ORTHOPEDIC TESTS: - Podbean



(P= procedure; += positive finding; C=condition)

Tests for the Shoulder:

1) Rotator Cuff Lesion:

Empty Can Test (to isolate supraspinatus)

P: Arm in Flexion and Abducted 45º (scaption) with thumb down

Therapist stabilizes pt’s shoulder and pushes down on elbow; patient resists

+: Pain during resistance

C: Supraspinatus mm. lesion/ Rotator Cuff Lesion

Drop Arm Test (Codman’s Test)

P: Passive 90º ABduction of arm. Pt then slowly (and in control) lowers arm

+: Pt is unable to lower arm slowly or severe pain is felt during test

C: Rotator Cuff Lesion

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2) Bicipital Tendinitis:

Speed’s Test (getting Biceps to contract)

P: Shoulder flexed 90º, elbow extended, and forearm supinated

Therapist stabilizes shoulder (other hand on ant. elbow); Pt flexes arm against resisitance

+: Pain and/or weakness during movement

C: Biceps Tendinitis (lesion of biceps tendon)

Yergason’s Test

P: Pt’s arm along side of body, elbow flexed 90º, and forearm pronated

Pt laterally rotates arm and supinates forearm against therapist’s resistance

+: Pain in bicipital groove or tendon may pop out of groove

C: Bicipital Tendinitis

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3) Impingement Syndrome:

Painful Arc Test

P: Active ABduction of arm

+: Pain between 60º-130º of ABduction indicates impingement of supraspinatus tendon or infraspinatus, or a subacromial bursa problem

C: Impingement Syndrome

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4) Dislocations/Separations:

Shoulder Apprehension Test (dislocation)

P: Passive ABduction of arm and flexion on elbow, both to 90º

Therapist then slowly laterally rotates shoulder

+: Look/feeling of apprehension on pt’s face and pt’s resistance

C: Anterior Dislocation

Acromioclavicular Shear Test (separation)

P: Therapist cups hands over deltoids, one hand over clavicle, one over spine of scapula. Therapist squeezes hands together.

+: Pain or abnormal movement at the AC joint

C: Shoulder Separation/AC Joint Injury

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No Special Regionalized Test For:

• Frozen Shoulder (Adhesive Capsulitis)- mm’s not involved

• Acute Bursitis- look for signs of inflammation

(P= procedure; += positive finding; C=condition)

Tests for the Elbow:

1) Lateral Epicondylitis:

Police Stop Sign

P: Active flexion of arm, extended elbow, and extend wrist

+: Pain over lateral epicondlye and lateral forearm

C: Lateral Epidcondylitis

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2) Medial Epicondylitis:

Medical Epicondylitis (Golfer’s Elbow) Test

P: Therapist palpates medial epicondlye, then passively supinates forearm and extends elbow and wrist

+: Pain at medial epicondyle

C: Medial Epicondylitis

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3) Ligament Sprains:

Valgus/Varus Stress Test

P: Therapist supports supinated and flexed arm

To test lateral (valgus): push against med. elbow to stress lateral

To test medial (varus): push against lat. elbow to stress medial

+: Pain or abnormal movement laterally or medially

C: Ligament Sprains/Instability

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4) Ulnar Nerve Entrapment at the Cubital Tunnel:

Tinel’s Sign (for any nerve problem)

P: Pt’s elbow slightly flexed. Therapist taps ulnar groove between olecranon process and medial epicondyle

+: Tingling sensation in ulnar distribution (medial forearm to last 2 fingers)

C: Ulnar Nerve Entrapment

(P= procedure; += positive finding; C=condition)

Tests for the Wrist and Fingers:

1) Carpal Tunnel Syndrome:

Phalen’s Test (commonly correlated w/ carpal tunnel)

P: Pt places dorsal hands together, then presses them together for 30 or 60 seconds (keep arms parallel)

+: Numbness and tingling in distribution of median nerve (ant. palm to first 3 ½ fingers)

C: Carpal Tunnel Syndrome

Tinel’s Sign

P: Therapist supports pt’s loosely flexed/supinated arm and taps the area of the carpal tunnel

+: Numbness and tingling in distribution of median nerve (ant. palm to first 3 ½ fingers)

C: Carpal Tunnel Syndrome

O-Ring Test

P: Active opposition. Therapist attempts to open the “O” with their finger

+: Marked weakness of thenar muscles

C: Carpal Tunnel Syndrome

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2) De Quervain’s Tenosynovitis:

Finkelstein’s Test

P: Pt makes a fist with their thumb inside and ulnar deviates (isolates and stretches)

+: Pain at lateral wrist/ region of “snuff box”

C: De Quervain’s Tenosynovitis

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No Special Regionalized Test For:

• Dupuytren’s Contracture

ORTHOPEDIC TESTS:

PAINFUL ARC

Active AB of shoulder

+ : Supraspinatus, Infra, bursa

EMPTY CAN

Scaption poition (abduct arm & medially rotate) w/ resistance

+ : Supraspinatus Lesion

SPEEDS

Flex shoulder against resist

+ : Bicep Tendinitis

YERGASONS

Ltrl rotate & supinate against ressitance

+ : Bicipital groove or tendon

AC JOINT COMPRESSION

Compress scap spine & clavicle

+ : AC joint pathology

DROP ARM/CODMAN’S

Actively lower arm

+ : instability of RTC tear/lesion…

POLICE STOP SIGN

Flex shoulder, extend elbow, extend wrist

+ : Ltrl Epicondylitis

GOLFER’S ELBOW

Palpate med epi. – Supinate forearm, extend elbow & wrist

+ : Medial epicondylitis

TINELS SIGN

Tap Ulnar groove

+ : tingling = ulnar nerve

PHALENS (carpals tunnel syn)

Actively place dorsal hands together. Press for 60 secs

+ : numb/tingle indicate median nerve disturbed

TINELS

Passively tap carpel tunnel area

+ : numb/tingle = median nerve disturbed

“O” RING

Actively oppose thumb & pinky together. Passivley attempt to open

+ : wkness of thumb mm = Carpel Tunnel Syndrome

FINKLESTEIN’S (DE QUERVAIN’S TENOSYNOVITIS

Actively flex thumb, wrap fingers, ulnar deviate

+ : pn in lateral wrist (anatomical snuff) = De Quer Tenso.

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