Upper Extremity Special Tests

Question 1

O’Brien Test- what does it test

Answer 1

AC joint pathology and detect superior glenoid labral tears

Question 2

O’Brien Test- Process

Answer 2

Athlete: flexes shoulder 90deg, with elbow straight and shoulder in 10-15 deg cross flexion; internally rotate shoulder fully- thumb points down
Tester: place hand on distal forearm (near ulnar head), other hand in C shape cupping shoulder; attempt to press town while athlete meats resistance
Instruct athlete to rotate shoulder- thumb up and repeat test
Look out for: shrugging of other shoulder or leaning to opposite side.

Question 3

O’Brien Test-postive result

Answer 3

AC joint: pain at AC joint with internal rotation, improves with external rotation.
Glenoid labral tear if pain is deep in joint wit click or clunk

Question 4

Apprehension and Relocation Test- what does it test

Answer 4

anterior glenohumeral instability

Question 5

Apprehension and Relocation Test-process

Answer 5

lie on tale, elbow flexed.
tester beside table facing athlete. Place medial hand across humeral head and lateral hand grasps the forearm or flexed elbow
tester: abduct should to 90 deg, then laterally rotate shoulder to end range STOP if athlete becomes apprehensive or if pain is reproduced. then press humeral head posteriorly

Question 6

Apprehension and Relocation Test-positive test

Answer 6

pain or apprehension is alleviated with relocation

Question 7

Hawkins Kennedy test- What does it test

Answer 7

for subacromial impingement

Question 8

Hawkins Kennedy test- process

Answer 8

seated athlete, raises arm to 90 deg in scapular plane (30-40 deg anterior to frontal plane) with elbow flexed 90 deg.
tester: internally rotates shoulder to end range with one hand placed under the elbow to act as pivot point, other hand grasps distal forearm pulling it downwards to rotate the shoulder.
only internally rotate to point of pain or where scapular starts to rise.

Question 9

Hawkins Kennedy test-positive test

Answer 9

If test reproduces pain; beneath the acromion anterior and or laterally with possible referral to deltoid.

Question 10

Empty can and Full can test-what does it test

Answer 10

Supraspinatus pathology

Question 11

Empty can full can test- process

Answer 11

upright in chair, abduct shoulder 90 degrees in scapular plane. Internally rotate shoulder (thumb down), tester standing in front applies downward pressure against the distal end of the forearm- athlete resists.
Repeat process in full can position (thumb up-shoulder externally rotated)
avoid shrugging or leading to opposite side

Question 12

Full can empty can test- positive test

Answer 12

pain or weakness presnt with test, local to the supraspinatus insertion at the greater tuberosity

Question 13

Speed’s test- what does it test

Answer 13

biceps tendon pathology at the shoulder and labral tears

Question 14

Speed’s test- process

Answer 14

seated in cahir- shoulder flexed 90 degrees, elbow fully extended. Shoulder externally rotated and forearm supinated.
Tester places one cupped hand across the top of shoulder girdle, other hand placed against distal end of athlete’s forearm. Push downwards for isometric contraction.*watch for leaning back or shoulder shrugging
Reat contraction with muscle in lengenthed position (adds more tensile load)- model seated with shoulder in 45 degrees of GH extension. Repeat test

Question 15

Speed’s test- positive test

Answer 15

Bicep: pain at insertion (on humerus)
labral tear: pain deeper

Question 16

Valgus test for the elbow-What does it test

Answer 16

MCL of elbow

Question 17

Valgus test for the elbow- process

Answer 17

athlete seated at the edge of the table, tester stands facing the athlete, lateral to their arm.
Tester places on hand (top hand) on lateral aspect of distal humerus (without grasping), just above teh elbow. Second hand (botom) placed against distal end of forearm on ulnar side.
Tester supports athletes elbow in slightly flexed postion
-tester stabilize humerus while abducting distal end of forearm, creating valgus stress at elbow

Question 18

Valgus test for the elbow- positive test

Answer 18

pain and or laxity is positive for damage of the MCL complex

Question 19

McMurray’s Test fort he Wrist-what does it test

Answer 19

Evaluate integrity of the TFCC

Question 20

Mcmurray of wrist process

Answer 20

elbow flexed, forearm in mid-prone (thumbs up)
tester- one hand stabilizes forearm, while other hand holds the athlete’s hand with an overhand grasp (covering palm)
-Tester places wrist into ulnar deviation (passive) while wrist is neutral (no flexion or extension).
Tester then compresses wrist- pressing carpals towards forearm while circumducting the wrist

Question 21

Valgus Test of the Thumb- what does it test

Answer 21

integrity of the ulnar collateral ligament (UCL) of the thumb

Question 22

Mcmurray of wrist- postive test

Answer 22

clicking or clunking suggests TFCC tear

Question 23

Valgus Test of the Thumb- process

Answer 23

Rest forearm in mid-prone position on table.
tester: one had apply pressure against lateral aspect of the shaft of the first metacarpal to stabilize
second hand grasps thumb, drawing it backwards into extension, next attempt to abduct at the MCP joint, producing a valgus stress while the thumb is extended

Question 24

Valgus Test of the Thumb- positive test

Answer 24

pain

Question 25

Lateral epicondyle: Passive test-what does it test

Answer 25

lateral epicondylitis

Question 26

Lateral epicondyle: Passive test- process

Answer 26

seated, elbow flexed, forearm pronated, fist closed
palpate lateral epicondyle with one hard stabilizing the flexed elbow. Place other hand across the back of the athlete’s closed fist, near the head of the second and third metacarpal. Passively extend the elbow and flex the wrist simultaneously

Question 27

Lateral epicondyle: Passive test- positive test

Answer 27

sharp pain at lateral epicondyle

Question 28

Lateral epicondyle: Active test-what does it test

Answer 28

lateral epicondylitis

Question 29

Lateral epicondyle: Active test- process

Answer 29

seated, elbow extended, forearm pronated, fist closed
support arm as hold it out in front of body
apply pressure to theback of the second and thrid metacarpal heads, near the knuckles to resist wrist extension.
firts perform in an extended psotion, if negative, repeat in flext wrist postion to increase challenge hold for 5 seconds!

Question 30

Lateral epicondyle: Active test- positive test

Answer 30

pain when resisting base of 3rd: Extensor carpi radialis brevis
pain when resisting base of 2nd: ***