of the shoulder under 20 degrees. Employ active-assisted movements to strengthen muscles. Wright’s hyperabduction test (Testing for neurovascular compression due to hypertension of the pectoralis minor muscle.) The client is in a seated position. Therapist abducts the arm to 180 degrees, then slightly extends the arm. The therapist then monitors the client’s radial pulse. A positive result will be indicated by numbness or tingling in the client’s arm or hands or by a diminished radial pulse. The therapist massage the scalene and pec minor area of the affected side to relieve compression on the brachial plexus nerve bundle. Acromionclavicular (AC) joint shear test (Testing for the integrity of the AC joint ligaments.) The client is in a seated position. The therapist stands behind the client. Therapists interlaces their fingers with the palm of one hand on the lateral aspect of the clavicle and the other palm on the client’s scapula. The therapist squeezes their hands together. Dysfunctional AC joint ligaments will be indicated by pain or excessive movement of the joint. The therapist should use cold therapy to reduce pain and avoid moving the shoulder joint. Adhesive capsulitis abduction test (Testing for the Frozen Shoulder / ROM at the glenohumeral joint.) The client is in a seated position. The therapist stands behind the client and palpates the inferior angle of the scapula with one hand. The therapist’s other hand holds the client’s arm above the elbow and abducts the client’s arm slowly out to 90 degrees. Frozen shoulder will be indicated by pain with a limited ROM before 90 degrees. The therapist should massage any hypertensive muscles around the affected shoulder, but should advise the client that massage cannot help this chronic condition since its cause is unknown. Drop arm test (Testing for a dysfunction of the supraspinatus muscle and tendon.) The client is in a seated position. The client abducts their arm to 90 degrees, holds, then slowly adducts (adds) (Testing for tendonitis of the biceps brachii muscle.) The client is in a seated position. The client fully extends their arm and supinates their forearm. The therapist stands behind the client and resists the client’s attempt to flex their arm at the elbow. Tendonitis of the bicep brachii is indicated by pain at either the muscle’s origin or insertion. Apply cold therapy to reduce inflammation and use cross-fiber friction to massage the area. Yegason’s test Assessments for the arm Speed’s test (Testing for the integrity of the bicep brachii tendons.) The client is in a seated position. The therapist stabilizes the client’s arm against the client’s body. The client then actively supinates and extends their forearm at the elbow while externally rotating the humerus. Pain at the humerus’ bicipital groove indicates a tendon dysfunction of the (long head of the) biceps brachii. Apply cold therapy at the affected shoulder and avoid ROM movements. Upper limb tension test 1 (Testing for nerve impingement at C5-C7 as a cause of upper limb or shoulder pain.) The client is supine on the table with their arms at their side. The therapist applies compression to the affected shoulder while taking the client’s wrist and abducting the arm to 110 degrees. The therapist then extends the arm posteriorly 10 degrees while externally rotating the arm to approximately 60 degrees. The therapist then slowly extends the client’s fingers. A nerve impingement between C5-C7 will cause pain of the arm or shoulder. The therapist should massage the base of the neck to relieve hypertension which may relieve the impingement. Upper limb tension test 2 (Testing for nerve impingement of median nerve or axillary nerve as a cause of upper limb or shoulder pain.) The client is supine
their arm to their body. A supraspinatus muscle dysfunction is indicated by pain or the client being unable to slowly or smoothly adduct their arm. Apply hot or cold therapy as the client’s muscle indicates. Hawkins Kennedy impingement test (Testing for injury to the supraspinatus muscle or tendon.) The client is in a seated position. The client abducts their arm to 90 degrees then internally rotates their humerus at the elbow. A supraspinatus muscle dysfunction or injury is indicated by pain at the acromion. Apply hot or cold therapy as the client’s muscle indicates. Infraspinatus strength test (Testing for the strength of the infraspinatus muscle.) The client is in a seated position. The client abducts their arm to 90 degrees then flexes at the elbow to 90 degrees. The therapist tries to internally rotate the client’s humerus while the client resists by externally rotating their humerus. An infraspinatus muscle dysfunction or injury is indicated by pain in the infraspinatus muscle or along the superior lateral border of the scapula. Painful arc test (Testing for a supraspinatus tendon and subacromial bursa impingement.) The client is either seated or standing. The client abducts their arm through its full ROM. A positive result is indicated by pain at the acromion starting at 70 degrees of abduction and easing after 130 degrees of abduction. Apply hot or cold therapy as the client’s muscle indicates. Subscapularis strength test (Testing for a dysfunction of the subscapularis muscle.) The client is in a seated position. The client flexes their elbow to 90 degrees. The therapist directs pressure towards external rotation while the client tries to resist by internally rotating the humerus. Weakness of the subscapularis will be indicated by pain or the client being unable to resist external rotation of their humerus. The therapist should employ active-assisted exercises to strengthen the subscapularis muscle. on the table with their affected arm near the edge of the table. The therapist applies compression on the affected shoulder then abducts the arm to 10 degrees. The therapist then extends the fingers while supinating the forearm and extending the elbow. A nerve impingement of the median nerve or axillary nerve will cause pain of the arm or shoulder. The therapist massages muscles near the lateral border of the scapula, the scalene and pec minor area of the affected side to relieve hypertension near the axillary nerve. Upper limb tension test 3 (Testing for nerve impingement of the radial nerve as a cause of upper limb or shoulder pain.) The client is supine on the table with their affected arm near the edge of the table. The therapist applies compression on the affected shoulder then abducts the arm to 10 degrees. Therapist then flexes the client’s fingers while bringing the wrist into medial deviation. Therapist then pronates 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 shoulder, arm and forearm of the affected side with as deep pressure as the client’s pain tolerance will allow. Note that further nerve impingement should be avoided, so the therapist should communicate with the client about burning, tingling or numbing sensations. Upper limb tension test 4 (Testing for nerve impingement of the ulna nerve as a cause of upper limb or shoulder pain.) The client is supine on the table with their affected arm near the edge of the table. The therapist applies compression on the affected shoulder then abducts the arm to 90 degrees. Therapist then flexes the client’s elbow while supinating the forearm. Therapist then extends the fingers while bringing the wrist into lateral deviation. A nerve impingement of
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Book Code: MLA1224
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