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:

-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
 -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.