Shoulder Special Tests

Question 1

Apprehension test

Answer 1

Instability
Pt positioned in supine, 90* abd and elbow flexion. PT externally rotates the shoulder and looks for apprehension on pt’s face

Question 2

Sulcus sign

Answer 2

Instability
pts arm in 20-50* abduction
PT pulls arm inferiorly and looks for depression between acromion and humeral head

Question 3

Ludington’s test

Answer 3

Biceps Pathology
pt positioned in sitting and clasping both hands behind head with fingers interlocked, and contracts bicep
If biceps do not contract, may be indicative of a ruptured long head of biceps.

Question 4

Speed’s Test

Answer 4

Biceps Pathology
sitting with elbow extended and forearm supinated.
PT places hand over bicipital groove and the other hand on the volar surface of the forearm, and resists active shoulder flexion.
Positive = pain at the bicipital groove indicating tendonitis

Question 5

Yergason’s Test

Answer 5

Biceps Pathology
sitting with 90 degrees of elbow flexion and forearm pronation and actively supinate and laterally rotate against resistance.
Positive = pain or tenderness in the bicipital groove indicating tendonitis

Question 6

Drop Arm Sign

Answer 6

RTC Pathology - tear
sitting or standing with arm in 90* of abduction, and instructed to slowly lower the arm.
Positive = pt failing to slowly lower the arm due to pain.

Question 7

Hawkins-Kennedy

Answer 7

RTC Pathology - shoulder impingement involving the supraspinatus tendon

Question 8

Infraspinatus test

Answer 8

RTC pathology - infraspinatus tear or strain

MMT of lateral/external rotation

Question 9

Lateral rotation lag sign

Answer 9

RTC pathology
PT passively moves pt’s shoulder into 20* scaption and near and-range lateral rotation and asks pt to hold position.
Positive = pt cannot hold position - indicative of infraspinatus or supraspinatus pathology.

Question 10

Lift off sign (medial rotation lag sign)

Answer 10

RTC pathology - subscapularis lesion

Combined ext/ADD/IR, lifting arm off of low back.

Question 11

Neer Impingement Test

Answer 11

RTC pathology - supraspinatus impingement
passive shoulder flexion with scapula stabilized.
Positive = pain with motion

Question 12

Supine impingement test

Answer 12

RTC pathology

PT laterally rotates and abducts shoulder so that arm is near the pt’s head and medially rotates shoulder.

Question 13

Supraspinatus test

Answer 13

RTC pathology - suprascapular nerve or tear in supraspinatus tendon
arm in 90* abduction followed by 30* horizontal adduction with the thumb pointing down. PT resists abduction.

Question 14

Adson maneuver

Answer 14

Thoracic Outlet Syndrome
therapist monitors the radial pulse and asks the pt to rotate their head to face the test shoulder and extend head while therapist laterally rotates and extends the pt’s shoulder.
Positive = diminished radial pulse

Question 15

Allen test

Answer 15

Thoracic Outlet Syndrome
test arm in 90* of abduction, lateral rotation, and elbow flexion and rotates head away from test shoulder.
Positive = diminished radial pulse

Question 16

Costoclavicular syndrome test (Eden’s test)

Answer 16

Thoracic Outlet Syndrome
passively pull shoulder into hyper extension with cervical extension
Positive = diminished radial pulse

Question 17

Roos Test

Answer 17

Thoracic Outlet Syndrome
arm in 90* abduction, lateral rotation and flexion. Pt asked to open and close their hands for three minutes.
Positive = unable to maintain test position, weakness in arms, sensory loss, or ischemic pain.

Question 18

Write test (hyperabduction test)

Answer 18

Thoracic Outlet Syndrome

PT moves pt’s arm overhead in the frontal plane while monitoring the patient’s radial pulse.

Question 19

Acromioclavicular Crossover test

Answer 19

therapist moves pt’s shoulder into 90 degrees of flexion then fully horizontally adduction the shoulder.

Question 20

O’Brien’s test

Answer 20

AC joint pathology
shoulder flexed to 90 degrees, horizontally adducted 10-15 degrees, and medially rotated. pt resists downward force on arm. Then performed in lateral rotation.
Positive = more pain in medial rotation than lateral

Question 21

Jerk Test

Answer 21

Posterior shoulder instability
Sitting with shoulder elevated to 90 degrees and in medial rotation with elbow bent. therapist provides an axial compression force through the patient’s elbow while horizontally adducting the shoulder.
Positive: Sudden clunk or jerk as the humeral head subluxes posteriorly

Question 22

Upper limb tension test 1

Answer 22

Median nerve, Anterior interosseus nerve

Question 23

Upper limb tension test 2

Answer 23

median nerve, musculocutaneous nerve, axillary nerve

Question 24

Upper limb tension test 3

Answer 24

radial nerve

Question 25

Upper limb tension test 4

Answer 25

ulnar nerve