Sports Medicine II
Shoulder Special Tests
Name _______________________
Patient Position
SC Glide Test
subject sits with involved arm relaxed at the side
Examiner Position
in front of the subject
Procedures
1. place one hand on the proximal end of the subject’s clavicle and the other hand on the
spine of the scapula.
2. Examiner applies a gentle inferior and posterior pressure on the clavicle, noting any
movement at the sternoclavicular joint.
Positive Test
pain and/or movement of the clavicle
Implications
sternoclavicular ligament sprain
Patient Position
GH Glide Test
lying supine with the GH joint over the edge of the table
Examiner Position
standing lateral to the side being tested
Procedures
1. Place one hand stabilizing the shoulder complex by grasping the scapula and the other
grasping the humerus just below the surgical neck.
2. Apply a gentle, yet firm force that moves the humeral head anteriorly relative to the
glenoid fossa while applying slight distraction to the joint to separate the humeral head
from the fossa.
3. Repeat procedure in the posterior and inferior direction.
Positive Test
pain or increased motion compared with the same direction on the opposite shoulder
Implications
laxity of the static stabilizers of the GH joint
Patient Position
Anterior Apprehension Test
supine; GH joint abducted to 90° and the elbow flexed to 90°
Examiner Position
beside the patient on the involved side
Procedures
1. Support the humerus at midshaft while the forearm is grasped proximal to the wrist.
2. Passively externally rotate the GH joint by slowly applying pressure to the anterior
forearm.
Positive Test
Patient displays apprehension that the shoulder may dislocate and resists further
movement. Pain centered in the anterior capsule of the GH joint.
Implications
anterior capsule, inferior GH ligament, or glenoid labrum compromised
Patient Position
AC Compression Test
sitting or standing with the arm hanging naturally at the side
Examiner Position
standing on the involved side
Procedures
1. Cup hands over the anterior and posterior joint structures.
2. Squeeze hands together, compressing the AC joint.
Positive Test
pain at the AC joint or excursion of the clavicle over the acromion process
Implications
damage to the AC ligament and possibly the coracoclavicular ligament
Patient Position
AC Traction Test
sitting or standing; arm hanging naturally from the side
Examiner Position
standing lateral to the involved side
Procedures
1. grasp patient’s humerus proximal to the elbow and palpate the AC joint with the
opposite hand.
2. Apply a downward traction on the humerus
Positive Test
humerus and scapula move inferior to the clavicle, causing a step deformity, pain, or both
Implications
sprain of the AC or coracoclavicular ligaments
Patient Position
Posterior Apprehension Test
Supine; shoulder flexed to 90° and the elbow flexed to 90°; GH joint being tested off the
side of the table
Examiner Position
standing on the involved side
Procedures
1. Grasp the forearm with one arm and stabilize the posterior scapula with the opposite
hand.
2. Apply a longitudinal force to the humeral shaft, encouraging the humeral head to move
posteriorly on the glenoid fossa.
3. Examiner may choose to alter the amount of flexion and rotation of the humerus
Positive Test
patient displays apprehension and produces muscle guarding to prevent the shoulder from
subluxating posteriorly.
Implications
laxity in the poster GH capsule, torn posterior labrum
Patient Position
Sulcus Sign
sitting, arm hanging at the side
Examiner Position
standing lateral to the involved side
Procedures
1. Grip patient’s arm distal to the elbow.
2. Apply a downward traction force to the humerus.
Positive Test
Indentation appears beneath the acromion process.
Implications
humeral head slides inferiorly on the glenoid fossa, indicating laxity in the superior GH
ligament
Patient Position
Yergason’s Test
sitting or standing; GH joint in the anatomical position; elbow flexed to 90°; forearm in
neutral position
Examiner Position
positioned lateral to the patient on the involved side
Procedures
1. Stabilize the olecranon inferiorly and maintain close to the thorax; stabilize forearm
proximal to the wrist.
2. patient provides resistance while the examiner concurrently moves the GH joint into
external rotation and the proximal radioulnar joint into supination.
Positive Test
pain or snapping (or both) in the bicipital groove
Implications
Primary: snapping or popping in the bicipital groove indicates a tear or laxity of the
transverse humeral ligament.
Secondary: pain with no associated popping in the bicipital groove may indicate bicipital
tendinitis
Patient Position
Speed’s Test
sitting or standing; elbow extended; GH joint in neutral position or slightly extended to
stretch biceps brachii
Examiner Position
Standing lateral to and in front of the involved limb
Procedures
1. Position fingers of one hand over the bicipital groove while stabilizing the shoulder.
Stabilize the forearm proximal to the wrist.
2. Resist flexion of the GH joint and elbow while palpating for tenderness over the
bicipital groove.
Positive Test
pain along the long head of the biceps brachii tendon, especially in the bicipital groove
Implications
inflammation of the long head of the biceps tendon as it passes through the bicipital
groove
Patient Position
Drop Arm Test
sitting or standing; humerus fully abducted and externally rotated and the forearm
supinated
Examiner Position
standing lateral to, or behind, the involved extremity
Procedures
1. patient slowly lowers the arm to the side
Positive Test
arm falls uncontrollably from a position of approximately 90° abduction to the side
Implications
lesions to the rotator cuff, especially the supraspinatus
Patient Position
Neer Impingement Test
standing or sitting; shoulder, elbow, and wrist in the anatomical position
Examiner Position
standing lateral or forward of the involved side
Procedures
1. Stabilize the patient’s shoulder on the poster aspect. Grip patient’s forearm distal to the
elbow joint.
2. With elbow extended, humerus is placed in internal rotation and the forearm is
pronated.
3. GH joint is forcefully moved through forward flexion as the scapula is stabilized.
Positive Test
pain with motion, especially near the end of ROM
Implications
pathology in rotator cuff or the long head of the biceps brachii tendon
Patient Position
Hawkin’s Shoulder Impingement Test
sitting or standing; shoulder, elbow, and wrist in the anatomical position
Examiner Position
standing lateral or forward of the involved side
Procedures
1. Grip the patient’s arm at the elbow joint and wrist.
2. With elbow flexed, GH joint elevated to 90° in the scapular plane.
3. Passively internally rotate humerus.
Positive Test
pain with motion, especially near the end of ROM
Implications
pathology is present in rotator cuff or the long head of the biceps brachii tendon
Patient Position
Empty Can Test
sitting or standing; GH abducted to 90° in the scapular plane, elbow extended, and the
humerus internally rotated and the forearm pronated so that the thumb points downward
Examiner Position
standing facing the patient
Procedures
1. Place one hand on the superior portion of the midforearm to resist the motion of
abduction in the scapular plane.
2. Resist abduction (apply a downward pressure)
Positive Test
weakness or pain accompanying the movement
Implications
supraspinatus tendon is:
1-being impinged between the humeral head and the coracoacromial arch
2-is inflamed or
3-contains a lesion
Patient Position
Adson’s Test
sitting; shoulder abducted to 30°, elbow extended with the thumb pointing upward,
humerus externally rotated
Examiner Position
standing behind the patient
Procedures
1. Palpate the radial pulse.
2. Externally rotate and extend the patient’s shoulder while the face is rotated toward the
involved side and extends the neck.
3. Patient is instructed to inhale deeply and hold the breath.
Positive Test
radial pulse disappears or markedly diminishes
Implications
subclavian artery is being occluded between the anterior and middle scalene muscles and
the pectoralis minor
Patient Position
Allen’s Test
sitting; the head facing forward
Examiner Position
standing behind the patient
Procedures
1. Palpate the radial pulse.
2. Elbow is flexed to 90° while the clinician abducts the shoulder to 90°.
3. Passively horizontally abduct and externally rotate the shoulder.
4. Patient rotates head towards the opposite shoulder.
Positive Test
radial pulse disappears
Implications
pectoralis minor muscle is compressing the neurovascular bundle