Impingement Sign
Forward Flexion >90
(+) pain
(Impingement/Rotator Cuff)
Jobe Empty Can
Pronate arm, resisted FF in scapular plane
Pain or weakness indicates supraspinatus tear
Hawkins Test
FF 90, then IR
Pain
(Impingement/Rotator Cuff)
Drop Arm
FF>90, try to maintain it
Inability to hold flexion indicates supraspinatus tear
Shoulder Forward Flexion
0-160
Shoulder Extension
0-60
Shoulder External Rotation
Elbow at side: 30-60
Shoulder Abduction
0-160/180
TUBS
Traumatic, Unidirectional, Bankart, Surgery
Shoulder Instability
AMBRI
Atraumatic, Multidirectional, Bilateral, Rehab, Inferior Shift
(Shoulder Instability)
Generalized laxity, microtrauma due to overuse
Shoulder Laxity Tests
Drawer - AP translation
Sulcus - downward pressure, see gap
Frozen Shoulder
Normal Xray
Insiduous
Flexion, External Rotation
Shoulder Stability Tests
Apprehension - abduct 90, externally rotate, force from behind -> pain
Job Relocation - apply force to anterior shoulder
Shoulder Impingement Tests
Impingement Sign
Jobe Empty Can Test
ER lag sign
ER shoulder, patient holds it
Inability to maintain ER indicates infraspinatus tear
Horn blower’s
resisted ER in slight abduction
weakness indicates rotator cuff tear involving infraspinatus
Lift Off
Hand behind back, push backward
weakness indicates subscapularis tear
Lift Off Lag Sign
Lift hand off back, patient holds it
Inability to hold hand off of low back indicates subscapularis tear
Belly press
Hand on belly, push toward belly
Weakness indicates subscapularis tear
Active Compression (O’Brien) Test
FF 90, adduct 10, resisted flexion in pronation then supination
Pain with resisted flexion, greater in pronation indicates SLAP tear; may also suggest AC joint pathology
SLAP
Superior Labral Tear from Anterior to Posterior
Crank Test
Abduct 90, axial load, rotate
Pain indicates SLAP tear
Speed’s Test
Resisted Flexion in scapular plane
Pain indicates biceps lesion or tendinitis
Yergason’s Test
Elbow 90, resisted supination
Pain indicates biceps tendinitis
Apprehension Test
Abduct, ER
Pain or apprehension indicates anterior instability
Relocation Test
Abduct, ER, posterior force to arm
Relief of pain/apprehension indicates anterior instability
Load and Shift Test
Axial Load, ant/post translation
Increased translation indicates anterior or posterior instability
Jerk Test
Supine, adduct, FF 90, push posterior
pain/apprehension/translation indicates posterior instability
Sulcus Test
Pull down on adducted arm
Sulcus under lateral acromion indicates inferior instability
X-body adduction Test
Adduct Arm across body
Pain at AC joint indicates AC joint pathology
Scapular Winging
Push against wall
Winging of scapula indicates nerve palsy or muscle weakness
Adson’s Test
Palpate pulse, rotate neck
Numbness or tingling suggestive of thoracic outlet syndrome
Wright’s test
Extend arm, rotate neck away
numbness or tingling suggestive of thoracic outlet syndrome
Spurling’s Test
Lateral flex/axially compress neck
Reproduction of symptoms indicates cervical neck pathology