SHOULDER SPECIAL TEST - PDF Filename UTF-8''SHOULDER SPECIAL TEST

University of the East Ramon Magsaysay Memorial Medical Center Inc.
3B
SPECIAL TESTS SHOULDER | Bobby Lee, PTRP & Symon Jervis Chan, PTRP | June
17, 2017
Test: Load and Shift Test

Test: Relocation Test
Test for what: Anterior/Posterior Instability
Test for what: Anterior Instability
Indication: Laxity of glenohumeral joint
Indication: Glenohumeral instability, dislocation, and
How to know if positive: Excessive movement of joint
subluxation.
Procedure: Examiner stabilizes the shoulder with one
How to know if positive: When test is applied, pain
hand over the clavicle and scapula. With the other
commonly decreases
hand, the examiner grasps the head of the humerus.
Procedure: Abduct the arm to 90 and laterally rotate
Thumb over the posterior humeral head, and fingers on
the patients shoulder slowly(same as the crank test
the anterior humeral head. That is the load. The
procedure), then apply a posterior translation stress to
examiner then pushes the humeral head anteriorly or
the head of the humerus.
posteriorly. That is the shift
Test: Crank Test

Test for what: Anterior Instability Test: Anterior Release test (Surprise Test)
Indication: Shoulder Dislocation Test for what: Anterior Instability
How to know if positive: Facial Apprehension from the Indication: Anterior shoulder instability, labral
Patient or if the patients tells you that they feel their lesion(bankart or SLAP), or bicipital peritenonitis or
shoulder is going to pop out, then it is considered tendinosus.
positive. How to know if positive: Pain and forward translaton of
Procedure: Abduct the arm to 90 and laterally rotate the humeral head are noted in positive tests.
the patients shoulder slowly. Procedure: Abduct the arm to 90 and laterally rotate
the patients shoulder slowly(same as the crank test
procedure), then apply a posterior translation stress to
the head of the humerus(same as the relocation test),
immediately release the arm in the newly acquired
range.
Page 1 of 13 Physical Therapy 3: Tests and Measurements

Transcribed by: Lagman, Mary Grace O. | Mabaquiao, Reinier M. | Madamba, Paco M. | Magallanes, Brad
David M. | Mantaring, Linno Andre A. | Marcos, Aaron G.

University of the East Ramon Magsaysay Memorial Medical Center Inc. 3B
17, 2017
Test: Dugas Test

Test for what: Anterior Instability
Indication: Unreduced anterior shoulder dislocation.
How to know if positive: A patient with anterior Test: Posterior Stress test
dislocation cannot execute the procedure; Facial Test for what: Posterior Shoulder Instability
apprehension or if the patient tells you there is pain at How to know if positive: Apprehension or patient
the acromioclavicular joint. resisting the movement or reproduction of patients
symptoms.
Procedure: Patient is asked to place the hand on the Procedure: Supine or sitting position. Elevate shoulder
opposite shoulder and then attempt to lower the elbow in the plane of scapula to 90 while stabilizing the
to the chest. scapula. Apply posterior force on elbow. While applying
force, horizontal adduction and medial rotation is done
slowly.
Test: Jerk Test

Test for what: Posterior Instability
Indication: Suspected posterior instability/torn
posterior or posteroinferior labrum.
How to know if positive: Production of the clunk or Test: Feagin test
sudden jerk as the humeral head slides off the back of Test for what: Inferior/Multidirectional Instability
the glenoid. When the arm is returned to the original How to know if positive: Apprehension = presence of
anteroinferior instability
90 abduction position, a second jerk may be felt as the Procedure: Standing or Sitting, 90 abduction of
head reduces. shoulder and elbow extended. In standing, patients arm
Procedure: Patient sits with the arm medially rotated resting on examiners shoulder and examiners hands
and forward flexed to 90. The examiner grasps the are clasped together over patients humerus then push
patients elbow and axially loads the humerus in a downward and forward. In sitting, which gives examiner
proximal direction. Then, the examiner moves the arm greater control, one hand on elbow and hold patients
arm using your body and upper arm (na nakahawak din
horizontally across the body. sa elbow) while other hand lateral to the acromion over
the humeral head then push downward and forward.
SHOULDER MUSCLES SHOULD BE RELAXED


17, 2017 Test: Hawkin Kennedy test

Test for what: Anterior Impingement
How to know if positive: Pain
Procedure: Patient stands then 90 flexion of shoulder
then forcibly medially rotate the shoulder.
Test: Sulcus test

Test for what: Inferior/Multidirectional Instability
How to know if positive: Sulcus sign present
Procedure: Standing with arms at the side and muscles
relaxed then grasp forearm below the elbow and pulls
distally.
Test: Neer Impingement test

How to know if positive: Face of patient showing pain
Procedure: Patients arm is passively and forcibly fully
elevated in the scapular plane with the arm medially
rotated by examiner.
Test: Coracoid Impingement test

Procedure: Patient stands then 90 flexion of shoulder
and 10 to 20 horizontal adduction then forcibly
medially rotate the shoulder.
Test: Supine Impingement test

How to know if positive: Increase in pain
Procedure: Patient in supine position and examiner ath
the side of the shoulder to be tested. Hold patients wrist
and humerus (near elbow) and elevate arm to end range
(170-180). Then laterally rotate the arm and adduct in
into further elevation with supinated arm against
patients ear. Then medially rotate the arm.


17, 2017
Test: Posterior Internal Impingement Test

Test for what: Posterior Impingement
How to know if positive: If the test elicits localized pain
Test: Yocum test
in the posterior shoulder.
Procedure: First, the patient is placed in a supine lying
position then the examiner passively abducts the
Procedure: First, place the patients hand on his/her
shoulder to 90 to 110, with 15 to 20 extension and
opposite shoulder then the examiner lifts the patients
maximum lateral rotation.
elbow.
Test: Zaslav test

How to know if positive: INTERNAL IMPINGEMENT -
If the patient has good strength in lateral rotation but not
in medial rotation. CLASSIC EXTERNAL ANTERIOR
IMPINGEMENT If the patient exhibits more weakness
in lateral rotation
Procedure: *A follow-up test to Neer test* First, the
Test: Active Compression of OBrien
patient stands with the arm abducted to 90 and laterally
Test for what: Labral Tear
rotated 80 to 85. Then the examiner applies isometric
How to know if positive: If pain in the joint line or
resistance into lateral rotation followed by isometric
painful clicking is produced inside the shoulder *not in
resistance into medial rotation.
the AC joint* in the first part and reduced in the second
part.
Procedure: First, the patient stands with the arm
forward flexed to 90 and the elbow fully extended, then
the arm is horizontally adducted 10 to 15 and medially


rotated so 17,the2017
thumb faces downward., then the
examiner stands behind the patient and applies a
downward eccentric force to the arm, then the arm is
returned to the starting position and palm is supinated so
the shoulder is laterally rotated, and the downward
eccentric force is repeated.
Test: Anterior Slide Test

How to know if positive: If pain is produced deep in the
shoulder.
Procedure: First, the patient sits with his/her hand on
Test: Kim Test I
the waist, thumbs posterior, then the examiner stands
behind the patient and stabilizes the scapula and clavicle
How to know if positive: A sudden onset of posterior
with one hand, while the other hand applies an
anterosuperior force at the elbow. shoulder pain and click.
Procedure: First, the patient sits with the back
supported then the arm is abducted to 90 with the
elbow supported in 90 flexion then the examiners hand,
while supporting the elbow and forearm, it applies an
axial compression force (patulak towards the midline) to
the glenoid through the humerus. While maintaining the
axial compression force, the other hand applies a
downward and backward force to the proximal arm.
Test: Clunk Test

How to know if positive: A clunk or grinding sound
Procedure: First, the patient lies supine then the
examiner places one hand on the posterior aspect of the
shoulder over the humeral head then the examiner hold
the humerus above the elbow then the examiner fully
abducts the arm over the patients head then the
examiner pushed anteriorly with the hand over the
humeral head while the other hand laterally rotates the
humerus.


17,II 2017
Test: Kim test
Test for what: Labral tear
Indication: SLAP Lesions
How to know if positive: If the apprehension remains
the same or the shoulder becomes more painful.
Procedure: The patient is recommended to be in supine
position with the shoulder abducted to 120 degrees and
laterally rotated with the elbow flexed to 90 degrees
and the forearm supinated. The examiner performs an
apprehension test on the patient by taking the arm into
full lateral rotation. If apprehension appears, the
examiner stops lateral rotation and holds the position.
The patient is then asked to flex the elbow against the Test: Scapular Load test
examiners resistance at wrist. Test for what: Scapular Dyskinesia
How to know if positive: The test is positive if the
difference of the distance measured from the original
measure is > 1- 1.5 cm or 0.5-0.75 inches
Procedure: Examiner measures the distance Base of
the spine of scapula to spinous process of T2/T3
OR - Inferior angle of scapula to the spinous process of
T7/T8/T9 - T2 to Superior angle of scapula
Tested in four positions:
Hands on waist (45 ABD), 90 ABD with IR,120 ABD,
and 150 ABD
Test: Mayo Shear test

Test for what: Labral tear
How to know if positive: It is considered positive if the
patient reports pain or a click in the posterior or
posterosuperior shoulder and indicates a superior labral
tear
Procedure: The patient stands with the examiner
standing behind. The examiner elevates the patients
arm to about 70 degrees and then laterally rotates the
arm. Once laterally rotated, the patients arm is taken
into full elevation. The examiner then brings the arm
down while maintaining lateral rotation and applying an
anterior directed force with the hand on the posterior
shoulder. Test: Scapular Retraction test
Test for what: Scapular Dyskinesia
Indication: Weak scapular stabilizers
How to know if positive: Perform empty can test, if
pain reduces when empty can test is performed the it is
positive.
Procedure: The patient is in the standing position. The
examiner, standing behind the patient, places the
fingers of one hand over the clavicle with the heel of
the hand over the spine of the scapula to stabilize the
clavicle and scapula and to hold the scapula retracted.

17, 2017
The examiners other hand compresses the scapula joint, however if localized pain in the sternoclavicular
against the chest wall. Holding the scapula in this joint occurs it indicates that the joint is at fault
position provides a firm stable base for the rotator cuff Procedure: The patient stands and reaches the hand
muscles, and often rotator cuff muscles improve. across to the opposite shoulder. The examiner may also
passively perform the test. With the patient in sitting
position, the examiner passively forward flexes the arm
to 90 degrees and then horizontally adducts the arm as
far as possible.
Test: Wall Push-ups

Test for what: Scapular Dyskinesia
Indication: Scapular Winging Test: Paxinos test
How to know if positive: The test is positive if a Test for what: AC joint (acromioclavicular joint)
weakness or winging started to show within 5 to 10 How to know if positive: If the pain in the area of the
push ups acromioclavicular joint is increased
Procedure: The patient stands arms length from a wall. Procedure: The patient is asked to be seated with arm
The patient is then asked to do a wall push-up 15 to relaxed on at the side. The examiner stands beside the
20 times. Any weakness of the scapular muscles or test arm and places one hand over the shoulder so that
winging usually shows up with 5 to 10 push ups. For the thumb is under the posterolateral aspect of the
stronger/younger people, a normal push up on the floor acromion and the index finger and long fingers of the
shows similar scapular changes, usually with fewer same hand (The fingers of the opposite hand may also
repetitions. be used instead) over the middle part of the clavicle on
the same side. The examiner then applies pressure to
the acromion with the thumb anterosuperiorly while
applying an inferior directed counterforce to the clavicle
with the fingers.
Test: Cross over test

Test for what: AC joint (acromioclavicular joint)
How to know if positive: The test is positive if the
patient feels localized pain over the acromioclavicular


17, 2017
Test: Drop Arm (Codmans) Test

Test for what: Ligament Pathology
Indication: Tear in rotator cuff complex Test: Lateral Rotation Lag Sign (Infraspinatus Spring
How to know if positive: Pain/Inability to return the arm Back Test)
to the side slowly. Test for what: Ligament Pathology
Procedure: Patient stands. Abduct the patients Indication: Teres Minor/Infraspinatus Weakness
shoulder to 90 then ask the patient to slowly lower the How to know if positive: Patient cannot hold the
arm to the side in the same arc of movement. position/Hand springs back anteriorly
Procedure: Patient is seated or standing with arm by
the side and elbow flexed to 90. Examiner passively
abducts arm to 90 then laterally rotate the shoulder to
end range and ask the patient to hold.
Test: Infraspinatus Test

Indication: Infraspinatus Strain
How to know if positive: Pain/Inability to resist
Procedure: Patient stands with arm at the side with
elbow flexed at 90 and the humerus is medially rotated
to 45 (Forearm in mid-prone position). Apply a medial
rotation force then ask the patient to resist.
Test: Lift-Off Sign

Indication: Lesion of the subscapularis tendon/Scapular
Instability
How to know if positive: Inability to lift hand away from
back
Procedure: Patient stands with hand supinated behind
his/her back (against the mid lumbar spine), then lifts

his/her hand17,
away2017
from the back. *If patient is able to do
test with ease, apply a load by pushing the hand toward
the back to test how the scapula acts under dynamic
loading. If a torn subscapularis tendon is present,
passive/active lateral rotation increases.
Test: Speeds Test (Biceps or Straight-Arm Test)

Test: Rent Test Test for what: Ligament Pathology
Test for what: Ligament Pathology Indication: SLAP (type II) Lesion
Indication: Rotator Cuff Tear How to know if positive: Pain/Tenderness in bicipital
How to know if positive: Presence of a depression/A groove
more prominent greater tuberosity compared to the other Procedure: Resist forward shoulder flexion (At around
UE 90) while forearm is supinated and elbow is fully
Procedure: Patient is seated with the examiner behind. extended. Then resist forward shoulder forward flexion
Palpate for the anterior margin of the patients acromion while forearm is pronated and elbow is fully extended.
with one hand while holding the patients elbow at 90 Positive if pain is present when forearm is supinated,
with the other hand. Passively extend the patients arm and none or decreased pain when forearm is pronated.
and slowly medially & laterally rotate the patients
humerus while palpating the greater tuberosity and
rotator cuff tendons.
Test: Serratus Anterior Weakness (Punch Out Test)

Test for what: Ligament Pathology Test: Supraspinatus (Empty Can or Jobe) Test
Indication: Weak Serratus Anterior Test for what: Muscle/Tendon Pathology
How to know if positive: Medial Border of the Scapula Indication: Tear of Supraspinatus Tendon or
Wings (Classic Winging) neuropathy of scapular nerve.
Procedure: Patient is in standing position and forward How to know if positive: Weakness or pain
flexes the arm to 90. The examiner applies a backward Procedure: Patient stands and arms is abducted to 90
force to the arm. with neutral rotation and examiner provides resistance to
abduction. Shoulder is then medially rotated and angled

forward 3017,that2017
the patients thumb point toward the
floor (Empty Can Position).
Test: Trapezius Test

Test for what: Muscle/Tendon Pathology
Indication: Pectoralis minor, Pectoralis major, or
latissimus dorsi is tight.
How to know if positive: Theres protraction without
trapezius contraction. Test: Whipple Test
Procedure: Patient sits down and places hands together Test for what: Muscle/Tendon Pathology
over the head. Push the elbows forward. Indication: Partial rotator cuff tears and/or superior
Upper Traps abduct patients arm with head labrum tears
slightly flexed. Resist shoulder abduction. How to know if positive: Rotator cuff tears
Procedure: Patient stands with the arm forward flexed
Middle Traps patient prone with arm abducted to
to 90 and adducted until the hand is opposite the
90 and ER. Resist horizontal extension while
shoulder. Push downward at the wrist while the patient
watching for retraction of scapula that should
resist.
occur normally.
Lower Traps patient prone with arm abducted to
120 and shoulder laterally rotated. Resistance
to diagonal extension and watches scapular
retraction that occur normally.
Test: Yergasons Test

Test for what: Muscle/Tendon Pathology


Indication: 17, 2017 humeral ligament tear if biceps

Transverse extended. Fingers extended. Neck contralateral flexion.
tendon also pops out when palpated. Elbow extended.
How to know if positive: Painful
Procedure: Patient standing. Elbow flexed to 90 and
stabilized near the thorax with forearm pronated. Resist
supination and patient also laterally rotates the arm
against resistance. Other hand palpates the long head of
biceps.
Test: ULTT 2
Test: Hornblower Test Test for what: Upper Limb Tension Test
Test for what: Muscle/Tendon Pathology Indication: Median, MsN, Axillary
Indication: Rotator cuff tear How to know if positive: Nerve signs of weakness,
How to know if positive: Arm cannot abduct paresthesia or shooting pain.
Procedure: Patient Standing. Ask the patient to bring Procedure: Supine Patient. Shoulder depressed and
both hands to the mouth with the arms abducted. abducted to 10 ER. Forearm supinated. Wrist extended.
Fingers extended. Elbow extended. Neck contralateral
flexion.
Test: ULTT 1 Test: ULTT 3

Test for what: Upper Limb Tension Test Test for what: Neurological Function (Radial Nerve)
Indication: Median Nerve, AIN Indication: Stretching of dura matter in cervical spine
How to know if positive: Nerve signs of weakness, How to know if positive: Pain in the form of tingling or
paresthesia or shooting pain. a stretch or ache in the cubital fossa.
Procedure: Supine patient. Shoulder depressed and Procedure: Patient supine. Use hip to depress the
abducted to 110 IR. Forearm supinated. Wrist shoulder. Abduct arm to 10, flex elbow to 90. Then
pronate the forearm, flex wrist and fingers. Slowly extend
elbow until patient is in pain. To confirm findings, flex

17,ask
elbow a little, 2017
patient to laterally flex neck to the
opposite direction. Test: Halsteads Test (Haway)
Test for what: Vascular Dysfunction
Indication: Thoracic Outlet Syndrome
How to know if positive: Radial Pulse is absent
Procedure: Examiner locates for the radial pulse. The
patients head will face away from the examiner.
Examiner will extend the shoulder then the patient will
extend his head while examiner takes a deep breathe.
Test: ULTT 4
Test for what: Neurological Function (Ulnar nerve and
nerve roots C8-T1)
Indication: Stretching of dura matter in cervical spine
How to know if positive: Pain in the form of tingling or
a stretch or ache in the cubital fossa.
Procedure: Patient supine. Depress shoulder, abduct
arm to 90, pronate forearm, extend wrist and fingers,
laterally rotate shoulder and slowly bring his fingers Test: Military Brace Test
towards his ear till symptoms are felt. To confirm Test for what: Vascular Dysfunction
findings, flex elbow a little, ask patient to laterally flex Indication: Thoracic Outlet Syndrome
neck to the opposite direction. How to know if positive: Radial Pulse is absent
Procedure: Examiner palpates the radial pulse and
draws the shoulder down and back.
Test: Adsons Test (Arap)

Test for what: Vascular Dysfunction
Indication: Thoracic Outlet Syndrome
How to know if positive: Radial Pulse is absent Test: Roos Test
Procedure: Examiner locates for the radial pulse. The Test for what: Vascular Dysfunction
patients head will face the side of the examiner. Indication: Unable to keep the arms in starting position
Examiner will extend the shoulder then the patient will for 3 minutes
extend his head while examiner laterally rotates and How to know if positive: Suffers ischemic pain,
extends the shoulder. Make the patient have a deep heaviness or profound weakness of arm, or numbness
breathe. and tingling of hand. (Minor fatigue and distress are
considered negative.)
Procedure: Abduct arm to 90, externally rotate
shoulder, flex elbow to 90, then let patient open and
close hands for 3 minutes.


17, 2017
Test: Apley Scratch Test

Test for what:
Indication:
How to know if positive: Fingers are not able to touch
or overlap.
Procedure: Dominant arm reaches for the upper back
from the top, then non dominant hand reaches for the
upper back from below. After, use the non dominant arm
to reach for the upper back from the top, and the
dominant arm to reach the upper back from below.
Test: Gerbers Test (Lift off Sign)

Test for what: Muscle Pathology
Indication: Lesion in subscapularis, tear in
subscapularis tendon
How to know if positive: Inability to lift the hand away
from the back.
Procedure: Patient puts arm on the back with palms
facing outward. Patient tries to lift the hand from the
back. If patient can lift, return hand into starting position,
examiner will apply load to the patients hand by pushing
it towards the patients back.


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University of the East Ramon Magsaysay Memorial Medical Center Inc.

Test: Load and Shift Test

Test: Crank Test

Page 1 of 13 Physical Therapy 3: Tests and Measurements

David M. | Mantaring, Linno Andre A. | Marcos, Aaron G.

Test: Dugas Test

Test: Jerk Test

Page 2 of 13 Physical Therapy 3: Tests and Measurements

David M. | Mantaring, Linno Andre A. | Marcos, Aaron G.

17, 2017 Test: Hawkin Kennedy test

Test: Sulcus test

Test: Neer Impingement test

Test: Coracoid Impingement test

Test: Supine Impingement test

Page 3 of 13 Physical Therapy 3: Tests and Measurements

David M. | Mantaring, Linno Andre A. | Marcos, Aaron G.

Test: Posterior Internal Impingement Test

Test: Zaslav test

Page 4 of 13 Physical Therapy 3: Tests and Measurements

David M. | Mantaring, Linno Andre A. | Marcos, Aaron G.

Test: Anterior Slide Test

Test: Clunk Test

Page 5 of 13 Physical Therapy 3: Tests and Measurements

David M. | Mantaring, Linno Andre A. | Marcos, Aaron G.

Test: Mayo Shear test

David M. | Mantaring, Linno Andre A. | Marcos, Aaron G.

Test: Wall Push-ups

Test: Cross over test

Page 7 of 13 Physical Therapy 3: Tests and Measurements

David M. | Mantaring, Linno Andre A. | Marcos, Aaron G.

Test: Drop Arm (Codmans) Test

Test: Infraspinatus Test

Test: Lift-Off Sign

David M. | Mantaring, Linno Andre A. | Marcos, Aaron G.

Test: Speeds Test (Biceps or Straight-Arm Test)

Test: Serratus Anterior Weakness (Punch Out Test)

David M. | Mantaring, Linno Andre A. | Marcos, Aaron G.

Test: Trapezius Test

Test: Yergasons Test

Page 10 of 13 Physical Therapy 3: Tests and Measurements

David M. | Mantaring, Linno Andre A. | Marcos, Aaron G.

Indication: 17, 2017 humeral ligament tear if biceps

Test: ULTT 1 Test: ULTT 3

David M. | Mantaring, Linno Andre A. | Marcos, Aaron G.

Test: Adsons Test (Arap)

Page 12 of 13 Physical Therapy 3: Tests and Measurements

David M. | Mantaring, Linno Andre A. | Marcos, Aaron G.

Test: Apley Scratch Test

Test: Gerbers Test (Lift off Sign)

Page 13 of 13 Physical Therapy 3: Tests and Measurements

David M. | Mantaring, Linno Andre A. | Marcos, Aaron G.

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