Shoulder Special Tests

Question 0

Describe the apprehension test for posterior shldr dislocation:

Answer 0

The pt is positioned in supine w the arm in 90 degrees of flexion and medial rotation. The therapist applies a posterior force through the long axis of the humerus. A positive test is indicated by a look of apprehension or a facial grimace prior to reaching an end point.

Question 1

Describe the apprehension test for anterior shldr dislocation:

Answer 1

The pt is positioned in supine with the arm in 90 degrees abduction. The therapist laterally rotates the pts shldr. A pos test is indicated by a look of apprehension or a grimace prior to reaching an end point.

Question 2

Describe the Speed’s Test

Answer 2

The pt is positioned is sitting or standing w the elbow extended and the forearm supinated. The therapist places one hand over the bicipital groove and the other hand on the volar surface of the forearm. The therapist resists active shoulder flexion. A positive test is indicated by pin or tenderness in the bicipital groove region and may be indicative of bicipital tendonitis.

Question 3

Describe the Yergason’s Test

Answer 3

The pt is positioned in sitting w 90 degrees of elbow flex and the forearm pronated. The humerus is stabilized against the pts thorax. The therapist places one hand on the pts forearm and the other hand over the bicipital groove. The pt is directed to actively supinate and laterally rotate against resistance. A positive test is indicated by pain or tenderness in the bicipital groove and may be indicative of bicipital tendonitis.

Question 4

Describe the Drop Arm Test

Answer 4

The pt is positioned in sitting or standing w the arm in 90 degrees of abduction. The pt is asked to slowly lower the arm to their side. A pos test is indicated by the pt failing to slowly lower the arm to their side or by the presence of sever pain and may be indicative of a tear in the rotator cuff.

Question 5

Describe the Hawkins-Kennedy Impingement Test:

Answer 5

The pt is positioned is sitting or standing. The therapist flexes the pts shldr to 90 degrees and then medially rotates the arm. A positive test is indicated by pain and may be indicative of shldr impingement involving the supraspinatus tendon.

Question 6

Describe the Neer Impingement Test

Answer 6

The pt is positioned in sitting or standing. The terapist positions one hand on the posterior aspect of the pts scapula and the other hand stabilizing the elbow. The therapist elevates the pts arm through flexion. A positive test is indicated by a facial grimace or pain and may be indicative of shoulder impingement involving the supraspinatus tendon.

Question 7

Describe the Supraspinatus Test

Answer 7

The pt is positioned w the arm in 90 degrees of abduction followed by 30 degrees of horizontal adduction w the thumb pointing downward. The therapist resists the pts attempt to abduct the arm. A positive test is indicated by weakness or pain and may be indicative of a tear of the supraspinatus tendon, impingement or suprascapular nerve involvement.

Question 8

Describe the Adson maneuver

Answer 8

The pt is positioned in sitting or standing. The therapist monitors the radial pulse and asks the pt to rotate his head to face the test shldr. The pt is then asked to extend his head while the therapist laterally rotates and extends the pts shldr. A positive test is indicated by an absent or diminished radial pulse and may be indicative of thoracic outlet syndrome.

Question 9

Describe the Allen Test

Answer 9

Testing for Thoracic outlet syndrome - The pt is positioned in sitting or standing with the test arm in 90 degrees of abduction, lateral rotation, and elbow flexion. The pt is asked to rotate the head away from the test shldr while the therapist monitors the radial pulse. A positive test is indicated by n absent or diminished pulse when the head is rotated away from the test shldr.

Question 10

Describe the Roos test:

Answer 10

For Thoracic outlet syndrome - The pt is positioned in sitting or standing with the arms positioned in 90 degrees of abduction, lateral rotation, and elbow flexion. The pt is asked to open and close their hands for 3 minutes. A positive test is indicated by the inability to maintain the test position, weakness of the arms, sensory loss or ischemic pain.

Question 11

Describe the Varus Stress Test for elbow-

Answer 11

The pt is positioned is sitting w the elbow in 20-30 degrees of flexion. The therapist places one hand on the elbow and the other hand proximal to the pts wrist. The therapist applies a varus force to test the lateral collateral ligament while palpating the lateral joint line. A pos test is indicated by increased laxity in the lateral collateral ligament when compared to the contralateral limb, apprehension or pain.

Question 12

Describe the Valgus stress test for elbow -

Answer 12

For MCL sprain of elbow - The pt is positioned in sitting w the elbow in 20-30 degrees of flexion. The therapist places one hand on the elbow and the other hand proximal to the pts wrist. The therapist applies a valgus force to test the medial collateral ligament while palpating the medial joint line. A pos test is indicated by increased laxity in the medial collateral ligament when compared to the contralateral limb, apprehension or pain. T pos test may be indicative of a medial collateral ligament sprain.

Question 13

Describe the Cozen’s Test for elbow

Answer 13

For lateral epicondylitis - The pt is positioned in sitting w the elbow in slight flexion. The therapist places his thumb on the pt s lateral epicondyle while stabilizing the elbow joint. The pt is asked to make a fist, pronate the forearm, radially deviate, and extend the wrist against resistance. A pos test is indicated by pain in the lateral epicondyle region or muscle weakness.

Question 14

Describe the Lateral epicondylitis test for elbow

Answer 14

The pt is positioned in sitting. The therapist stabilizes the elbow w one hand and places the other hand on the dorsal aspect of the pts hand distal to the proximal interphalangeal joint. The pt is asked to extend the third digit against resistance. A pos test is indicated by pain in the lateral epicondyle region or muscle weakness.

Question 15

Describe the Medial epicondylitis test for elbow

Answer 15

The pt is positioned in sitting. The therapist palpates medial epicondyle and supinates the pts forearm, extends the wrist, and extends the elbow. A pos test is indicated by pain in the medial epicondyle region.

Question 16

Describe the Neurological Dysfunction test of the elbow (Tinel’s sign)

Answer 16

For ulnar nerve compression or compromise - the pt is positioned in sitting w the elbow in slight flexion. The therapist taps w the index finger btwn the olecranon process and the medial epicondyle. A pos test is indicated by a tingling sensation in the ulnar nerve distribution of the forearm, hand, and fingers.

Question 17

Describe the Ulnar collateral ligament instability test

Answer 17

Gamekeeper’s or skier’s thumb - the pt is in sitting. THe therapist holds the pts thumb in extension and applies a valgus force to the metacarpophalangeal joint of the thumb. A pos test is indicated by excessive valgus movement and may be indicative of a tear of the ulnar collateral and accessory collateral ligaments.

Question 18

Describe the Allen Test

Answer 18

For wrist/hand vascular insufficiency - the pt is sitting or standing. The pt is asked to open and close the hand several times in succession and then maintain the hand in a closed position. The therapist compresses the radial and ulnar arteries. The pt is then asked to relax the hand and the therapist releases the pressure on one of the arteries while observing the color of the hand and fingers. A pos test is indicated by delayed or absent flushing of the radial or ulnar half of the hand.

Question 19

Describe Froment’s sign for wrist/hand

Answer 19

This neurological dysfunction is used to detect ulnar nerve compromise or paralysis. The pt is positioned in sitting or standing and is asked to hold a piece of paper between the thumb and index finger. The therapist attempts to pull the paper away from the pt. A pos test is indicated by the pt flexing the distal phalanx of the thumb due to adductor pollicis muscle paralysis. If at the same time, the pt hyperextends the metacarpophalangeal joint of the thumb it is termed Jeanne’s sign. Both objective findings may be indicative of ulnar nerve compromise or paralysis.

Question 20

Describe the Phalen’s test for wrist/hand

Answer 20

The pt is positioned in sitting or standing. The terapist flexes the pts wrists maximally and asks the pt to hold the pos for 60 sec. A pos test is indicated by tingling in the thumb, index finger, middle finger, and lateral half of the ring finger and may be indicative of carpal tunnel syndrome due to median nerve compression.

Question 21

Describe Tinel’s sign for wrist/hand

Answer 21

The pt is positioned in sitting or standing. The therapist taps over the volar aspect of the pts wrist. A positive test is indicated by tingling in the thumb, index finger, middle finger, and lateral half of the ring finger distal to the contact site at the wrist. A pos test may be indicative of carpal tunnel syndrome due to median nerve compression.

Question 22

Describe the Finkelstein test for wrist/hand

Answer 22

THe pt is positioned in sitting or standing and is asked to make a fist w the thumb tucked inside the fingers. The therapist stabilizes the pts forearm and ulnarly deviates the wrist. A pos test is indicated by pain over the abductor pollicis longus and extensor pollicis brevis tendons at the wrist and may be indicative of tenosynovitis in the thumb (de Quervain’s disease)