ORTHOPEDIC TESTS FOR THE ARM, ELBOW AND WRIST
Speed’s test Testing for tendonitis of the biceps brachii muscle. The client can be in a seated or standing position. The client fully extends their arm and supinates their forearm so that the palm of their hand is facing the floor. The client is then asked to flex their elbow Yergason’s test Tests for the integrity of the bicep brachii tendons. The client can be in a seated or standing position while the massage therapist stabilizes the client’s arm against the client’s body at the wrist and elbow. The client then supinates their forearm and Upper limb tension test I Tests for nerve impingement at C5-C7 as a cause of upper arm or shoulder pain. The client should be lying supine on the table with their arms at their side. Make a note that the client should be lying close to the edge of the table on the side being tested. The massage therapist takes the client’s wrist, flexes the client’s elbow to 90 degrees, and abducts the arm to just over 90 degrees. The therapist then extends the arm 10 degrees while Upper limb tension test 2 Tests for nerve impingement of the median or axillary nerves as a cause of upper limb or shoulder pain. The client should be supine on the table with their affected arm near the edge of the table. The massage therapist applies an inferiorly directed compression to the affected shoulder with their hip, then abducts the arm to 10 degrees. The therapist leans forward and extends the client’s fingers while supinating the forearm and Upper limb tension test 3 Tests for a nerve impingement of the radial nerve as a cause of upper limb or shoulder pain. The client should be supine on the table with their affected arm near the edge of the table. The massage therapist applies an inferiorly directed compression to the affected shoulder then abducts the arm to 10 degrees. The therapist keeps the client’s hand face down, leans forward and medially rotates the arm, then flexes the client’s fingers while bringing the wrist into ulnar deviation. If no symptoms arise, the Upper limb tension test 4 Tests for a nerve impingement of the ulna nerve as a cause of upper limb or shoulder pain. The client should be supine on the table with their affected arm near the edge of the table. The massage therapist applies an inferiorly directed compression to the affected shoulder then abducts the arm to 90 degrees. The therapist then flexes the client’s elbow while supinating the client’s forearm to the end of its ROM. The therapist then extends the client’s fingers while bringing the wrist into Golfer’s elbow test Tests for medial epicondylitis of the humerus. The client may be seated or standing and should flex their elbow to 90 degrees with their palm face up. Their fingers should be flexed into a fist. The massage therapist palpates the medial epicondyle with one Tennis elbow test Tests for lateral epicondylitis of the humerus. The client may be seated or standing and should flex their elbow to 90 degrees with their palm face down. Their fingers should be flexed into a fist. The massage therapist palpates the lateral epicondyle with one hand while maintaining a grip on the back of the client’s Pinch-grip test Tests for a compression or dysfunction of the anterior interosseous nerve. The client may be seated or standing and asked to pinch their thumb and index finger together. A lack of Flick test Tests for carpal tunnel syndrome. This simple test involves the massage therapist asking the client what they do when they feel carpal tunnel syndrome symptoms (i.e. tingling, numbness, burning and/or pain in the palm, thumb, index and/or middle
to 90 degrees while the massage therapist stands behind the client and resists the client’s attempt at flexion. Tendonitis of the bicep brachii is indicated by pain at either the muscle’s origin or insertion.
extends their elbow while laterally rotating their arm. Pain at the humerus’ bicipital/intertubercular groove indicates a tendon dysfunction at the origin of the (long head of the) biceps brachii.
laterally rotating the arm to approximately 60 degrees. Once in this position, the therapist slowly extends the client’s wrist and fingers. A nerve impingement between C5-C7 will cause pain of the arm or shoulder. The therapist should focus on massaging the base of the neck to relieve any hypertonic muscles which may be causing the impingement. making sure the elbow is fully extended. A nerve impingement of the median or axillary nerves will cause pain in the upper arm or shoulder. The therapist should focus the massage near the lateral border of the scapula for hypertonicity in teres minor and deltoid, and the scalenes and pectoralis minor area of the affected side to relieve any hypertonicity near these nerves. therapist may then pronate the forearm while bringing the arm into extension. A nerve impingement of the radial nerve will cause pain of the arm or shoulder. The therapist should massage the entire anterior shoulder, arm and radial side of the forearm of the affected side. Note that further nerve impingement should be avoided, so the therapist should communicate with the client about burning, tingling or numbing sensations during the massage. extension. A nerve impingement of the ulna nerve will cause pain of the arm or shoulder. Similar to the previous test, the therapist should massage the entire anterior shoulder, arm and ulnar side of the forearm of the affected side. Again, further nerve impingement should be avoided, so the therapist should communicate with the client about burning, tingling or numbing sensations. hand while maintaining a grip on the client’s wrist with the other hand. The therapist then supinates the client’s forearm while extending the elbow and wrist. A positive result is indicated by pain or discomfort in the area of the medial epicondyle. hand. The therapist first resists the client’s attempt to place their wrist in extension and second, the client moving their wrist into radial deviation. A positive result is indicated by pain or discomfort in the area of the lateral epicondyle.
strength or an inability to do so may indicate hypertonic forearm flexor muscles.
fingers). If the client flicks their wrist, this is considered a positive indicator of the pathology. The therapist should start with light myofascial release of the entire flexor retinaculum of the wrist before addressing hypertonicity in the forearm.
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Book Code: MTX1324B
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