every shoudler eval notecard

what is a labrum injury?

this is when the ring aorund the glenohumeral joint (scoket) gets torn, frayed, or detatched

→ foosh, or overuse

causes shoulder instability, deep pain, clicking, or locking sensations

what are the tests for a labrum injury?

posterior apprehension test

clunk test

o´briens test

what is posterior apprehension test?

labrum injury

have patient laying down face up

bring their arm bent at 90 degrees so up blocking across shoulders

then push down onto elbow looking for patient apprehension

positive if: patient apprehension

what is clunk test?

labrum injury

have patent laying face up

have hand up so pointing to ceiling

make fist and put it underneath the glenohumeral joint- put the finger part of fist onto the scapula part of shoulder

when you put their arm up as if asking question lift fist up (thumb up) this creates anterior glide at the glenohumeral joint

positive if: grinding clunking or patient apprehension

what is o´briens test?

labrum injury

have patent sitting or standing

bring their arm up pointing in front of them

then bring to midline 10 degrees

then thumb down

push down on wrists

then palm up as much as possible and push down again

positive if: the symptoms increased with thumb down and then decreased when palm up

what is glenohumeral instability (shoudler subluxation/dislocation history)

when the head of the humerus cant stay properly centered in the glenoid (socket)

this could be from a shoulder subluxation/dislocation history

subluxation- humeral head partially comes out of socket

dislocation- humeral head completely comes out of socket

what are the tests for glenohumeral instability (shoudler subluxation/dislocation history)

apprehension (crank) test

apprehension with relocation test

sulcus test

jerk test (*also for labrum)

what is apprehension (crank) test?

CONFUSED ASK

have patent laying on back

have the elbow bent at 90 degrees so fist is pointing torward celling then bring fist back so inline with head

hold bicep and push with hand on forearm

look for signs of apprehensition

positive if: fear of dislocation

what is apprehension with relocation test?

CONFUSED ASK

have patent laying on back

have the elbow bent at 90 degrees so fist is pointing toward ceiling

rest bicep on top of leg

palpate the top of shoulder with one hand and then bring fist back so inline with head

push with hand on forearm

if feel apprehension- then bring arm up so in between head and facing up to ceiling

push down with the palpating hand onto the shoulder then push arm to head again

once at head gently remove the hand on shoulder

positive if: fear of dislocation and apprehension in all parts

what is sulcus test?

glenohumeral instability (shoulder subluxation/dislocation history)

have patent sitting

grab shoulder with fingers on collarbone (to stabilize)

pull down on arm above elbow

positive if: sulcus in elbow (you can see shoulder dislocate)

what is jerk test (*also for labrum)?

ASK WDYM ALSO FOR LABRUM?

glenohumeral instability

have patent sitting

grab shoulder with fingers on collarbone (to stablize)

bring their arm bent with hand facing ground (robot)

push arm into socet from elbow

keep the compresstion and bring elbow infront of them

positive if: click or clunk or repoduction of symptopms

what is a tear of the subscapularis injury (rotator cuff)?

what are tests for subscapularis injury (rotator cuff)?

lift off test (gerbers)

what is lift off (gerbers) test?

subscapularis injury

have patent sitting or standing

have them put their back of their hand on small of back

tell them to lift hand off back

positive if: they cant lift hand off back

blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah

blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah blah

what is a tear of the supraspinatus (rotator cuff)?

this is a tear of the suprasinatus tendon- one of the four rotator cuff tendons

what are tests for tears of the rotator cuff (supraspinatus)

drop arm test

full cam/ empty can (jobe) test

what is the drop arm test?

tear of supraspinatus (rotator cuff)

have patent sitting

bring their arm up so looks like trying to fly- palm to ground

ask them to hold position and let go of arm

if they can hold up arm have them slowly lower it with control

positive if: cannot hold arm out to side or cant slowly lower arm to ground

what is the full can/empty can (jobe) test?

tear of the supraspinatus (rotator cuff)

have patent standing- stand behind them

full can: bring both arms up to sides (flying) wiht thumbs facing celling push down on wrists

empty can: flip arms so thumbs facing ground then push on wrists again

positive if: decreasre in stregth or increase in pain in thumbs down position compared to the thumbs up position (more pain in thumbs down)

what is biceps tendon subluxation

when the long head of the biceps tendon partially slips out of the bicipital groove in the front of the shoulder from repetive over head use (throwing or lifting)

what are the tests for biceps tendon subluxation?

yergasons test/ internal rotation

ludingtons test

speeds test

what is yergasons test/ internal rotation?

biceps tendon subluxation

have patient sitting or standing

flex elbow to 90 degrees and pronate arm

tell patient to try to bring palm up to celling

palpate the biceps tendon/ bicipital groove

positive if: reproduction of symptoms inside the bicipital groove

what is ludingtons test?

biceps tendon subluxation

have patent sitting or standing - stand behind them

have them put both hands on head interlocking fingers to support weight of arms

place two fingers on the front of the long heads of the biceps tendon

ask them to contract and relax both biceps at the same time

positive if: contraction is not felt on the injured side

what is speeds test?

have patent standing

bring arm in front of them with palm facing ceiling

have them bring arm up while resisting

positive if: pain

dont bend arm

what is impingement syndrome?

this is when the tendons of the rotator cuff (supraspinatus, infraspinatus, subscapularis, and teres minor) or the subacromial bursa get pinched and compressed between the head of the humerus and the acromion during arm movement

if they are already irritated and swollen it can get even worse

especially supraspinatus tendon

what are the tests for impingement syndrome?

hawkins-kennedy test

neer test

yocums (forced flexion)

what is hawkins-kennedy test?

impingement syndrome

have patient seated

stand behind them

bring their arm pointing in front of them then bend at elbow so blocking chin

stabilize top of shoulder

bring wrist down to ground

compare to other side

positive if: limited ROM and pain in shoulder

what is neer test?

impingement syndrome

have patient seated- stand behind them

one hand depress scaplula

have arm pointing forward and point thumb to ground

then lift arm up as if asking question

causes forced flextion in glenohumeral joint

positive if: pain reproduction on hurt side

what is yocums (forced flexion) test?

impingement syndrome

have patient seated

have them place their hand onto opposite shoulder

then have them bring their bring the elbow to nose

positive if: pain in subaromial arch

what is an AC joint injury?

when the acromiclavivialar joint is injured where the clavical meets the scaplua. Most commonly caused by a direct fall into shoulder or a blow in contact sports

what are the tests for an AC joint injury?

piano key sign

AC shear test

Cross body adduction (scarf) test

AC traction test

what is piano key sign test?

AC joint injury

patient seated or standing

stand in front of patient

do if there is a step off noted during observation

apply pressure to the deformed part of clavicle

positive if: bobbing of the clavical

what is AC shear test?

AC joint injury

have patient seated

fold hands together and pinch palms of hands around the AC joint

positive is: reproduction of symptoms

what is Cross body adduction (scarf) test?

AC joint injury

patient sitting

bring arm into horizontal adduction- across neck

positive if: pain on top of AC joint

what is AC traction test?

AC joint injury

patient seated

close hand palpates the AC joint

other hand pull down on arm grabbing right above elbow

positive if: downward movement of scapula and humerus this causes a step deformity at the AC joint