shoulder tests Flashcards
(16 cards)
describe empty/full can (what does it test for, how to do it, ++ findings)
tests for supraspinatus tear or tendinopathy, (empty) flex to 90, move into scaption, IR pts arm completely (thumbs down), apply pressure to wrist ++ if pain or weakness
full: flex to 90, move into scaption, ER pts arm completely (thumbs out), apply pressure to wrist ++ if pain or weakness
Gerber “lift off” (what does it test for, how to do it, ++ findings)
subscapularis tendinopathy or rupture, the patient is asked to place the back of the affected arm (dorsum of the hand) in the mid lumbar spine area. The testing movement involves the patient performing internal rotation (IR), by lifting the hand off the back (if easy, apply pressure: while the examiner places pressure on the hand[2].
The test is considered to be positive if the patient cannot resist, lift the hand off the back or if she/he compensates by extending the elbow and shoulder
ER lag sign ((what does it test for, how to do it, ++ findings)
to assess the integrity, and tears, of the supraspinatus (SSP) and infraspinatus muscles. also be used for the clinical examination of a shoulder impingement syndrome (SIS). pts elbow 90 flexion, 20 elevation, near end range ER, ask pt to hold it. ++ test if pts is unable to hold position
speed test
superior labral tears or bicipital tendonitis, To perform the Speed’s Test, the examiner places the patient’s arm in shoulder flexion, external rotation, full elbow extension, and forearm supination; manual resistance is then applied by the examiner in a downward direction.[1] The test is considered to be positive if pain in the bicipital tendon or bicipital groove is reproduced.
yergasons test ((what does it test for, how to do it, ++ findings)
bicipital tendonitis and unstable sup labral anterior posterior (SLAP) lesion. with the humerus in a neutral position and the elbow in 90 degrees of flexion in a pronated position. The patient is asked to externally rotate and supinate their arm against the manual resistance of the therapist produced by wrapping the hand around the distal forearm (just above the wrist joint).[2] Yergason’s Test is considered positive if the pain is reproduced in the bicipital groove and a biceps or a SLAP lesion is suspected. If a “clicking” sensation familiar to the patient is produced during the test, damage to the transverse humeral ligament (which overlies the intertubercular sulcus) should be suspected too
biceps load test I and II
Superior labral anterior posterior tears. The patient is in the supine position with the shoulder in 90/120 degrees of abduction and full external rotation, while the elbow is in 90 degrees of flexion, and the forearm in supination. The patient is then asked to flex the elbow as the clinician provides resistance. A positive test is defined as pain experienced during resisted elbow flexion or pain exacerbation during resisted elbow flexion.[1]
O’briens test
Active Compression Test is to indicate potential labral (SLAP Lesion) or acromioclavicular lesions as cause for shoulder pain. With the patient in sitting or standing, the upper extremity to be tested is placed in 90° of shoulder flexion and 10-15° of horizontal adduction
The patient then fully internally rotates the shoulder and pronates the elbow
The examiner provides a distal stabilizing force as the patient is instructed to apply an upward force
The procedure is then repeated in a neutral shoulder and forearm position
A positive test occurs with pain reproduction or clicking in the shoulder with the first position and reduced/absent with the second position
Depth of symptoms must also be assessed as superficial pain can indicate acromioclavicular joint symptoms and deep pain is more often a sign of a labral lesion.
RC shoulder pain presnts
pain and movement impairment during elevation, ER, and abduction
Neer test
possible subacromial impingement syndrome. The examiner should stabilize the patient’s scapula with one hand, while passively flexing the arm while it is internally rotated. If the patient reports pain in this position, then the result of the test is considered to be positive.
Hawkins/Kennedy
This test is commonly used to identify possible subacromial impingement syndrome. The examiner places the patient’s arm shoulder in 90 degrees of shoulder flexion with the elbow flexed to 90 degrees and then internally rotates the arm. The test is considered to be positive if the patient experiences pain with internal rotation.[
stiff shoulder presentations
adhesive capsulitis, osteoarthritis, ostechondromatosis 50 yrs, restriction in AROM and PROM, loss of ER w/ power still, normal x ray
load and shift
The patient should be seated. The therapist stabilizes the scapula to the thorax with one hand, while the other hand is placed across the posterior GH joint line and humeral head, and the web space across the patient’s acromion. The index finger should the over the anterior GH joint line. The clinician should now apply a “load and shift” of the humeral head across the stabilized scapula in an anteromedial direction to assess anterior stability, and in a posterolateral direction to assess posterior instability. Normal motion anteriorly is half of the distance of the humeral head, more movement is considered to be a sign of GH joint laxity. pts w/ history of dislocation but no subluxation
inf sulcus test
glenohumeral joint for inferior instability, due to laxity of the superior glenohumeral ligament and coracohumeral ligament. This test can be performed with the patient sitting, standing, or in a supine position with their shoulder in neutral (0 degrees rotation). The examiner then pulls the distal part of the humerus in a caudal direction[3][4]. However, the sitting position with arms by the side is considered to provide more reliable results as suggested by McFarland et al. [2]The test is considered positive when the appearance of sulcus in the subacromial space is more than 1cm as the humeral head translates in the inferior direction[ if neg could indicate- sup. glenohumeral ligament or caracohumeral ligamentt dysf.
apprehension test
t the integrity of the glenohumeral joint capsule, or to assess glenohumeral instability in an anterior direction. ll flex the patient’s elbow to 90 degrees and abducts the patient’s shoulder to 90 degrees in sagittal plane and 180 degrees in frontal plane (horizontal abduction), maintaining neutral rotation. The examiner then slowly applies an external rotation force to the arm to 90 degrees while carefully monitoring the patient[1]. Patient apprehension from this maneuver, not pain, is considered a positive test. Pain with the maneuver, but not apprehension may indicate a pathology other than instability, such as posterior impingement of the rotator cuff
ant drawer test
atient in supine position.
Step2. Relax the affected shoulder by holding patients arm ( or placing hand on axilla) with therapist one hand.
Step3. Abduct the patient shoulder between the 80 and 120 degree, Forward flexed up to 20 degree, laterally rotated up to 30 degree.
Step4. Stabilize the patient scapula with the therapist opposite hand by pushing the spine of the scapula with index and middle finer. Applying counterpressure on patients coracoid process with the therapist thump.
Step5. Draws the humerus forward (anteriorly) using the hand that is holding patients arm (or placing hand on axilla).
Step6. Positive test indicates the anterior instability decided by the amount of anterior translation which is accessible comparing with the normal side. o reliably diagnose anterior subluxations even in patients who may have a negative apprehension test.
