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Special Tests > Shoulder Tests > Flashcards

Shoulder Tests Flashcards

1
Q

Sulcus Sign

A

Purpose: inferior and multidirectional instability

Positive: sulcus between humeral head and acromion (only significant if pt is symptomatic)

Pt: sitting, arm by side
PT: stabilize shoulder girdle; pull down on arm either near humeral head or by condyles of humerus

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2
Q

Anterior Load & Shift

A

Purpose: anterior instability / capsular laxity

Positive: sharp pain in the shoulder with/without a clicking sound

Pt: sitting
PT: stabilize over acromion; pinch either side of humeral head, approximate humeral head into glenoid fossa, apply anterior force

Notes: Typically humeral head moves ~25% of the diameter of the humeral head. Grade I laxity is indicated by 25-50% and grade II laxity is indicated by greater than 50%.

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3
Q

Anterior Apprehension / Posterior (Jobe) Relocation

A

Purpose: anterior instability

Positive: pt expresses reluctance/apprehension; pain
For Jobe: pain/apprehension decreases with posterior translation

Pt: supine; 90º shoulder abduction, 90º elbow flexion
PT: passively/slowly ER humerus
For Jobe: add posterior translation of humerus

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4
Q

Posterior Load & Shift

A

Purpose: posterior instability

Positive: humerus shifts posteriorly in glenoid (graded)

Pt: sitting
PT: stabilize over acromion; pinch either side of humeral head, approximate humeral head into glenoid fossa, apply posterior force

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5
Q

Compression-Rotation (Snyder)

A

Purpose: SLAP lesion or AC tear

Positive: Pain; clicking; catching

Pt: sitting
PT: axially load the humerus at elbow, circumduct arm (slightly abducted 20º-90º) - small and large circles

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6
Q

Anterior & Posterior Slide

A

Purpose: SLAP lesion

Positive: pain/clicking

Pt: sitting
PT: axially load the humerus at elbow, flex shoulder and push posteriorly/superiorly; or extend shoulder and push anteriorly/superiorly

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7
Q

Speed’s

A

Purpose:

  1. Biceps Brachii
  2. SLAP lesion

Positive:

  1. anterior pain
  2. deep pain

Pt: sitting, flex shoulder to 90º; supinate, then repeat in pronation
PT: stabilize shoulder; give resistance proximal to elbow joint

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8
Q

O’Brien’s

A

Purpose: SLAP lesion

Positive: part 1 is NOT painful and part 2 IS painful

Pt: sitting
Part 1: 90º shoulder flexion, 10-15º horizontal adduction, supination (thumb up)
Part 2: 90º shoulder flexion, 10-15º horizontal addution, pronated (thumb down)
PT: stabilize shoulder; give resistance proximal to elbow joint

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9
Q

Yergason’s

A

Purpose:
1. SLAP lesion
Biceps brachii
Impingement: subacromial bursa, supraspinatus, long head biceps brachii

Positive:

  1. deep pain and clicking
  2. pain in bicipital groove (transverse humeral ligament probably torn and is allowing tendon to move in/out of groove

Pt: sitting; shoulder IR, elbow 90º flexion, pronation
PT: give resistance while pt ER and supinates

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10
Q

Crank

A

Purpose:
SLAP lesion
Bankart lesion

Positive:
pain/catching/painful clicking

Pt: supine; shoulder at 160º in scapular plane, 90º elbow flexion
PT: load humerus axially, IR and ER

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11
Q

Neer

A 
Purpose:
Biceps brachii
Impingement: subacromial bursa, supraspinatus, long head biceps brachii
Bursitis
Partial cuff tear

Postive:
pain in anterior shoulder

Pt: sitting
PT: forcibly flex pt shoulder in scapular plane with IR

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12
Q

Hawkins-Kennedy

A

Purpose:
Impingement: subacromial bursa, supraspinatus, long head biceps brachii
Full thickness cuff tear
Overall impingement

Positive:
pain in anterior shoulder

Pt: sitting, 90º shoulder/elbow flexion; relaxed arm
PT: push down on wrist while supporting elbow

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13
Q

Coracoid Impingement

A

Purpose:
Impingement: subacromial bursa, supraspinatus, long head biceps brachii

Positive:
pain

Pt: sitting
PT: Hawkins-Kennedy test with horizontal adduction (10-20º)

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14
Q

Painful Arc

A

Purpose:
Impingement: subacromial bursa, supraspinatus, long head biceps brachii
Full thickness cuff tear
Overall impingement

Positive:
pain in midrange / no pain at beginning and end of range

Pt: standing; AROM of shoulder in scapular plane

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15
Q

Infraspinatus Strength

A

Purpose:
Impingement: subacromial bursa, supraspinatus, long head biceps brachii
Full thickness cuff tear
Overall impingement

Positive:
pain/instability/weakness

Pt: sitting, 90º elbow flexion with arm by side, 45º IR
PT: apply medial resistance

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16
Q

Drop Arm

A

Purpose:
Full thickness cuff tear
Supraspinatus tear or impingement
RC Tear (supra, infra, long head biceps brachii)

Positive:
pain or arm drops

Pt: sitting
PT: abduct pt shoulder to 90º with palm down; ask pt to hold

17
Q

Empty Can

A

Purpose:
Impingement or tear of supraspinatus
RC tear (supra, infra, long head biceps brachii)

Positive:

tear: extreme weakness
impingement: pain

Pt: sitting, straight arm, 90º shoulder abduction in scapular plane, thumb down
PT: apply resistance at wrist

18
Q

Full Can

A 
Purpose:
RC tear (supra, infra, long head biceps brachii)

Positive:

tear: extreme weakness
impingement: pain

Pt: sitting, straight arm, 90º shoulder abduction in scapular plane, thumb up
PT: apply resistance at wrist

19
Q

ER Lag Sign

20º and 90º

A

(as described in class, sounds more like the drop test)

Purpose: RC Tear
infra/supra: 20º
infra/t minor: 90º

Positive:
unable to keep arm in position

Pt: sitting
PT: abduct at both 20º and 90º; ER end range
(pt supposed to keep arm in ER w/o moving)

20
Q

IR Lag Sign and Lift Off

A 
Purpose: 
RC tear (subscapularis)

Positive:
unable to life hand up

Pt: sitting
Lag sign: HBB, pt lifts hand off back, maintain there
Lift off: pt lifts hand off back
PT: can apply resistance by hand if strong in lift off

21
Q

Belly Press

A

Purpose:
RC Tear (subscapularis)
Tendinopathy
Biceps

Positive:
cannot keep hand on belly

Pt: sitting, hand over belly
PT: hand underneath pt’s hand, apply resistance away from pt’s belly

22
Q

Belly Off

A

Purpose:
RC Tear (subscapularis
tendinopathy
biceps

Positive:
cannot keep hand on belly

Pt: sitting, hand on belly
PT: apply anterior resistance to elbow
(pt needs to maintain position)

23
Q

Horizontal/Cross-Body Adduction

A 
Purpose:
RC Tear (supra, infra, long head biceps, subscap)
AC joint

Positive:
pain

Pt: sitting, reach toward opposite shoulder
PT: apply over pressure to elbow

24
Q

Jerk

A

Purpose:
posterior instability / posterior capsule and labrum

Positive:
clicking posteriorly, then reducing when back at normal

Pt: supine
PT: axially load humerus at 90º flexion while IR; horizontally adduct arm then return to neutral

Special Tests (3 decks)

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