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Orthopedic Foundations - Shoulder Assessment - Lesson 2

The document outlines various orthopedic tests for assessing shoulder conditions, including tests for range of motion, impingement, tendon tears, and instability. Key tests include Apleys Scratch Test, Wrights Test, Neer's Impingement Test, and others, each with specific procedures and indications. It serves as a comprehensive guide for evaluating shoulder health and diagnosing potential injuries.

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Chad Friel
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6 views15 pages

Orthopedic Foundations - Shoulder Assessment - Lesson 2

The document outlines various orthopedic tests for assessing shoulder conditions, including tests for range of motion, impingement, tendon tears, and instability. Key tests include Apleys Scratch Test, Wrights Test, Neer's Impingement Test, and others, each with specific procedures and indications. It serves as a comprehensive guide for evaluating shoulder health and diagnosing potential injuries.

Uploaded by

Chad Friel
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Orthopedic Foundations

Orthopedic Tests
for
Shoulder
Shoulder Review
Shoulder Assessment
AROM
PROM
RROM
Flexion, Extension, Abduction, Adduction, Internal Rotation, External Rotation

Scapula: Elevation, Depression, Protraction, Retraction


Orthopedic Tests for the Shoulder
● Apleys Scratch Test
● Wrights
● Neer's Impingement Test
● Hawkins Kennedy
● Empty Can
● Yergasons
● Sulcus Sign
● Apprehension Test
● Cross Adduction Test
Apleys Scratch Test
● Tests for: Tests for overall shoulder range of motion. ( not technically a specialized test)
● Patient Position: Standing facing away from therapist

● Examiner Position: behind patient

● Procedure:

1. Have patient complete flexion of the shoulder to 180° and flexion of the elbow as far as comfortable possible
2. Have patient bring opposite arm to extension, internal rotation and elbow flexion
3. Patient should be able to get fingers close to each other
4. Repeat other side

● Positive Sign: No positive or negative for this test.


● Indicates: General shoulder range of motion. ( patient should be able to get fingers within 2 or 3 inches of each
other or claps fingers together)
● If unable to reach normal roms, further testing is required
Wrights Test (Hyperabduction Maneuver)
● Tests for: Thoracic Outlet Syndrome (TOS) due to compression of the neurovascular bundle under the pectoralis
minor.

● Patient Position: Seated

● Examiner Position: Beside the patient.

● Procedure:

1. Palpate the radial pulse.

2. Passively complete shoulder flexion of the patient’s arm to 180° (overhead)


3. The patient may take a deep breath.

● Positive Sign: Diminished or absent radial pulse, or reproduction of symptoms like tingling or numbness.

● Indicates: Hypertonic Pectoralis Minor and Compression of the neurovascular bundle (brachial plexus and
subclavian vessels).
Neer’s Impingement Test
● Tests for: Subacromial impingement of the supraspinatus tendon or long head of the biceps.

● Patient Position: Seated or standing.

● Examiner Position: Beside the patient.

● Procedure:

1. Stabilize the scapula with one hand.

2. Passively flex the patient’s arm to full flexion (near the ear).

● Positive Sign: Pain in the anterior/lateral shoulder.

● Indicates: Impingement of supraspinatus or biceps tendon under the acromion


Hawkins-Kennedy Test
● Tests for: Subacromial impingement

● Patient Position: Seated or standing.

● Examiner Position: In front or beside the patient.

● Procedure:

1. Flex the patient’s shoulder and elbow to 90°.

2. Internally rotate the arm while stabilizing the elbow. (hand can be placed on opposite shoulder)

● Positive Sign: Pain in the shoulder.

● Indicates: Impingement of supraspinatus tendon or subacromial bursa.


Empty Can Test
● Tests for: Supraspinatus tendon tear or weakness.

● Patient Position: Standing or seated.

● Examiner Position: In front of the patient.

● Procedure:

1. Patient elevates arm to 90° in the scapular plane (about 30–45° forward of coronal).

2. Arms internally rotated (thumbs down, like emptying a can).

3. Examiner applies downward pressure as the patient resists.

● Positive Sign: Weakness or pain.

● Indicates: Supraspinatus tear, tendinopathy, or nerve involvement.


Yergason’s Test
● Tests for: Biceps tendinopathy or subluxation of the long head of biceps.

● Patient Position: Seated.

● Examiner Position: In front of the patient.

● Procedure:

1. Patient flexes elbow to 90° with forearm pronated.

2. Examiner resists patient’s attempt to supinate, flex elbow and externally rotate the forearm
while palpating the bicipital groove.

● Positive Sign: Pain or a pop in the bicipital groove.

● Indicates: Biceps tendon instability or tendinitis.


Sulcus Sign
● Tests for: Inferior glenohumeral instability.

● Patient Position: Seated or standing, arm relaxed at side.

● Examiner Position: Beside the patient.

● Procedure:

1. Examiner grasps the elbow or distal humerus and pulls downward.

2. Observe the shoulder for a depression (sulcus) below the acromion.

● Positive Sign: Visible sulcus or gap appears beneath the acromion.

● Indicates: Inferior shoulder instability or joint laxity.


Apprehension Test
● Tests for: Anterior shoulder instability or history of dislocation.

● Patient Position: Seated (can be Supine as well).

● Examiner Position: Beside the affected shoulder.

● Procedure:

1. Abduct the patient’s shoulder to 90°, elbow flexed to 90°.

2. Slowly externally rotate the arm while observing the patient’s expression.

● Positive Sign: Apprehension, fear, or resistance (not just pain).

● Indicates: Anterior instability or previous dislocation.


Cross Adduction
Tests for: Acromioclavicular (AC) joint pathology.

● Patient Position: Seated or standing.

● Examiner Position: In front of patient

● Procedure:

1. Patient elevates arm to 90°. And places hand over opposite shoulder

2. Examiner applies posterior force on patients elbow towards chest (horizontal adduction).

● Positive Sign: Pain at the AC joint. Or recreation of symptoms

● Indicates: AC joint inflammation, osteoarthritis, or injury.


Review
1. Apleys Scratch Test - General Shoulder Range of motion
2. Wrights - Pec Minor Syndrome
3. Neer's Impingement Test- Shoulder Impingement
4. Hawkins Kennedy - Shoulder Impingement
5. Empty Can- Supraspinatus tear/tendonitis
6. Yergason's - Bicipital Groove Tendonitis
7. Sulcus Sign - Inferior Glenohumeral instability
8. Apprehension Test - Anterior Instability
9. Cross Adduction Test - AC Joint Sprain / Seperation

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