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Dislocation

Apprehension test for anterior shoulder dislocation, Apprehension test for posterior shoulder disolocation

Bicep Tendon Pathology

Ludington's test, Speed's test, Yergason's test

Rotator Cuff Pathology/Impingement

Drop arm test, Hawkins-Kennedy impingement test, Neer impingement test, Suptraspinatus test

Throacic Outlet Syndrome

Adson maneuvar, Allen test, Costoclavicular syndrome test, Roos test, Wright test (hyperabduction test)

Miscellaneous

Glenoid labrum tear test

Shoulder Special Test Outline

Page 47

Apprehension test for anterior shoulder dislocation

The patient is positioned in supine with the arm in 90 degrees of abduction. The therapist laterally rotates the patient's shoulder. A positive test is indicated by a look of apprehension or a facial grimace prior to reaching an end point.

Apprehension test for posterior shoulder dislocation

The patient is positioned in supine with the arm in 90 degrees of flexion and medial rotation. The therapist applies a posterior force through the long axis of the humerus. A positive test is indicated by a look of apprehension or a facial grimace prior to reaching an end point.

Ludington's test

The patient is positioned in sitting and is asked to clasp both hands behind the head with the fingers interlocked. The patient is then asked to alternately contracted and relax the biceps muscles. A positive test is indicated by absence of movement in the biceps tendon and may be indicative of a rupture of the long head of the biceps.

Speed's test

The patient is positioned in sitting or standing with the elbow extended and the forearm supnated. The therapist places one hand over the bicipital groove and the other hand on the volar surface of the forearm. The therapist resists active shoulder flexion. A positive test is indicated by pain or tenderness in the bicipital groove region and may be indicative of bicipital tendonitis.

Yergason's test

The patient is positioned in sitting with 90 degrees of elbow flexion and the forearm pronated. The humerus is stabilized against the patient's thorax. The therapist places one hand on the patient's forearm and the other hand over the bicipital groove. The patient is directed to actively supinate and laterally rotate against resistance. A psitive test is indicated by pain or tenderness in the biciptal grove and may be indicative of bicipital tendonitis.

Drop arm test

The patient is positioned in sitting or standing with the arm in 90 degrees of abduction. THe patient is asked to slowly lower the arm to their side. A positive test is indicated by the patient failing to slowly lower the arm to their side or by the presence of severe pain and may be indicative of a tear in the rotator cufff.

Hawkins-Kennedy impingement test

The patient is positioned in sitting or standing. The therapist flexes the patient's shoulder to 90 degrees and then medially rotates the arm. A positive test is indicated by pain and may be indicative of shoulder impingement involving the supraspinatus tendon.

Neer impingement test

The patient is positioned in sitting or standing. The therapist positions one hand on the posterior aspect of the patient's scapula and the other hand stabilizing the elbow. The therapist elevates the patient's arm through flexion. A positive test is indicated by a facial grimace or pain and may be indicative of shoulder impingement involving the supraspinatus tendon

Supraspinatus test

The patient is positioned with the arm in 90 degrees of abduction followed by 30 degrees of horizontal adduction with the thumb pointing downward. The therapist resists the patient's attempt to abduct the arm. A positive test is indicated by weakness or pain and may be indicative of a tear of the supraspinatus tendon, impingement or suprascapular nerve involvement.

Adson maneuver

The patient is positioned in sitting or standing. The therpist monitors the radial pulse and asks the patient to rotate his/her head to face the test shoulder. The patient is then asked to extend his/her head while the therapist laterally rotates and extends the patient's shoulder. A positive test is indicated by an absent or diminished radial pulse and may be indicative of thoracic outlet syndrome.

Allen Test

The patient is positioned in sitting or standing with the test arm in 90 degrees of abduction, lateral rotation, and elbow flexion. The patient is asked to rotate the head away from the test shoulder while the therapist monitors the radial pulse. A positive tes is indicated by an absent or diminished pulse when the head is rotated away from the test shoulder. A positive test may be indicative of throacic outlet syndrome.

Costoclavicular syndrome test

The patient is positioned in sitting. The therapist monitors the patient's radial pulse and assist the patient to assume a military posture. A positive test is indicated by an absent or diminished radial pulse and may be indicative of thoracic outlet syndrome caused by compression of the subclavian artery between the first rib and the clavicle.

Wright test (hyperabduction test)

The patient is positioned in sitting or supine. The therapist moves the patient's arm overhead in the frontal plane while monitoring the patient's radial pulse. A positive test is indicated by an absent or diminished radial pulse and may be indicative of compression in the costoclavicular space.

Glenoid labrum tear test

The patient is positioned in supine. The therapist places one hand on the posterior aspect of the patient's humeral head while the other hand stabilies the humerus proximal to the elbow. The therapist passively abducts and laterally rotates the arm over the patient's head and then proceeds to apply an anterior directed force to the humerus. A positive test is indicated by a clunk or grinding sound and may be indicative of a glenoid labrum tear.

Shoulder Special Tests

Pages 47, 49 - 50

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