Sign
Purpose: Teres minor and infraspinatus
Position: seated or standing, arm by side, 90 elbow flexion
Test: passively abduct arm to 90 deg in scapular plane, ER shoulder to end range, ask pt to hold position
+ cannot hold position, hand springs back anteriorly toward body
Abdominal compression test
Other names: belly press, napoleon test
Purpose: subscapularis mm
Position: standing, hand on abdomen below xiphoid, pushes into abdomen as hard as possible, trying to bring elbow forward into scapular plane (causing IR)
+ unable to maintain pressure on abdomen, or posteriorly flexes the wrist, or extends the shoulder
Lift off sign
Other names: Gerber’s test
Purpose: subscapularis muscle
Position: dorsum of hand against mid lumbar spine, lifts hand away from back
+ unable to lift off back
Jerk Test
Purpose: posterior instability
Position: sitting, IR, 90 deg flexion
Test: axial load humerus (through elbow), move arm horizontally across body
+ sudden jerk/clunk (sublux)
Sulcus Sign
Purpose: inferior shoulder instability
Position: standing, arm by side, relaxes, examiner grasps forearms below elbow and pulls distally
+ sulcus sign
Pectoralis Major Contracture Test
Purpose: tightness of pec major
Position: supine, hands together behind head, arms lowered until elbows touch table
+ elbows do not reach the table
Halstead Maneuver
Purpose: thoracic inlet pathology (TOS)
Position: sitting, neck hyperextension, contralateral cervical rotation. Radial pulse in found, downward traction applied to extremity
+ absence of pulse
Clunk Test
Purpose: glenoid labrum tear
Position: supine, full abd, humeral head pushed anteriorly while rotating humerus externally
+ audible clunk
Anterior apprehension test
Other names: crank test
Purpose: anterior dislocation of shoulder/instability
Position: supine, 90 deg abd, shoulder is slowly ER
+ apprehension
Posterior apprehension sign
Purpose: posterior shoulder dislocation/instability
Position: supine or sitting, shoulder elevated to 90 deg in scapular plane, scapula stabilized, posterior/axial force applied to elbow, maintain force and horizontally adduct and IR arm
+ does not allow/like to move shoulder in that direction
Acromioclavicular shear test
Purpose: AC joint dysfunction
Position: sitting, cup hands over deltoid muscle (sitting laterally from pt), squeeze hands
+ pain
Adson’s Test
Purpose: TOS
Position: seated, head rotated ipsilaterally, radial pulse palpated, cervical extension, passive ER and extension of shoulder
+ absent pulse
Costoclavicular syndrome test
Purpose: TOS
Position: Seated, radial pulse palpated, passive shoulder extension
+ absent pulse
Wrist (hyperabduction) test
Purpose: TOS
Position: seated, radial pulse palpated, passive shoulder max abd and ER, rotate head contralaterally
+ neurological/vascular symptoms reproduced (loss of sensation, loss of pulse)
