Hawkins test Supraspinatus impingement Pain Passive Make a hawk wing
Neers test Supraspinatus impingement Pain Passive Arm near head
Resisted external rotation
Infraspinatus & teres minor injury Pain Test Checks for Positive if Notes Picture Lift off test Subscapularis injury Inability to move arm from small of back upwards
Crossover AC joint Pain Passive
Speeds test Biceps tendinitis Pain in bicipital groove Active; patient extends elbow, supinates forearm, and flexes shoulder against resistance
Yergasons test Biceps tendinitis Pain in bicipital groove Active; provider resists patients supination/bicep flexion simultaneously
Sulcus
Anterior shoulder instability Instability, shoulder pulls down Passive
Test Checks for Positive if Notes Picture Apprehension and relocation GHJ stability Patient grimace upon external rotation, with relief on provider pressing joint back down Passive
Anterior slide Clunk Labral tear Shoulder pain or pop Patient resists provider pushing up on elbow
OBrien test Labral tear Pain or pop Oh Brian! Your labrum is torn! Patient resists horizontal adduction and forward flexion of shoulder
Crank Labral tear Pain, pop, catching, grinding Internal and external rotation with gentle axial load
Scapular winging Injury to serratus anterior/long thoracic nerve Winging of scapula
Spurlings maneuver Brachial plexus injury (burner or stinger) Pain with position or pain with applied pressure Patient extends neck, rotates, and laterally bends while provider applies downward pressure
Adsons test
Thoracic outlet syndrome causing artery compression Loss of radial pulse in arm Pt turns head to affected side and breathes in while provider feels radial pulse
Test Checks for Positive if Notes Picture Roos test Thoracic outlet syndrome Reproduction of symptoms Pt repeatedly clenches and unclenches the fists while keeping the arms abducted and externally rotated
Resisted extension & supination Lateral epicondylitis Pain over lateral epicondyle Resisted wrist extension and supination
*All extensors originate@ lateral epicondyle Resisted flexion & pronation Medial epicondylitis Pain over medial epicondyle Resisted wrist flexion and pronation
*All flexors originate @ medial epicondyle Finkelsteins test DeQuervains tenosynovitis Pain along distal radius
Tinels sign Carpal tunnel Tingling or pain in median nerve distribution (thumb, 2 nd & 3 rd digits)
Phalens test Carpal tunnel Numbness or tingling over median nerve distribution Flexion of wrists 60-90 secs
Durkans Carpal tunnel ( more sensitive and specific than Tinels or Phalens) Numbness or tingling over median nerve distribution Pressure over carpal tunnel for 30 secs
Test Checks for Positive if Notes Picture Watson test Scapholunate dissociation Clunk +pain Patient ulnar and radial deviates while provider applies pressure to scaphoid
Compression test CMC osteoarthritis Provider moves CMC joint with longitudinal load applied
Grind test CMC osteoarthritis Provider grabs metacarpal base and rotates the thumb
Straight leg raise Radicular cause of pain in back of leg Pain, increased pain when you also dorsiflex the foot (Bragards test) Passive; straight leg flexion of hip Confirmation tests:
1.) Bragards: increased pain when you dorsiflex the foot after flexion 2.) Crossed straight leg raise: raising contralateral leg causes radicular pain on ipsilateral leg 3.) Distracted straight leg raise (FLIP): sneak the same test in but with the patient seated to confirm rxn
FABER = flexion, abduction, external rotation n Differentiate SI joint pain from other hip pain Pain =SI joint pain
Schobers test
Ankylosing spondylitis <5-7 cm movement Examiner marks L5, 5cm below, 10 cm above, pt bends forward to touch toes, difference from 15 cm measured
Test Checks for Positive if Notes Picture Barlow- Ortolani maneuver Hip dysplasia in infants Clunk heard or felt (+ Barlow), relocation clunk (+ Ortolani)
Thomas test Hip flexor tightness Abnormal degree of hip flexion with leg at rest (lower picture) UNAFFECTED knee to chest
Trendelenberg sign Weak hip abductors (gluteus medius) Sinking of pelvis Unaffected leg rises
Medial/lateral patellar glide Laxity of patellofemoral joint/patellar dislocation Hypermobility of patella
Patellar apprehension Instability of patellofemoral joint/patellar dislocation Grimace Same as above but with lateral motion Inhibition test
Patellofemoral syndrome Pain or crepitus Provider squeezes top of patella and displaces it inferiorly
Test Checks for Positive if Notes Picture Q angle Measures knee valgus Greater or less than 20
Valgus stress MCL damage No opening + pain (I), opening with endpoint (II), no endpoint (III) Pt knee in 20- 30 of flexion
Opposite direction of picture below Trying to open the medial joint line Varus stress LCL damage Same as above Pt knee in 20- 30 of flexion
Trying to open the lateral joint line Lachman ACL instability- gold standard! Abnormal forward mobility
Anterior drawer test
ACL instability Abnormal forward mobility *Beware of false +with PCL tear! Test Checks for Positive if Notes Picture Pivot shift ACL instability Feel clunking of tibia when moving into extension
Posterior drawer test PCL instability Abnormal downward mobility
Sag sign PCL tear Depression on anterior knee
Quad active test PCL tear Depression on anterior knee with quad flexion
Dial test @ 30 of flexion PCL Abnormal motion of tibial tubercle
McMurray test
Meniscus tear Click or catch For medial: external rotation +flexion + valgus stress For lateral: internal rotation +extension + varus stress
Test Checks for Positive if Notes Picture Apley grind with distraction Meniscus tear Pain with grind, NO pain with distraction (pain with both suggests ligament injury) Grind- push down on foot and rotate back and forth. Distraction- do the same but push down on thigh as well.
Obers test ITB tightness Leg remains elevated
Nobles test ITB syndrome Pain Pt repeatedly flexes and extends knee under providers thumb @ ITB
Ballottement test Major effusion in knee joint Fluid felt Squeeze fluid down from above knee and feel on either side of patella for fluid
Bulge sign Minor effusion in knee joint Fluid felt Squeeze fluid up medially, then tap laterally and watch for medial bulge
Anterior drawer test Laxity of anterior talofibular ligament Increased movement or sulcus sign
Talar tilt Laxity of calcaneofibular ligament/sprain Increased movement or pain
Test Checks for Positive if Notes Picture Thompson test Achilles rupture No movement of foot with gastroc squeeze
Squeeze test for fx Fracture of tibia or fibula Pain upon release of squeeze in an area that is NOT being squeezed Squeeze up and down leg in several places
Squeeze test for tear Anterior tibiofibular ligament tear or syndesmosis tear Pain upon release of squeeze Squeeze just above anterior talofibular ligament
External rotation test Anterior tibiofibular ligament tear Pain