Shoulders and special tests

Shoulders and special tests

1. Shoulder Instability

   • Load and Shift - Passive anterior and posterior movement, stabilize superior
   • Apprehension, Relocation and Release - Supine, 90/90, force ER, stabilize humeral head, release
   • Anterior Drawer- pull anterior Posterior Drawer- pull posterior
   • Posterior Apprehension- Supine 90/90, forced IR
   • Posterior Apprehension (Scapular Plane)- Forced IR, elbow 45, shoulder scap plane
   • Inferior Drawer- arm resting on shoulder and depress
   • Sulcus- pull humerus down

2. Labral Tear

   • SLAP
     • O'Brien - thumb down, in front of face, hold position
     • Clunk- Overhead IR/ER (near ears)
     • Crank Test- Shoulder 90/90 IR, lateral
     • Anterior Slide- Hand on hip, compress labrum, anterior force
   • Any positive instability
   • Passive compression- pt on side, stabilize AC, 90/90 anterior, compress labrum, flex/extend
   • Compression Rotation- supine, shoulder 90/90, IR/ER
   • Jerk test- 90/90 anterior IR, ADD, compress labrum,

3. Impingement

   • Rotator Cuff
     • Supraspinatus
       • O'Brien - thumb up, in front of face, hold position
       • Drop Arm- raise arms laterally passively, slowly lower
       • Empty can- thumbs down scapular plane
       • ER lag sign- attempt ER
       • Hawkins Kennedy- IR at 90/90 laterally (Relief test is coming out of position)
     • Infraspinatus
       • Strength test- palm down, scapular plane, resist downward force
       • ER lag sign- attempt ER
   • Bicep
     • Speed's test - palm up, shoulder flexion isometric
     • Ludington's- flex hands behind head (rupture test)
     • Yergason's- handshake ER and supination
   • Subacromial
     • Active Impingement - shoulder arc (pain)
     • Neer- Hold arms overhead 15s (bicep or supra)

4. AC Sprain

   • Shear Test- ant and post compression on AC joint
   • Compression- arm across chest, force adduction
   • O'Brien - thumb down, in front of face, hold position

5. SC Sprain

   • Compression- arm across chest, force adduction
   • Integrity test- joint play