Shoulder Examination and Tests

Treatment of shoulder injuries should include an assessment of strength, range of motion, impingement and instability (Figure 1). Sometimes unusual or odd names are given to shoulder clinical tests. Four examples of these odds tests are being described here; the speed test, SLAP test, empty can test and the jerk test. You can see the video for a better explanation of these tests. A test can be positive or negative for a specific problem. It can also help in diagnosing specific problems.

Speed Test

The speed test is done for biceps tendonitis. The patient is asked to actively forward flex the shoulder while the examiner is applying resistance to the movement. Tenderness over the bicipital groove indicates tendonitis of the long head of the biceps (Figure 2).

SLAP Test (O’Brien’s Test)

The O’Brien’s test is the most common test performed for a SLAP tear lesion. The patients will be placed at 90° of flexion, 10° of adduction, and full internal rotation with the forearm pronated. The examiner applies pressure to the forearm and instructs the patient to resist the downward force being applied. Pain at the shoulder joint indicates a SLAP lesion (Figure 3). A decrease in pain of the shoulder joint on supination of the arm is consistent with a SLAP lesion.

Empty Can Test

The empty can test is performed to evaluate subacromial impingement and cuff pathology. The arm should be anteriorly flexed at the level of the shoulder. Fully pronate the arm into the “empty can position”. The patient should resist the downward force being applied on the forearm by the examiner. Pain or weakness indicates a supraspinatus tendon lesion or pathology (Figure 4).

Jerk Test

The jerk test is performed to assess instability of the glenohumeral joint and posterior labrum. The patient’s arm is abducted to 90° and internally rotated. The examiner axially loads the humerus while the arm is moved horizontally across the body. A positive test is indicated by a sharp pain in the shoulder with or without a clicking sound (Figure 5).

Orthopaedic Humor

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