Shoulder Special Tests. External Impingement Neer’s Hawkins Kennedy Empty Can Test.
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Transcript of Shoulder Special Tests. External Impingement Neer’s Hawkins Kennedy Empty Can Test.
![Page 1: Shoulder Special Tests. External Impingement Neer’s Hawkins Kennedy Empty Can Test.](https://reader033.fdocuments.in/reader033/viewer/2022061604/5697bfa81a28abf838c991af/html5/thumbnails/1.jpg)
Shoulder Special Tests
![Page 2: Shoulder Special Tests. External Impingement Neer’s Hawkins Kennedy Empty Can Test.](https://reader033.fdocuments.in/reader033/viewer/2022061604/5697bfa81a28abf838c991af/html5/thumbnails/2.jpg)
External Impingement
• Neer’s• Hawkins Kennedy• Empty Can Test
![Page 3: Shoulder Special Tests. External Impingement Neer’s Hawkins Kennedy Empty Can Test.](https://reader033.fdocuments.in/reader033/viewer/2022061604/5697bfa81a28abf838c991af/html5/thumbnails/3.jpg)
Neer’s Test
• For: External Impingement• Posture: Patient seated with
examiner standing• Fixation: Ipsilateral scapula
to prevent protraction• Test: Passive forward
elevation of the arm• Positive: Pain in the shoulder• Modifications: Internal and
external rotation of humerus
![Page 4: Shoulder Special Tests. External Impingement Neer’s Hawkins Kennedy Empty Can Test.](https://reader033.fdocuments.in/reader033/viewer/2022061604/5697bfa81a28abf838c991af/html5/thumbnails/4.jpg)
Hawkins Kennedy
• For: External Impingement
• Posture: Patient seated with arm in 90° forward elevation
• Test: Passive forced internal rotation at different degrees of ab/adduction
• Positive: Pain in the shoulder
![Page 5: Shoulder Special Tests. External Impingement Neer’s Hawkins Kennedy Empty Can Test.](https://reader033.fdocuments.in/reader033/viewer/2022061604/5697bfa81a28abf838c991af/html5/thumbnails/5.jpg)
Empty Can Test
• For: External Impingement• Posture: Patient seated with
arm in 90° abduction, 30° horizontal adduction and full internal rotation
• Test: Resist abduction/flexion
• Positive: Pain in the shoulder; muscle weakness
• Modification: Repeat with full external rotation to reduce pain
![Page 6: Shoulder Special Tests. External Impingement Neer’s Hawkins Kennedy Empty Can Test.](https://reader033.fdocuments.in/reader033/viewer/2022061604/5697bfa81a28abf838c991af/html5/thumbnails/6.jpg)
Internal Impingement
• Posterior Internal Impingement
![Page 7: Shoulder Special Tests. External Impingement Neer’s Hawkins Kennedy Empty Can Test.](https://reader033.fdocuments.in/reader033/viewer/2022061604/5697bfa81a28abf838c991af/html5/thumbnails/7.jpg)
Posterior Internal Impingement
• For: Internal Impingement
• Posture: Patient supine, 90° abduction and maximal external rotation
• Test: Maximal Passive external rotation
• Positive: Pain POSTERIORLY
![Page 8: Shoulder Special Tests. External Impingement Neer’s Hawkins Kennedy Empty Can Test.](https://reader033.fdocuments.in/reader033/viewer/2022061604/5697bfa81a28abf838c991af/html5/thumbnails/8.jpg)
Rotator Cuff Tests
• External Rotation Lag Sign• Belly Press Test
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External Rotation Lag Sign
• For: Posterior Cuff Integrity• Posture: Patient seated with
the back towards the examiner. The shoulder in 20º abduction, the elbow in 90º flexion and maximal external rotation minus 5º to avoid elastic recoil in the shoulder.
• Test: Maintain this position• Positive: Unable to maintain
position
![Page 10: Shoulder Special Tests. External Impingement Neer’s Hawkins Kennedy Empty Can Test.](https://reader033.fdocuments.in/reader033/viewer/2022061604/5697bfa81a28abf838c991af/html5/thumbnails/10.jpg)
Belly Press Test
• For: Subscapularis Integrity
• Posture: Patient seated with arm 45° and full internal rotation
• Test: Resist further internal rotation
• Positive: Weakness present
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SLAP Tests
• Anterior Slide Test• Biceps Load II Test• O’Brien’s Test
![Page 12: Shoulder Special Tests. External Impingement Neer’s Hawkins Kennedy Empty Can Test.](https://reader033.fdocuments.in/reader033/viewer/2022061604/5697bfa81a28abf838c991af/html5/thumbnails/12.jpg)
Anterior Slide Test• For: SLAP• Posture: standing or sitting, hands
on the hips with the thumbs pointing posteriorly.
• Fixation: the examiner places one hand on top of the shoulder from posterior, with the index finger over the anterior aspect of the acromion. The other hand is placed behind the elbow.
• Test: A forward and slightly superior directed force is supplied to the elbow and upper arm. The patient is asked to push against this force
• Positive: pain or a click in the front of the shoulder under the examiner’s hand.
![Page 13: Shoulder Special Tests. External Impingement Neer’s Hawkins Kennedy Empty Can Test.](https://reader033.fdocuments.in/reader033/viewer/2022061604/5697bfa81a28abf838c991af/html5/thumbnails/13.jpg)
Biceps Load II
• For: SLAP• Posture: Supine with arm
abducted to 120° and maximally externally rotated, elbow at 90° and forearm supinated.
• Test: Resist elbow flexion• Positive: Pain
![Page 14: Shoulder Special Tests. External Impingement Neer’s Hawkins Kennedy Empty Can Test.](https://reader033.fdocuments.in/reader033/viewer/2022061604/5697bfa81a28abf838c991af/html5/thumbnails/14.jpg)
Instability Tests
• Apprehension Test• Relocation Test
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Apprehension Test
• For: Anterior Instability• Posture: Patient supine,
90° abduction and maximal external rotation
• Test: Anterior force through posterior aspect of humeral head
• Positive: Apprehension or pain
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Relocation Test
• For: Anterior Instability• Posture: Patient supine,
90° abduction and maximal external rotation
• Test: Posterior force through anterior aspect of humeral head
• Positive: Relief of pain
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Acromioclavicular Tests
• O’Brien Test• AC Joint Tenderness Test• Horizontal Adduction
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O’Brien Test
• For: AC Joint Dysfunction or SLAP
• Posture: Patient standing in front of examiner. Arm 90° forward flexion, 10-15 ° adduction and full internal rotation
• Test: Resist Flexion. Repeat with supinated wrist
• Positive: Pain over ACJ when in internal rotation OR Pain in shoulder
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AC Joint Tenderness Test
• For: AC Joint Dysfunction
• Posture: Patient sitting• Test: Palpation ACJ• Positive: Pain over ACJ
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Horizontal Adduction
• For: AC Joint Dysfunction
• Posture: Patient sitting• Test: Passive Horizontal
Adduction• Positive: Pain over ACJ