UE Special Tests

Question 1

Speed’s

Answer 1

Purpose: identify bicipital tendinosis/tendinopathy

Describe: Upper limb in full extension and forearm supinated. Resist shoulder flexion

Result: pain in long head of biceps tendon

Question 1

Yergason’s

Answer 1

Purpose: integrity of transverse ligament

Describe: Elbow flexed 90 and stabilized against thorax with forearm pronated. Resist supination and external rotation

Result: Tendon of long head of biceps will pop out of groove

Question 2

Neer’s Impingement test

Answer 2

Purpose: impingement of supraspinatus and biceps tendon

Describe: Pt’s arm is passive and forcibly fully elevated in scapular plan with the arm medially rotated by examiner.

Result: reproduces symptoms of pain

Question 3

Empty can

Answer 3

Purpose: identify tear of supraspinatus tenson or suprascapular nerve neuropathy

Describe: Pt’s arm abducted 90 with no rotation, examiner resists abduction -> medial rotate and angle arm forward 30 (thumbs toward floor)

Result: reproduces pain in empty can

Question 4

Drop test

Answer 4

Purpose: identify tear or full rupture of RTC

Describe: Examiner abducts pt’s arm to 90 and ask pt to slowly lower arm to side

Result: (+) unable to return arm to side slowly or severe pain

Question 5

Posterior internal impingement test

Answer 5

Purpose: identify impingement between RTC and greater tuberosity or posterior glenoid and labrum

Describe: Pt placed in supine lying, examiner passive abducts shoulder to 90 to 110 and 15-20 extension with max lateral rotation

Result: reproduction of pain in posterior shoulder

Question 6

Hawkins-Kennedy

Answer 6

Purpose: identify sub-acromial impingement

Describe: arm of pt passively flex to 90 in plane of scapula, arm stabilized and forearm forced into IR

Result: Pain (+) for supraspinatus tendinosis secondary to impingement

Modification (Yocum) pt’s hand on opposite shoulder and examiner elevates elbow

Question 7

Horn Blower’s sign (Patte test)

Answer 7

Purpose: detect RTC tears involving teres minor

Describe: Pt’s arm supported at 90 abduction with elbow flexed to 90 –> Pt asked to rotate forearm externally against resistance

Result: Unable = present sign

Question 8

Active compression test of O’brien

Answer 8

Purpose: to detect SLAP tear

Describe: 1) Pt with shoulder at 90 flexion, 10 horizontal adduction and max IR with elbow in extension. Pt resists downward force to distal arm 2) repeated with arm in max ER

Result: Pain in shoulder joint in 1st part and gone/decreased in second part

Question 9

Biceps load test

Answer 9

Purpose: check integrity of superior labrum

Describe: Pt supine/seated with shoulder abdcuted 120 and IR with elbow flexed 90, forearm supinated. Examiner performs apprehension test on patient by taking pt into full lateral rotation and holding. Pt then asked to flex the elbow against resistance

Result: If apprehension decreases, test is (-). If apprehension is the same or pain increases (+)

Question 10

Lateral rotation lag sign

Answer 10

Purpose: test teres minor and infraspinatus

Describe: Pt with arm by side and elbow flexed to 90. Examiner passively abducts the arm to 90 in scapular plane, laterally rotates the shoulder to end range and asks pt to hold it

Result: (+) pt cannot hold position and hand springs back anteriorly

Question 11

Abdominal compression test (belly press)

Answer 11

Purpose: test subscap

Question 12

Lift off sign

Answer 12

Purpose: detect lesion of subscap

Question 13

Jerk test

Answer 13

Purpose: test recurrent posterior instability

Describe: Pt sits with arm medially rotated and forward flexed to 90. Examiner grasps elbow and axially loads the humerus, maintains and moves arm horizontally across body

Result: (+) sudden jerk or clunk as humeral head slides off back of glenoid