Manual Muscle Testing Shoulder Girdle StrengtheningThe manual muscle examination for. The electromyographic activity of eight muscles of the rotator cuff and shoulder girdle (supraspinatus. Scapula MMT John Nulty. Subscribe Subscribed Unsubscribe 44 44. IC Kines 12,878 views. 18:37 Scapula and Shoulder Range of Motion and Manual Muscle Testing Demonstration Videos. Insidious Onset of Shoulder Girdle Weakness Shane a. Left Shoulder Manual Muscle Testing After the Onset of Symptoms* motion Day 4 Day 5 week 3 week 7 week 10 Flexion 1 2 2+ 4+ 5 Abduction 1 2 2+ 4+ 5. Shoulder Examination Tests. Manual Muscle Testing #1. The therapist places one hand on the shoulder and the other hand on. Muscle Testing Form Anatomically Order Begin/End Name: Date. Left Right SR NL NV MT AH OI AP PP Teres Major OK. The manual muscle examination for rotator cuff strength. An electromyographic investigation. Shoulder Impingement Syndrome Clinical Presentation. The entire shoulder girdle is palpated. Manual muscle testing. Concentrate on assessing the shoulder girdle muscles. Manual Muscle Testing Shoulder Girdle ExercisesShoulder Examination Tests . Many similar tests have been described by different people and given different names. Also, many different tests have been described by the same person. This can cause confusion. So far, I have tried to collect as many of the tests I can find and list them here. So far I have found 1. I hope to add descriptions, videos and references for the tests soon. If you have a description, reference or even a test not listed here, please contact us . Also, some of the descriptions or names below might be incorrect. Please contact us if you find inaccuracies below. SHOULDER CLINICAL TESTS 1. General Shoulder Pathology- Mazion Shoulder Maneuver - - Pt. Places hand on opposite shoulder, moves elbow to forehead - (+)intensifies & localized pain - Codman Sign - tests passive motion of shoulder. Examiner stands behind patient and stabilises scapula with one hand, whilst other hand holds patient's arm and moves arm in every direction. In early stages of cuff disease only active motion is reduced, but later passive motion reduces. Seated & instructed to place hand on opposite shoulder and touch elbow to chest - (+)pain & inablility to perform indicates dislocation - Calloways - - measure girth of affected shoulder & compare to unaffected - (+)increased girth indicates dislocation - Bryants Sign - look for lowering of axillary fold - (+)dislocation on low side Anterior Instability- Anterior Load and Shift (laxity test) - - Anterior Drawer Test ( Gerber- Ganz Anterior Drawer Test) - Pt. Examiner immobilisers scapula with one arm whilst the other grasps the arm and pulls it anteriorly. Anterior subluxation may occur. Displacement of the index finger is positive - Surprise/Release Test - This manoeuvre is variously described but essentially is the fmal component of the apprehension and relocation tests. It is an extremely provocative test and should be used with caution. As in the Jobe relocation tests the patient's arm is maximally externally rotated with a posteriorly directed force applied to the humeral head. At the limit of range the examiner suddenly removes the posteriorly directed force from the relocation test and again a feeling of apprehension is considered a positive test. In so doing, a subluxation of the humeral head is provoked and it is accompanied with a jerk recognised by the patient as his instability. A positive result should alert the examiner to the possibility of a bony lesion as the cause of symptomatic shoulder instability. Arthroscopy 2. 00. Kinetic Medial Rotation Test - used to differentiate to help determine whether symptoms are primarily impingement or instability. The subject lies supine with 9. The assessor places one finger on the coracoid process and one on the humeral head. The subject is asked to actively medially rotate the humerus. The ideal is 7. 0deg rotation without any finger movement. If the coracoid finger moves before 7. If the humeral finger moves before 7. If both fingers move forward then there is a combined impingement and instability risk. This test obviously needs to be used with other instability and impingement tests to confirm diagnosis but it is a good rehab indicator for where the primary focus should be. Manual Therapy 2. Posterior Instability- Posterior Load and Shift - Posterior Drawer Test - Gerber- Ganz Posterior Drawer Test- same as anterior drawer except with posterior force. Examiner pushes posteriorly - apprehension positive. The examiner stands with thumb resting on scapula spine and fingers over front of humeral head exerting a posterior force. Inferior Laxity- Gagey's Hyperabduction Test- Sulcus Sign at 0 Degrees - Sulcus Sign at 9. Inferior Apprehension Test - The examiner supports the 9. With the other hand the examiner tries to invoke an inferior subluxation by applying pressure downward on the patients upper arm. Core Stability- Kibler's Corkscrew test - for core instability SLAP Lesions- O'Brien's Test - Anterior Slide Test (Kibler) - Pt sitting with hands on hips and thumbs pointing posteriorly. Examiner places on hand on top of affected shoulder and other hand on point of elbow. Examiner then applies a forward and superior force on the elbow. Pt asked to resist this force. Pain over the front of the shoulder or a click is positive. An axial load is applied while the arm is rotated internally and externally and circumducted. A click associated with pain makes the test positive. This mechanism is similar to the Mc. Murray test for a torn meniscus in the knee. From this position a valgus stress is applied and a positive response is signified by pain at the shoulder. The Shoulder and the Overhead Athlete) - Pain Provocation Test - Examiner places one hand over scapula, whilst other hand hold patient's wrist. The patient's arm is in 9. ER, with elbow flexed 9. Pain worse on pronation indicates a SLAP tear. Am J Sports Med, 1. The Resisted Supination External Rotation Test - Original Article - The Passive Compression Test - Original Article - Patient position: lateral decubitus position with affected side up. The examiner standing behind patient, stabilising the affected shoulder by holding the AC joint with one hand and the elbow with the other. The examiner externally rotates the shoulder in 3. Confirmatory findings: pain or a painful click in the glenohumeral joint. Test rationale: with glenohumeral external rotation and extension (late cocking phase), the long head of the biceps tendon is placed under tensile forces while wrapping around the lesser tuberosity and ultimately shifting the superior labrum from the superior glenoid rim. Proximal migration of the humerus aggravates the displacement of the unstable labrum and passively displaces the superior labrum. Am J Sports Med 2. Passive distraction test - Patient position: supine. The examiner standing on the affected side of the patient and positions the extremity off the edge of the table, into 1. The examner pronates the forearm while maintaining steady position of the humerus. Confirmatory findings: pain reported deep inside the glenohumeral joint either anteriorly or posteriorly. Test rationale: peel- back phenomenon of the superior labrum. Arthroscopy 2. 00. The passive distraction test may be used for ruling in a SLAP lesion while the passive compression test may be used for both ruling in and ruling out a SLAP lesion. Seated & places both hands behind head with interlocked fingers, pt. Contracts & relaxes biceps while Dr. Seated, passive abduction, external rotation and lowering of arm, Dr. Palpates long head tendon- (+)a palpable click indicates dislocation of biceps tendon - Transverse Humeral Ligament Test - Pt. Seated, passive abduction of arm with elbow extended, shoulder is then internally rotated & externally rotated, Dr. The examiner palpates the biceps groove with one hand whilst the other hand rotates the shoulder. The asked to flex elbow against resistance. Formation of a biceps 'ball' shows a LHB rupture. AC Joint - Anterior/Posterior AC Shear Test - Pt. Phys Sports Med 1. Cross chest Adduction (Scarf / Forced Adduction Test) - the 9. In Andrews JR, Willk KE (eds): The Athlete's Shoulder. New York, Churchill Livingstone. The examiner forcible adducts the hanging affected arm behind the patient's back against the patient's resistance. A positive test is pain at the top of the shoulder. Pressure is applied by the thumb in an anterosuperior direction and inferiorly with the index- middle finger to the midshaft of the clavicle. The Shoulder and the Overhead Athlete) Subacromial Impingement - see Impingement Presentation - video of Impingement examination tests - Neer Sign - pain with passive abd. If pain disappears with increasing abduction this indicates bursitis - Coracoid Impingement Test - pain directly over coracoid with arm passively adducted across chest (distingiush from ACJ scarf test) - Internal Rotation Resistance Strength Test (IRRST) - The subject is asked to maximally resist first external rotation and then internal rotation with the arm in 9. ER. Pain = positive for bursitis. The examiner then applies an inferior and posterior force on the humeral head during the painful phase, which relieves the impingement pain. This eliminates the impingement mid- arc pain in patients with dynamic / secondary impingement and indicates scapula rehabilitation exercises are required (Rabin et al. J Orthop Sports Phys Ther. Shoulder Symptom Modification Procedure (SSMP) (Jeremy Lewis, 2. A series of four clinical tests to guide management - see here. Rotator Cuff - video of rotator cuff tests 1. Supraspinatus: - Apley's Scratch Test - Reach over shoulder to . Measure to which vertebrae thumb can reach - Jobes Supraspinatus test (also called ' Empy can test ') - Dawburn's sign - The pain is worse when lowering the arm from overhead - Sherry Party sign (Roger Emery) - Codman's Sign (Drop Arm Sign) - A sign seen in the absence of rotator cuff function or when there is a rupture of the supraspinatus tendon: the arm can be passively abducted without pain, but when support of the arm is removed and the deltoid contracts suddenly, the pain produced causes the patient to hunch the shoulder and lower the arm.(E. Codman: The Shoulder: Rupture of the Supraspinatus Tendon and Other Lesions in or about the Subacromial Bursa. Boston : Privately printed, 1. Reprint, Malabar, Florida : Krieger, 1. Rent Test - Described by Codman. Palpation of a supraspinatus tear through the deltoid. This is accomplished in a relaxed patient at the anterolateral border of the acromion. JSES 2. 00. 1 ) - Zero Degree Abduction Test - Patient standing with arms by their side. Reisted abduction causing pain or weakness suggests a rotator cuff tear. If the patient has to make compensatory motions or is able to place one hand behind the neck only with assistance this may indicate a rotator cuff tear.
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