Shoulder - Special Tests Flashcards
(26 cards)
Yergason’s
purpose: Biceps tendon pathology (transverse humeral ligament)
perform: Patient seated; elbow flexed to 90°, forearm pronated. Examiner resists supination and ER while palpating biceps tendon
positive: Pain in bicipital groove or subluxation of tendon
Speed’s
purpose: Biceps tendonitis
perform: Patient seated or standing; shoulder flexed to 90°, elbow extended, forearm supinated. Examiner resists flexion
positive: Pain in bicipital groove
Neer’s
purpose: Subacromial impingement
perform: Patient seated or standing; examiner passively flexes shoulder with arm in IR (thumb down) while stabilizing scapula.
positive: Pain = positive for impingement
Empty Can / Jobe
purpose: Supraspinatus integrity
perform: Patient seated or standing; arms elevated to 90° in scapular plane, thumbs down. Examiner applies downward force.
positive: Weakness or pain
Drop Arm
purpose: Rotator cuff tear (supraspinatus)
perform: Patient standing or seated; arm abducted to 90°. Patient slowly lowers arm to side under control.
positive: Inability to control movement or sudden drop
Posterior Internal Impingement
purpose: Posterior rotator cuff/labrum impingement
perform: Patient supine; shoulder abducted 90-110°, max ER, slight extension. Examiner applies overpressure.
positive: Pain in posterior shoulder
Hawkins-Kennedy
purpose: Subacromial impingement
perform: Patient seated or standing; shoulder and elbow flexed to 90°. Examiner internally rotates shoulder.
positive: Pain = positive for impingement
Yocum
purpose: Subacromial impingement
perform: Patient seated or standing; hand on opposite shoulder. Examiner resists elevation of elbow.
positive: Pain indicates impingement
Hornblower’s Sign / Patte
purpose: Teres minor involvement
perform: Patient seated or standing; shoulder abducted to 90°, elbow flexed to 90°. Examiner resists ER.
positive: Inability to ER = positive
O’Brien’s / Active Compression
purpose: Labral tear (SLAP), AC joint
perform: Patient seated or standing; arm flexed to 90°, adducted 10-15°, IR (thumb down). Examiner resists downward pressure. Repeat with ER (palm up).
positive: Pain with IR relieved by ER = SLAP; AC pain = AC lesion
Biceps Load
purpose: SLAP lesion
perform: Patient supine; shoulder abducted to 120°, elbow flexed to 90°, forearm supinated. Examiner resists elbow flexion.
positive: Pain = positive for SLAP
Lateral Rotation Lag Sign
purpose: Infraspinatus/teres minor tear
perform: Patient seated; shoulder 20° scaption, near full ER. Examiner supports elbow and wrist, then asks patient to hold.
positive: Lag into IR = positive
Abdominal Compression
purpose: Subscapularis function
perform: Patient standing or seated; places hand on abdomen, pushes inward with elbow forward. Examiner monitors elbow.
positive: Elbow drifts posteriorly = positive
Lift-Off / Gerber’s
purpose: Subscapularis tear
perform: Patient standing; hand behind back (IR), lifts hand off back. Examiner may apply resistance.
positive: Inability to lift off = positive
Jerk Test
purpose: Posterior labral tear
perform: Patient seated; shoulder flexed to 90°, IR. Examiner applies axial load and horizontally adducts the arm.
positive: Sharp pain or clunk = positive
Sulcus Sign
purpose: Inferior instability
perform: Patient seated; arm relaxed at side. Examiner pulls arm inferiorly and observes for sulcus below acromion.
positive: Visible sulcus or dip = positive
Pec Major Contracture
purpose: Tight pectoralis major
perform: Patient supine; hands behind head. Examiner presses elbows toward table.
positive: Inability for elbows to reach table = positive
Halstead Maneuver
purpose: Thoracic Outlet Syndrome (TOS)
perform: Patient seated; examiner palpates radial pulse, applies downward traction while patient extends neck and rotates away.
positive: Diminished pulse = TOS
Clunk Test
purpose: Labral tear
perform: Patient supine; examiner fully abducts arm, applies anterior force to humeral head while ER shoulder.
positive: Clunk or grind = positive
Crank / Anterior Apprehension
purpose: Anterior instability/labral tear
perform: Patient supine; arm abducted to 90°, elbow flexed. Examiner slowly ERs the shoulder.
positive: Apprehension = anterior instability
Posterior Apprehension
purpose: Posterior instability
perform: Patient supine; arm flexed to 90°, IR. Examiner applies posterior force through elbow.
positive: Apprehension or muscle guarding
AC Shear
purpose: AC joint pathology
perform: Patient seated; examiner cups hands over clavicle and scapular spine and squeezes together.
positive: Pain or abnormal movement = AC joint pathology
Adson’s
purpose: TOS (scalene involvement)
perform: Patient seated; examiner palpates radial pulse. Patient extends neck, rotates toward test side, inhales deeply. Examiner extends and ERs arm.
positive: Diminished pulse = positive
Costoclavicular / Military Brace
purpose: TOS (1st rib/clavicle)
perform: Patient seated; examiner palpates radial pulse while patient retracts and depresses shoulders in ‘attention’ posture.
positive: Diminished pulse = positive
