muscle/tendon pathology

Speed’s test (bicipital paratenonitis or tendinosis)

standing

shoulder foward flexed to 90, elbow extended, palm up

push down at the wrist

yergason’s test (biceps tendon subluxation/ligament intactness to hold tendon in bicipital groove)

standing

shoulder IR, elbow flexed to 90, forearm pronated

examiner pulling into ER and supination, patient resists

abrasion sign (general rotator cuff, tendons are frayed)

seated

shoulder abducted to 90

rent test (general rotator cuff, tendon tear)

seated

arm at side, palpate acromion

elbow flexed to 90, shoulder extended

IR and ER the arm

whipple test (general rotator cuff partial tear or superior labrum)

stands

shoulder flexed to 90, elbow extended, thumb up

adduct arm

push down at the wrist

champagne toast position (supraspinatus)

seated

stabilize scapula

shoulder IR, flexed to 30

elbow flexed to 30

push arm down and pack, patient resists

drop arm test (supraspinatus, rotator cuff tear)

seated

elevate shoulder to 90 abduction, elbow extended

patient holds for 10 sec and then lowers down arm

“empty can” test (tear of supraspinatus or neuropathy of suprascapular nerve)

shoulder abducted to 90 (scaption), thumbs down

pushing down at the wrist

Bear hug test (subscapularis)

standing

hand is on opposite shoulder

examiners hand is underneath patients, attempting to pull patients hand off shoulder

stabilize at elbow

belly press/abdominal compression/Napolean test (subscapularis)

standing

hand placed on stomach

examiners places hand underneath patients hand, attempt to lift hand off of stomach

Belly-off sign (subscapularis)

seated

hand placed on stomach

put arm into full IR

ask patient to hold position, then let go

Lift-off sign/Gerber’s test (subscapularis)

standing

hand placed on to lower back

ask patient to try and lift hand off of their back

Medial rotation lag or “spring back” test (subscapularis)

stands

hand placed on to lower back, lift arm/hand off of their back

ask patient to hold position

dropping sign (infraspinatus, full rupture)

standing

arm at side, externally rotated to 45, elbow flexed to 90

push into IR, patient should resist

infraspinatus test (infraspinatus, partial test)

standing

arm at side, ER neutral, elbow flexed at 90

push into IR, patient should resist

lateral rotation lag sign (infraspinatus)

seated

shoulder abducted to 90, elbow flexed to 90

put into ER, ask patient to hold

Hornblower’s sign (Teres Minor)

standing/seated

shoulder abducted to 90 (scaption), elbow flexed to 90

patient ER arm against resistance

second way to do test:

standing

arms at side

patient asked to bring hands to mouth (arm will abduct to reach mouth if +)

Trapezius test position 1 (upper trap)

seated

shoulder abducted to 90, elbow extended

examiner push arm down and head away

Trapezius test position 2 (mid trap)

prone

shoulder abducted to 90, elbow flexed

patient retract scapula and hold against resistance

Trapezius test position 3 (lower trap)

prone

shoulder abducted overhead

pull scapula down and in, patient holds against resistance

Punch out test (serratus anterior)

standing

shoulder foward flxed to 90, elbow extended

patient “punches out” and holds position

examiner apply force to push arm back

pectoralis minor contracture test (pec minor)

supine

arms at side

looking at distance from acromion to table

pectoralis major contracture test (pec major)

supine

hands behind head

arms should be able to lay flat against table

latissimus dorsi tight test (latissimus dorsi)

supine

arms overhead

then knees to chest