NPTE all Special Tests

Yergason's Test

Tests Integrity of transverse ligament; may also identify Bicipital tendonosis

-pt sitting with shoulder in neutral stabilized by trunk and elbow at 90 forearm pronated

-PT resist supination and ER of shoulder

-tendon of biceps long head will "pop-out" of groove. May also reproduce pain in long head of biceps tendon

Speed's Test

Identifies Bicipital tendonosis/tendonopathy

-pt sitting or standing with upper limb in full extension and forearm supinated

-PT resist shoulder flexion

-reproduces symptoms (pain) in long head of biceps tendon

Neer's impingement test

Impingement of soft tissue structures of shoulder complex (long head of biceps and the supraspinatus tendon)

-pt sitting and shoulder is passively IR then fully abducted

-reproduces symptoms of pain within shoulder region

Empty can test

(Supraspinatus test)

Impingement of the supraspinatus tendon or possible suprascapular nerve neuropathy

-pt is sitting with shoulder at 90 and no rotation and resist shoulder abduction; then place shoulder in empty can position, IR and 30 horizontal adduction

-compare positions

-reproduces pain in supraspinatus tendon and/or weakness while in empty can position

Drop arm test

Tear or rupture of rotator cuff muscles

-pt sitting with shoulder passively abducted to 120; instructed to slowly bring arm to side

-PT guards arm from falling

-positive test is pt unable to lower arm to side

Posterior internal impingement test

Impingement of rotator cuff muscles between the greater tuberosity

-pt supine

-PT moves arm at 90 degrees abduction, maximal external rotation and 15-20 horizontal adduction

-reproduction of pain in posterior shoulder during test

Clunk test

Glenoid labrum tear

-pt supine with arm in full abduction

-PT push humeral head anterior while rotating humerus externally

-audible clunk is heard during test

Anterior apprehension test

History of anterior shoulder dislocation

-pt supine with shoulder in 90 abduction

-PT slowly takes shoulder to ER

-pt does not allow or does not like shoulder movement in that direction

Posterior apprehension sign

History of posterior shoulder dislocation

-pt supine with shoulder abducted to 90 with scapula stabilized by table

-PT places posterior force through shoulder on patients elbow while moving shoulder into IR and horizontal adduction

-pt does not allow or does not like shoulder movement in that direction

Acromioclavicular shear test

Dysfunction of the AC joint (arthritis, separation)

-pt sitting with arms rested at sides

-PT clasps hands and outs one heel of hand on spine of the scapula and one heel of hand on clavicle; squeeze hands together causing compression

-positive test is reproduction of pain at AC joint

Adson's test

Thoracic outlet syndrome

-pt sitting

-PT find radial pulse rotate head toward extremity, then extend and ER shoulder while head extended

-neuro/vascular symptoms reproduced in UE

Costoclavicular syndrome

Thoracic outlet syndrome

-pt sitting

-PT finds radial pulse and moves shoulder down and back

-neuro/vascular symptoms reproduced in UE

Wright test

Thoracic outlet syndrome

-pt sitting

-PT finds radial pulse and move shoulder into max abduction and ER; instruct patient to rotate head award from extremity being tested

-neuro/vascular symptoms reproduced in UE

Roos test

Thoracic outlet syndrome

-pt sitting with arms fully ER and 90 abducted, slight horizontal abduction and elbows flexed to 90

-PT instructs patient to open and close hands for 3 mins slowly

-neuro/vascular symptoms reproduced in UE

Upper limb tension test

Peripheral nerve compression

ULTT1 - median and interosseous nerve bias

-shoulder depressed and abducted 110

-elbow extension

-forearm supination

-wrist extension

-fingers and thumb extended

-cspine contra lateral side flexion

ULTT2- median, axillary, and musculocutaneous nerve bias (pic)

-shoulder depression and abduction 10

- elbow extension

-forearm supination

-wrist extended

-finger and thumb extended

-shoulder lateral rotation

-cspine contra lateral side flexion

ULTT3 - radial nerve

-shoulder depression and abduction 10

- elbow extension

-forearm pronated

-wrist flexion and UD

-fingers and thumb flexion

-shoulder medial rotated

-cspine contra lateral side flexion

ULTT4 - ulnar nerve

-shoulder depression and abduction 10-90 with hand to ear (waiter's position)

-elbow flexion

-forearm supination

-wrist extended with RD

-finger and thumb extended

-shoulder lateral rotation

-cspine contra lateral side flexion

Hawkins-Kennedy (impingement) Test

Identifies subacromial impingement

-PT places pt's shoulder into 90 shoulder flexion and 90 elbow flexion; passively IR shoulder

-positive test is pain with IR

Lateral epicondylitis test

Tennis elbow/ lateral epicondylosis

Medial epicondylitis test

Golfers elbow/medial epicondylosis

Tinel's sign

Ulnar nerve dysfunction (elbow) median nerve dysfunction (wrist) common fibular nerve (knee) posterior tibial nerve (ankle)

Pronator Teres syndrome test

Median nerve entrapment

sitting, elbow in 90 degrees flexion, resist forearm pronation and elbow extension

Finkelstein's test

De Quervain's tenosynovitis

Froment's sign

Ulnar nerve dysfunction

Phalen's test

Median nerve compression in carpal tunnel

Allen's test

Vascular compromise of the hand

Patrick's (FABER) test

Hip dysfunction

Grinding/scouring test

Degenerative joint disease of the hip

Trendelenburg sign

Week gluteus medius

Thomas test

Tight hip flexors

Ober's test

Tightness of Tensor fascia latae of or IT band

Ely's test

Tightness of rectus femoris

90-90 hamstring test

Hamstring tightness

Piriformis test

Piriformis syndrome

Leg length test

True leg length discrepancy

Craig's test

Abnormal femoral anti-torsion angle

Lochman test

Anterior cruciate ligament integrity

supine; knee flexed 20-30 degrees; stabilize femur and try to glide tibia anteriorly

Pivot shift

Anterior cruciate ligament integrity

Posterior sag test

Posterior cruciate ligament integrity

Posterior drawer test

Posterior cruciate ligament integrity

Reverse Lochman

Posterior cruciate ligament integrity

prone; knees flexed 30 degrees; stabilize femur and glide tibia posteriorly

McMurray's test

Meniscal tears

Apley test

Differentiate between meniscal and ligamentous insult

Hughston's test

Dysfunction of the plica

Patellar apprehension test

History of patella dislocation

Clarke's sign

Patellofemoral dysfunction

Ballotable patella/ patellar tap test

Infrapatellar effusion

Fluctuation test

Knee joint effusion

Q angle measurement

Knee dysfunction

Noble compression test

IT band friction syndrome

Anterior drawer test of the ankle

Integrity of anterior talofibular ligament

Talar tilt test

Calcaneofibular or deltoid ligament instability

Thompson's test

Integrity of Achilles tendon

Morton's test

Stress fracture or Neuroma in forefoot

Vertebral Artery test

Vertebrobasilar vascular system

Hautant's test

Vascular versus vestibular causes of dizziness or vertigo

Sitting; shoulders 90 degrees flexion; palms up; close eyes for 30 seconds and see if arms drift

Transverse ligament stress test

Integrity of transverse ligament

Anterior shear test

Integrity of upper cervical spine ligaments and capsule

Foraminal compression/Spurling's test

Cervical nerve root dysfunction

Maximum cervical compression test

Compression of a neural structures at intravertebral foramen and/or facet dysfunction

Distraction test

Compression of a neural structures at intravertebral foramen and/or facet dysfunction

Shoulder abduction test

Compression of neural structures with in intravertebral foramen

Lhermitte's sign

Dysfunction of spinal cord and/or an upper motor neuron lesion

Romberg test

Upper motor neuron lesion

Rib springing

Rib of mobility

Thoracic springing

Intervertebral joints mobility

Slump test

Dysfunction of neurological structures supplying the lower limb

Lasegue's test / straight leg raise

Dysfunction of neurological structures that supply lower limb

Femoral nerve traction test

Compression of femoral nerve

Valsalva maneuver

Space occupying lesion

Babinski test

Upper motor neuron lesion

Quadrant test

Compression of a neural structures at intervertebral foramen and/or facet dysfunction

Stork standing test

Spondylolisthesis

McKenzie's slide glide test

Differentiates between scoliotic curve versus neurological dysfunction

Standing; PT standing on trunk shift side; place shoulder against pt's trunk; wrap hands around pt's pelvis; pull pelvis to create proper alignment

Bicycle van Gelderen's test

Differentiates between intermittent claudication and spinal stenosis

Bike in trunk extension and trunk flexion; pain with extension and not flexion = stenosis not intermittent claudication

Gillet's test

Posterior movement of the ileum relative to the sacrum

Ipsilateral anterior rotation test

Anterior movement of ilium relative to sacrum

Opposite of picture; leg should be extending

Gaenslen's test

SI joint dysfunction

Long sitting test

SI joint dysfunction

Goldthwait's test

Differentiate between dysfunction in lumbar spine versus SI joint

TMJ compression

Pain with compression of the retrodiscal tissue