Quick Shoulder tests Flashcards
(25 cards)
Anterior Aprehension
Rationale: anterior instability
pt position: supine
PT: put shoulder 90/ER, Elbow 90
+: aprehension/pain
Anterior Drawer
Rationale: anterior instability
pt position: Supine
PT: anterior glide
Jobe relocation
Rationale: anterior instability
pt position: after anterior aprehension
PT: put humeral head back if comes out after anterior aprehension
Rockwood
Rationale: anterior instability
pt position: stand
PT: she said therapists flexes shoulder all the way up over head and ER the patient
Posterior Apprehension
Rationale: posterior instability
pt position: supine, shoulder 90, elbow 90
PT: push posteriorly through elbow through humerus
Posterior Drawer
Rationale: posterior instability
pt position: supine
PT does posterior glide
Sulcus Sign
Rationale: inferior instability
pt position: sit relaxed
PT palpate acromion, drop off –feel space
Sulcus Test
Rationale: inferior instability
pt position: sit
PT stabilize scapula, push inferiorly at forearm
Faegin Test
Rationale: inferior instability
pt position: stand
shoulder abducted
PT push inferiorly at greater tuberosity
Rowe Test
Rationale: multidirectional instability
Pt position: lean forward at waist, other hand on table
PT does three tests: push anteriorly, posteriorly and inferiorly: stabilize at scapula
Yergason Test
Rationale: bicep
pt position: sit
arm at side, elbow bent 90 degrees and forearm pronate
PT: Resist patient supination, shoulder ER, and isometric flexion
Speed Classic
Rationale: Bicep—using biceps tendon as secondary shoulder flexor
pt position: sit, shoulder 90 flex and ER, elbow extended, forearm supinated
PT: resist isometric hold of shoulder flexion
Positive sign: pain in bicipital groove area (biceps tendon)
Speed Extension
Rationale: Bicep—using biceps tendon as secondary shoulder flexor
Position: seated with shoulder extended, shoulder ER, elbow straight (forearm supinate?)
Test: PT resists isometric hold of shoulder flexion (this puts more stretch on the tendon by putting into extension)
Positive sign: pain in bicipital groove area
Drop Arm Test
Rationale: can the rotator cuff be a dynamic stabilizer: If rotator cuff is not being a dynamic stabilizer it will start to drop (muscle strain, muscle tear)—deltoid and rotator cuff synergy
Pt position: stand, arms abducted***Patient lowers arms slowly to the side
PT: Phase 2: If patient can perform, give gentle tap as patient lowers
Positive sign: lack of eccentric control
(***be ready to catch the arm as it falls to the side)
Supraspinatus Test
Rationale: this position puts the supraspinatus in line with the humerus and is under the acromion lower than the impingement, we only want to test the ability of supraspinatus and not the area where you impinge (lower than 90 degrees). EMG: first part of arch of motion is supraspinatus, keep arm low to be more specific to supraspinatus
pt position: arms below 90 degrees in scaption and IR ( range where the supraspinatus functions in a more isolated fashion)
PT: Therapist resists distal forearm (push down)
Positive: see if it provokes pain or cardinal sign (or if it drops?)
Can Test
Rationale: Rotator Cuff Tear
pt Position: arm elevated to 90 degrees in SCAPTION
- Empty can test: thumb down (IR)
- Full can Test: thumb up (ER)
PT: push down humerus as patient attempts an isometric contraction
Positive signs: pain and weakness
Empty can: IR causes grinding whatever attach to proximal humerus under acromial arc –by resisting and contracting muscles create more impinge.
Full can is beneficial because it gives the same data with the arm in a position of neutral or ER that doesn’t create an impingement.
Hawkins-Kennedy Impingement Test
Rationale: for subacromial impingement (supraspinatus tendon against the anterior portion of the coracoacromial ligament—pain if the patient has supraspinatus tendinitis (rosen)
Pt position: arm 90 degrees scaption, elbow 90 degrees of flexion
PT: overpressure arm into IR
Positive: Pain
————-Pain secondary to compression of structures under coracoacromial ligament and acromion
Yocum Test
Rationale: for subacromial impingement
Pt position: Affected hand is placed on opposite shoulder
TEST: Patient lifts elbow
Positive: pain
——–Pain secondary to compression of structures under coracoacromial ligament and acromion
Neer Test
Rationale: for subacromial impingement
Pt position:
PT: Stabilize the trunk– IR arm and lift arm to flexion to ear
Positive: Pain
——Pain secondary to compression of structures under coracoacromial ligament and acromion
If all 3 positive: Hawkins, Yocum, Neer: this indicates ____?
Some articles say if all 3 positive: Hawkins, Yocum, Neer: this indicates impingement
Coracoachrimial ligament
Whenever patient says painful, you ask where –is it subacromial, is it AC joint,
Posterior impingement test
: put stretch on capsule as bring arm up—like neer to the ear but do it in the supine position
- Supine, arm in flexion, elbow bent, rotate
- (see Dutton page 523)
Crank Test
Rationale: labral pathology
Pt position: seated or supine, arm in 160 degrees scaption, elbow flexed 90 degrees
PT: stabilizes the patient’s posterior shoulder
and pushes toward the joint through the patients elbow while gently rotating the arm IR and then ER—cranking
Positive sign: pain with ER or reproduction of the cardinal sign during overhead activities
O’Brien’s Test
Rationale: active compression test to provoke labral symptoms (superior labrum is close to the attachment of the biceps tendon)
Pt position: standing
Part 1: (IR) flex shoulder 90 degrees, shoulder IR, (elbow straight) then does horizontal adduction.
Part 2: (ER) flex shoulder 90 degrees, shoulder ER, (elbow straight) then does horizontal adduction patient turn palm up
PT: resists by pushing down: for an isometric hold of the position
Positive sign:
- -pain with part 1 and no pain with part 2: rule in Labrum
- -pain for both part 1 and part 2—the problem may be at the AC joint.
IR: In a stressful place and push down so muscles will be compressing and by resisting provoke pain in the labrum in part 1, IR,
ER: Turning palm up puts biceps on slack and less stress there in part two, changing the compression did not change symptoms then we suspect the AC joint
Mimori New Pain Provocation
Rationale: superior labral problem–passive compression test, stretching the biceps tendon over the GH joint–does it pinpoint patient pain
Pt position: patient seated, therapist stabilizes the shoulder and holds the distal forearm
Phase 1: PT to pt:
90 degrees abduction and fully ER with elbow flexed to 90 degrees and forearm pronated. (Bicep on slack one joint, but stretching a little as a pronator)
allow patient to rest a second with arm at side
Phase 2: again but with forearm supinated (slack bicep both jts)
Positive sign: pain provoked with pronation or pain greater in pronation than in supination—LABRUM
