(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
-------------------------------------------------------------------------------------------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
-------------------------------------------------------------------------------------------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
--------------------------------------------------------------------------------------------
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
-------------------------------------------------------------------------------------------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
-------------------------------------------------------------------------------------------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
-------------------------------------------------------------------------------------------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
-------------------------------------------------------------------------------------------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
-------------------------------------------------------------------------------------------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
-------------------------------------------------------------------------------------------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.