Upper Extremity-Shoulder Special Test

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Author:
ae_228
ID:
285860
Filename:
Upper Extremity-Shoulder Special Test
Updated:
2014-10-14 21:27:19
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upper extremity shoulder special tests
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Description:
Special tests for shoulder injuries
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  1. Sternoclavicular Joint Instability
    • P: sitting or standing
    • E: in front of the athlete, on hand palpating the SC joint, the other grasping the proximal third of the clavicle.
    • Pr: Apply an anterior, inferior and superior force to the SC joint
    • Do not apply a posterior force (life threatening, blocking airway or arteries)
    • +: pain and/or laxity; bi lat
    • I: sprain of SC joint
  2. Acromioclavicular Joint Instability
    • P: sit/stand
    • E: in front of athlete on affected side, one hand palpating the AC joint, the other on the distal third of the clavicle
    • Pr: Apply a pressure in all four directions (ant, post, inf, sup)
    • +: pain and/or laxity; bi lat
    • I: AC sprain
  3. Acromioclavicular Compression Test
    • P: sitting
    • E: lateral to the affected side, one hand on posterior side of AC joint, the other on the anterior side of the AC joint
    • Pr: Apply a compression force by squeezing the hands together
    • +: pain
    • I: grade 1 or 2 AC sprain
    • *Note: Do not perform with a noticeable deformity
  4. Glenohumeral Instability Test (load and shift)
    • P: sitting
    • E: lateral to affected side, one hand stabilizing the shoulder, the other grasping the humeral head
    • Pr: apply an anterior, posterior glide
    • -move hand to humeral shaft to apply and inferior force
    • +: pain, hypermobility or hypomobility; bi lat
    • I: Capsular injury depending on direction
  5. Anterior Drawer Test (shoulder)
    • P: laying supine, arm abducted 45*, horizontally adducted 10* and externally rotated 10*
    • E: standing lateral to the affected side. One hand grasping the humeral head, the other on the shoulder stabilizing the scapula
    • Pr: glide the humeral head anteriorly while applying a slight distraction
    • +: increased laxity and/or pain; bi lat
    • I: insufficiency of the anterior capsule and integrity of the anterior labrum
  6. Posterior Drawer (shoulder)
    • P: laying supine, arm abducted 90*, horizontally adducted 20* elbow flexed to 90*
    • E: standing lateral to the affected side, one hand grasping the humeral head, the other on the shoulder stabilizing the scapula
    • Pr: the humerus is internally rotated and the humeral head is glided posteriorly
    • +: laxity and/or pain; bi lat
    • I: insufficiency of the posterior capsule, possible labrum injury
  7. Sulcus Test
    • P: sitting
    • E: standing lateral to the affected side, one hand on distal humerus, the other hand stabilizing the shoulder
    • Pr: apply an inferior force by pulling down on the humerus
    • +: increased laxity creating a step off or depression (a sulcus) under the acromion; bi lat
    • I: inferior capsule injury
  8. Clunk Test
    • P: laying supine, shoulder abducted to 90, elbow flexed to 90
    • E: standing lateral to the affected side, one hand grasping the mid humerus, the other hand at the distal humerus
    • Pr: apply an axial load to the glenoid fossa and then the humeral head is circumducted in both directions
    • +: feeling a clunking sensation; bi lat
    • I: tear of the labrum
  9. Jerk Test
    • P: laying supine, shoulder abducted to 90, elbow flexed to 90, and the humerus is internally rotated
    • E: lateral to the affected side, one hand on the shoulder stabilizing the scapula, the other on distal humerus
    • Pr: passively horizontally adduct the arm while applying an axial load to the humerus
    • +: a clunk or pain; bi lat
    • I: posteriorinferior instability with or without posteriorinferior labral tear
  10. O'Brien's Test
    • P: sit/stand, shoulder flexed to 90, horizontally adducted 15, and fully pronated
    • E: lateral to the affected side, one hand palpating the shoulder, the other hand on the distal forearm
    • Pr:
    •    *have the patient resist a downward force to the distal forearm
    •    *instruct the athlete to slowly rotate from pronation to supination
    •    *have the athlete resist another downward force
    • +:  
    •    *pain and/or weakness while in pronation
    •    *clicking or popping while rotating from pronation to supination
    •    *have the athlete resist another downward force
    •    *compared bi-lat
    • I: SLAP lesion
  11. Apprehension Test (Crank Test) Relocation Test
    • P: laying supine with the shoulder on the table, shoulder abducted to 90, elbow flexed to 90
    • E: lateral to affected side, one hand on the distal forearm, other hand on the distal humerus
    • Pr: 1. externally rotate the humerus
    • 2. apply and anterior pressure to the glenohumeral joint and then externally rotate
    • +: 1. pain/apprehension; bi lat
    • 2. alleviation of pain
    • I: anterior glenohumeral instability
  12. Posterior Apprehension
    • P: laying supine, shoulder flexed to 90, elbow flexed 90, internally rotated
    • E: lateral to affected side, one hand stabilizing the scapula, other hand on the distal humerus
    • Pr: apply a posterior force through the humerus
    • +: apprehension/pain; bi lat
    • I: posterior glenohumeral instability
  13. Grind Test
    • P: laying supine, shoulder abducted 90, elbow flexed 90
    • E: lateral to the affected side, one hand on the distal forearm, other hand on the distal humerus
    • Pr: internally and externally rotate the humerus while applying an axial load through the humerus
    • +: feeling a grinding sensation with or without pain; bi lat
    • I: SLAP lesion
  14. Neer's Test
    • P: sit/stand, arm in pronation
    • E: behind the athlete, one hand on the distal humerus, other hand on the opposite shoulder
    • Pr: passively move the shoulder into full abduction
    • +: pain; bi lat
    • I: shoulder impingement
  15. Hawkins-Kennedy Test
    • P: sit/stand, shoulder flexed to 90, elbow flexed to 90
    • E: standing in front of the athlete, one hand on the distal forearm, other hand on the distal humerus
    • Pr: internally rotate the humerus
    • +: pain; bi lat
    • I: shoulder impingement
  16. Drop Arm Test
    • P: sit/stand, shoulder fully abducted, arm fully supinated
    • E: observing
    • Pr: instruct athlete to slowly lower the arm while keeping it supinated
    • +: arm will uncontrollably drop, or patient will deviate from the frontal plane; bi lat
    • I: rupture of the supraspinatus tendon
  17. Empty Can Test
    • P: sit/stand, shoulder abdcuted 90, horizontally adducted 45, fully pronated
    • E: standing in front of the athelte, one hand on the distal forearm
    • Pr: apply a downward force while the athlete resists
    • +: pain and/or weakness; bi lat
    • I: supraspinatus weakness or injury
  18. Serratus Anterior Muscle Weakness Test
    • P: leaning against the wall in a push up position
    • E: observing
    • Pr: instruct athlete to perform a full push up finishing with a scapular punch
    • +: scapular winging; bi lat
    • I: serratus anterior muscle weakness
  19. Yergason's Test
    • P: sit/stand. elbow flexed to 90, forearm in neutral
    • E: lateral to the affected side, one hand palpating the biceps tendon, the other hand grasping the distal forearm
    • Pr: 1. instruce the athlete to resist as you apply a downward force and then instruct them to supinate the forearm as you give resistance
    • 2. instruct the athlete to resist as you apply a downward force and then passively externally rotate the humerus
    • +: pain, weakness and tendon subluxation; bi lat
    • I: bicepital tendinitis
  20. Speed's Test
    • P: sit/stand, arm relaxed and supinated
    • E: Lateral to the affected side, one hand palpating the biceps tendon, the other hand on the distal forearm
    • Pr: 1. instruct the athlete to flex the shoulder against resistance to 60*
    • 2. from the 60* of shoulder flexion, instruct the athlete to flex the elbow against resistance
    • +: pain and/or weakness; bi lat
    • I: biceps tendinitis, irritation
  21. Ludington's Test
    • P: sit/stand, both hand on their head
    • E: behind the athlete, one hand palpating each bicep
    • Pr: instruct the athlete to press down on their head, contracting biceps
    • +: no or weak contraction of the bicep
    • I: biceps rupture
  22. Adson's Test
    • P: standing with neck rotated toward the affected side
    • E: behind the athlete with one hand on the shoulder, the other taking a pulse
    • Pr: extend the shoulder
    • +: dramatically weakened or no pulse
    • I: subclavian artery is obsturcted between the 2 heads of the scalene muscles
  23. Allen's Test (shoulder)
    • P: standing with neck rotated away from affected side
    • E: behind the athlete with one hand on the shoulder, the other taking a pulse
    • Pr: extend the shoulder
    • +: dramatically weakened or no pulse
    • I: subclavian artery is obstructed behind pectoralis minor and under the coracoid process
  24. Military Brace Position Test
    • P: standing with shoulders retracted and neck extended
    • E: behind the athlete, one hand on the shoulder, the other taking a pulse
    • Pr: extend the shoulder
    • +: dramatically weakened or no pulse
    • I: subclavian artery obstructed between the 1st rib and clavicle
  25. Roo's Test
    • P: standing, both shoulders and elbows flexed to 90
    • E: observing
    • Pr: instruct the athelte to open and close their fist repeatedly for 3 min
    • +: inability to complete the test or numbness and tingling
    • I: subclavian artery is obstructed between the 1st rib and clavicle
  26. Gerber's Lift-off Test for Subscapularis Weakness
    • P: sit/stand. humerus internally rotated, forearm pronated and the posterior side of the hand resting on the lumbar spine
    • E: observing
    • Pr: instruct the athlete to lift their hand off the lumbar spine
    • +: inability to perform the test; bi lat
    • I: subscapularis weakness

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