Test/Sign Procedure (+) IND
Dawbarn Sign Passively abduct the Pain in the painful Subacromial
shoulder/arm while palpating a spot disappears with Bursitis
tender subacromial area arm abduction
Apley Test Superior: Pt approximates their Exacerbation of pain Rotator Cuff
hand behind their head towards Tendinopathy/
the top of the opposite shoulder Tendinitis (esp.
blade Supraspinatus)
Inferior: Pt approximates their
hand behind their back towards
bottom of opposite shoulder
blade
Empty Can Weakness & Pain Supraspinatus
Test Tendinopathy
Full Can Test Other:
is same Impingement
except
Thumbs up
Codman’s Examiner passively abducts pt’s Inability to hold up Supraspinatus
Drop Test arm above 90 and without arm after examiner Tear
warning, let's go of it. relief AND/OR
Deltoid hunching
Subacromial Thump pressure toward midline Production/increase Supraspinatus
Push Button of clavicle in shoulder pain Tear
Sign
Supraspinatus Weakness or Pain Supraspinatus
Press Test Tear
Rent Test 1.Passive extension elbow Palpation of adjacent Full thickness tear
flexed and IR rent depression
2.Examiner IR/ER humerus
while palpating AC
External First Position: Drifting of arm into Rotator Cuff Tear
Rotation Lag Support patient’s elbow and ER IR
Sign shoulder then back off 5 degrees
2nd: Release arm but support
elbow as it may “drift” into IR
Lateral Jobe Patient’s arm is abducted 90 Pain/Weakness Rotator Cuff
Test degrees and examiner places a Tendinopathy/
45 degree anterior-downward Tear
force onto the humerus
Belly Press Patient puts a hand on the Patient can’t press Subscapularis
stomach and pushes as against the belly Tear
hard as possible. while rotating the
shoulder
Belly Off •Examiner removes hand from Pt can’t maintain the Subscapularis
patients palm and asks position and hand Tear
patient to maintain their lifts off belly
hand on abdomen
Bear Hug Examiner resists internal rotation Pain/Weakness Subscapularis
in this position Tear
Gerber Lift Off Pt arm is internally rotated such Shoulder is used to Subscapularis
that the hand is placed on the “lift off” instead of Tear
lumbar spine and tries to push muscle
arm away from body
Load & Shift P-A: Anterior Glenohumeral
Test Instability Instability
A-P: Posterior
Instability
Sulcus Sign Performed 2x—once at 0 Subluxations Graded Glenohumeral
degrees of abduction and once 1-3: Instability
at 45 degrees 1+: <1cm
Pull distally on the extremity and 2+: 1-2cm
observe for a sulcus/dimple b/w 3+: >2cm
the humeral head and acromion
Apprehension Anterior (Sitting): Abduction & Apprehension or Anterior/Posterior
Test ER resist motion Dislocation
Posterior (Supine): Flexion & IR -Glenohumeral
Instability
Relocation •Repeat Apprehension test but Relief of pain or Glenohumeral
Test the examiner applies A-P visible signs of Instability
force to relieve pain or apprehension
sense of apprehension
Bryant Sign Observe axillae Lowering of axillary Dislocation /
fold Glenohumeral
Instability
Calloway Test Tape measure around axilla Affected joint girth > Dislocation/
unaffected joint Glenohumeral
Instability
Dugas Test Pt places the hand on the Pt can’t touch the Shoulder
opposite shoulder and attempts chest wall with the Dislocation/GH
to touch the elbow to the chest elbow Instability
Hamilton Test Straight edge measurement tip Lateral epicondyle Dislocation/
of shoulder to lateral epicondyle and tip of shoulder Glenohumeral
line up such that the Instability
straight edge can
rest upon them
Transverse Affected shoulder is passively Snap in & out during Transverse
Humeral abducted, IR and then ER while external rotation Humeral Ligament
Ligament Test the examiner’s fingers are in the
bicipital groove
Yergason Test Pt flexes elbow and tries to flex Pain over 1.Transverse
and supinate their arm against intertubercular Humeral Ligament
the examiner’s groove 2. Tenosynovitis
extension/pronation resistance 3.SLAP lesion
Abbott Examiner fully abducts and ER Palpable or audible Biceps
Saunders Test pt’s arm and then lowers it to the click Tendinopathy
side
Ludington Absence of Muscle Biceps
Test contraction Tendinopathy
Esp. LHB
Speed Test Pt supinates and extends the Increased bicipital 1.Biceps
elbow at the forearm while groove tenderness Tendinopathy/itis
examiner resists this 2.SLAP Lesion
Neer Arm is elevated through forward Pain Subacromial
Impingement flexion by the examiner Impingement
Test
Hawkins Examiner flexes shoulder and Pain Subacromial
Kennedy Test elbow to 90 and then IR (bring Impingement
flexed arm across the torso)
*can be
seated or
standing
Impingement Pt’s arm is slight abducted and Shoulder Pain Subacromial
Sign moved fully through flexion Impingement
Crank Test 1.Maximal Flexion Painful clicking Labral Tear
2.IR/ER
Kim Test 1.Passive shoulder elevation to Sudden onset of Labral Tear
90 with axial load while lifting the pain
distal humerus (radial deviate up
after axial load)
Jerk Test 1.Passively elevate the shoulder Pain w/ or w/out Labral Tear
to 90 and stabilize the scapula clunk
2.Apply axial compression while
horizontally adducting the
shoulder
Anterior Slide Examiner stabilizes shoulder Painful click or pop SLAP Tear/Lesion
Test while pushing long axis (axial
load) of humerus in a
superoanterior direction—pt
must resist
O’Brien’s Sign 1.Full IR (thumb down) with Pain relief with the SLAP Lesion/Tear
horizontal adduction (10-15) thumbs up position OR
2.Examiner applies pressure AC pathology is
REPEAT SAME PROCEDURE *if pain remains pain stays same
WITH THUMB UP same=AC pathology
Biceps Load 1.Passive 120 degrees ER, Pain during SLAP lesion
Test II elbow flexion and supination with attempted elbow
pt supine raise
2.examiner asks patient to flex
elbow while examiner resists
Test unaffected and affected side
Shoulder LR Clusters (Souza)
1. Instability/Labrum Tear:
a. Apprehension/Relocation (instability)
b. Biceps Load II (SLAP)
c. Jerk or Kim Test (for Posterolateral Labrum Tear)
2. Rotator Cuff Tear
a. Age 60+, Painful arc
b. Drop Arm
c. Infraspinatus Muscle test
d. Rent Test
3. Subacromial Impingement
a. Internal Rotation test (weaker than external rotation)
b. Hawkins-Kennedy, Painful Arc, Infraspinatus Muscle Test
4.
SHOULDER CONDITION CROSS REFERENCE CHART
A. GH Instability/Dislocation
1. Anterior/Posterior Apprehension
2. Sulcus Sign
3. Load & Shift Test
4. Relocation Test
5. Bryant Sign
6. Dugas Test
7. Calloway Sign
8. Hamilton Sign
B. Labral Tears
1. Crank Test
2. Kim Test
3. Jerk Test
C. SLAP Lesion/Tear
1. Yergason
2. Speed
3. O’Brien Sign
4. Biceps Load Test II
D. Rotator Cuff Tears
1. Codman/Drop Arm Test
2. Empty/Full Can Test
3. Rent Test
4. External Rotation Lag Sign
5. Lateral Jobe Test
6. Apley Test
7. Subacromial Push Button Sign
E. Supraspinatus
1. Empty/Full Can Tests
2. Supraspinatus Press Test
3. Impingement Sign
F. Impingement Syndrome
1. Impingement Sign
2. Hawkins-Kennedy
3. Neer Impingement
4. Empty/Full Can Tests
G. Biceps Tendinopathy
1. Yergason
2. Speed
3. Abbott-Saunders Test
4. Ludington Test
5. Transverse Humeral Ligament Test
H. Subscapularis
1. Belly Off Sign
2. Belly Press Sign
3. Bear Hug Test
4. Gerber Lift Off Test
I. Subacromial Bursitis
1. Dawbarn Sign
J. Any Shoulder Pathology
1. Mazion Shoulder Maneuver
