Here we are checking test to identify different shoulder joint problems, that includes speeds test, drop arm test, belly press test…
Tests for muscles & tendons pathology:
1.test to identify shoulder joint problems, Yergason’s test:
- Aim of the test: Identifies the integrity of transverse ligament & bicipital tendonitis.
- Patient position: Patient is sitting with shoulder in neutral stabilized against trunk, elbow at 90°, & forearm pronated. The therapist resists supination of forearm & external rotation of shoulder
- Positive sign: Tendon of biceps long head will “pop out” of groove & pain on long head of biceps tendon.
2. Speed’s test (Biceps straight arm)
- Aim of test: Identifies bicipital tendonitis
- Patient position: Patient sitting or standing with upper limb in full extension & forearm supinated. The therapist resists shoulder flexion. May also place shoulder in 90° flexion & push upper limb into extension causing eccentric contraction of biceps
- Positive sign: Pain in long head of biceps tendon.
3.Drop arm test:
- Aim of test: Identifies tear &/or full rupture of rotator cuff
- Patient position: Patient sitting with shoulder passively abducted to 120°. Patient is instructed to slowly bring arm down to side .Guard patient’s arm from falling in case it gives way.
- Positive sign: Patient unable to lower arm back down to side
4. Empty can test:
- Aim of test: Identifies tear &/or impingement of supraspinatus tendon or possible suprascapular nerve neuropathy.
- Patient position: Patient sitting with shoulder at 90° & no rotation. Resist shoulder abduction. Then place shoulder in “empty can” position, which is internal rotation and 30° forward (horizontal adduction), the patient’s thumb point down to the floor, and resist abduction. Differentiate if pain present between two positions. Another test with thumb up “full can” is best for maximum contraction of supraspinatus & resist abduction.
- Positive sign: Reproduces pain &/or weakness in supraspinatus tendon.
5. Lift-off test:
- Aim of the test: identify tear/weakness of subscapularis muscle & scapula instability.
- Patient position: Patient stands & places the dorsum of the hand against the mid lumbar spine. Then the patient lifts his hand away from the back. If the patient is able to take the hand away from the back, the examiner should apply a load pushing the hand toward back to test the strength of the subscapularis and test how the scapula acts under dynamic loading.
- Positive sign: Inability to move the dorsum off the back indicates subscapularis rupture or dysfunction
6. Belly-Press (abdominal compression) test:
- Aim of the test: Identify tear/weakness of subscapularis muscle; especially if patient can’t medially rotate the shoulder behind his back.
- Patient position: The examiner put his hand on patient’s abdomen to feel the contraction; patient put his hand of the tested shoulder on examiner’s hand & push as hard as he can. While pushing the patient attempt to bring elbow forward causing greater medially shoulder rotation.
- Positive sign: Inability to maintain the pressure on examiner’s hand while moving elbow forwards.