MSK UE Source Tests

Empty can

Jobes test - subacromial impingement (supraspinatus)

procedure

• shoulder in 90 deg flexion and slight abduction (scapular plane)

• shoulder is in IR & forearm pronation (thumb DOWN)

• pressure is applied down at the wrist

Positive test = GH joint pain/weakness

painful arc

tests for subacromial impingement & rotator cuff tendinopathy

procedure

• AROM for abduction

positive test = pain between 60-120 degrees

Neer’s test

tests for subacromial impingement (supraspinatus) , rotator cuff tendinopathy

procedure

• Passive test!!!

• shoulder is lifted above head & in IR

• PT stabilizes scapula

positive test = reproduction of pain

hawkins kennedy

tests for subacromial impingement (supraspinatus), rotator cuff tendinopathy

procedure

• passive test!!

• shoulder is in 90 flexion, elbow 90 flexion

• move arm into FULL IR

positive test = reproduction of pain

external rotation lag sign

tests for rotator cuff integrity (supraspinatus or infraspinatus)

procedure

• Passive test!!!

• pt’s arm is in slight flexion/abduction

• shoulder is in full ER

• elbow at 90 flexion

• ask pt to hold the position

positive test = loss of active ER

• 5-10 degrees lag → infraspinatus

• >10 degrees lag → infraspinatus & supraspinatus

lift off test

gerber’s sign → rotator integrity tests (subscapularis)

procedure

• active test

• have pt place back of hand onto their back

• ask pt to then lift hand off their back

positive test = inability to lift hand away

false positive = if pt does not have the ROM to place their arm into testing position

belly abdominal press

rotator integrity test (subscapularis)

procedure

• active test

• have pt place hand onto their abdomen

• full IR → make sure arm is in slight flexion

• have pt press their hand into their abdomen

positive test = elbow moves posteriorly & shoulder extends

yergason’s test

biceps tendon test → tests ability of the transverse humeral ligament to keep biceps tendon in groove

procedure

• active test

• elbow flexed to 90 & forearm in full pronation (palm DOWN)

• PT resists the pt as they try to supinate

positive test = pain or pop in biceps groove

speed’s test

tests for long head bicep pathology

procedure

• arm is at the pt’s side with forearm in full supination (PALM UP)

• PT applies resistance at distal forearm

• pt does active shoulder flexion until ~60 degrees

positive test = pain or pop in biceps groove

anterior apprehension sign

tests for anterior GHJ instability

procedure

• pt is in supine shifted towards edge of table

• place pt in 90 abduction and move into LR

positive test = pt displays apprehension & resisting further motion

relocation test

assesses for anterior instability in pt’s with internal impingement

procedure

• pt is in supine shifted towards edge of table

• place pt in 90 abduction and move into full LR

• IF there is pain → apply a posterior force to the anterior proximal humerus

positive test = if pain is alleviated by the posterior glide

biceps load test

assesses for a SLAP tear

procedure

• pt is in supine shifted towards edge of table

• place pt in 120 abduction and move into LR, elbow 90 flexion, full supination (palm pointing towards head)

• PT applies pressure into anterior wrist & pt pushes into the hand to contract the biceps

positive test = reproduction of pain deep in GHJ

active compression test

O’brien’s test - assesses for labral tear

procedure

• ACTIVE test

• shoulder in 90 flexion, ~10-20 degrees ADDUCTION and full IR (THUMB DOWN)

• elbow in full extension

• PT applies downward force at distal forearm

• IF there is pain → put arm into ER (PALM UP)

positive test = reproduction of pain deep in GHJ that is lessened or eliminated in ER,,, clicking is also a positive sign

pain at the AC joint → AC problem NOT labral tear

horizontal adduction

tests for an AC joint injury

procedure

• PASSIVE TEST

• passively move pt arm into FULL horizontal adduction

positive test = pain directly over the AC joint

alar ligament test

screening to see if the alar ligament is intact

should be performed before cervical mobility testing/treatment is initiated

procedure

• PASSIVE TEST

• pt is seated

• palpate the C2 SP

• passively sidebend the head

positive test = no movement of the SP → STOP testing

should feel the SP move in the OPPOSITE direction of the sidebend

VBI positional testing

tests the integrity of blood flow to the brain,, ensure that end range positioning will not compromise circulation of cervical arteries

DO NOT TEST IF VASCULAR PATHOLOGY IS SUSPECTED

procedure

• PASSIVE TEST

• pt in supine, eyes must stay open

• full cervical rotation to one side, hold for 10 sec

• return to neutral & hold for 15 sec

• test opposite side

positive test = 5 Ds 3 Ns

spurling test

detects cervical radiculopathy

procedure

• PASSIVE TEST

• full cervical extension

• full sidebend

• PT applies downward pressure to the head

positive test = reproduction of pain or tingling in the shoulder radiating distally to the elbow

valsalva test

detect cervical radiculopathy

procedure

• pt is seated

• pt takes deep breath and holds for 3 sec & bears down

positive test = reproduction of pain/symptoms in neck/arm

cervical flexion rotation test

assess ROM at C1/2

procedure

• PASSIVE TEST

• pt in supine with head off edge of table

• full cervical flexion → full rotation to both sides

• stop at onset of pain or resistance

positive test = limitation of more than 10 degrees from the normal ROM of 40-45 degrees

neck distraction test

detect cervical radiculopathy

procedure

• pt inn supine with head off edge of table

• fingertips on occipital condyles & palms on occiput

• PT in split stance position and leans back to apply traction force superiorly

positive test = pt’s symptoms are reduced or eliminated when traction is applied

MNT1

starting position: supine, head in neutral (no pillow) & shoulder at edge of table

ensure pt has practiced full active contralateral cervical flexion before starting

PT starting position: stand at head of table and use body to hold shoulder abduction, place hand on top of shoulder to prevent elevation,, other hand holds pt hand with pistol grip (wrap hand around their fingers and use pointer finger to hold their thumb)

all fingers should be extended, elbow flexed 90, GHJ neutral rotation, forearm/wrist neutral

1. shoulder 90 abduction

2. shoulder LR

3. forearm supination

4. wrist extension & finger extension

5. elbow extension

contralateral flexion → distal symptoms

wrist flexion → proximal symptoms