Shoulder Special Tests

Shoulder Special Tests

 

Today we will be doing an overview of the special tests of the shoulder, that help the therapist develop a differential diagnosis. 


Biceps Involvement:

Speeds test
-Biceps tendinitis
 + test pain in bicipital groove or tenderness


Yergasons Test
-Laxity in transvers humeral ligament and or biceps tendonitis
 +Popping or snapping in bicipital groove, pain and tenderness


Ludingtons Sign
-Rule out long head of bicep rupture
 +Diminished or no tension under long head of the bicep tendon


RailRoad Wistle test
-Speeds test with pressure on biceps
-Biceps tendonitis or impingement
 + pain decreasing versus speeds test

 

Impingement tests:

Hawkins-Kennedy
-Supraspinatus and bicep tendon impingement
 + pain with resistance


Neers Test
-Shoulder impingement of supraspinatus and or biceps
 + Shoulder pain and apprehension with motion


Empty Can
-Impingement of supraspinatus, or pathology
 + Pain or weakness

 

Cluster Findings for Impingement
3 or greater + tests indicate +subacromial Impingement with a + LR of 2.93
 -Hawkins-Kennedy
 -Neers
 -Painful arc
 -Empty Can
 -ER resistance

 

AC joint

 

Acromioclavicular joint compression


-Tests Acromioclavicaulr and Coracoclavicular ligaments
 +pain with compression

 

Acromioclavicualr Joint stress
-Stresses sternoclavicular ligament and AC joint
 + pain

 

Spring sign
-Instability of AC joint
 + inferior shift of clavicle with pressure, superior shift with pressure relief

 

Cross Impingment Test
-AC join sprain
 + Pain on superior shoulder


SLAP Lesion

O’Briens Test
-Identifies a SLAP lesion
 +Pain present with IR, and diminished ER position

 

Glenoid Labrum and instability testing

Clunk Test
-Identifies a glenoid labrum Tear
 +clunking or grinding sensation with pain provocation

 

Anterior Apprehension Test
-Anterior capsule, compromised glenoid labrum
 +Resistance of movement or apprehension or pain

 

Jobe Relocation Test
-Anterior instability
 +decrease pain or decrease apprehension with anterior apprehension test

 

Anterior Drawer
-Tests for anterior instability
 +Increase anterior translation of the humeral head

 

Sulcus Sign
-Inferior Instability
 +Pain provocation with distraction, or palpable humeral head


Grind Test
-Grinding or clunking
 + Glenoid labrum Tear


Jerk Test
-Possible posterior subluxation or dislocation
 +Posterior apprehension or pain


Anterior INstabulity cluster findingsn:

If 2/3 tests are + the minimum + LR ratio is 18
 -Jobe relocation test
 -Anterior Drawer
 -Apprehension test

 

Thoracic outlet

 

Adsons Maneuver
-Thoracic outlet
 +Absent radial pulse

 

Allens test
-Thoracic outlet
 +Absent radial pulse

 

Roos test
-Thoracic outlet, or Neurovascular compromise
 +Unable to hold position


Rotator cuff Pathology

 

Drop arm Test
-Rotator cuff pathology
+Patient unable to slowly lower arm without pain

 

Lift off test
-Subscapular pathology
 + Unable to left hand off of buttocks or increase pain

 

Resources include Current concepts of Orthopedic physical therapy, Emed, Phyiopedia.
Let me know if you have additional comments or tests you would like to be added.