Msk Shoulder, Elbow, Wrist

Front 1

Shoulder Joint Positions

Back 1

Loose Packed - 55ﾟ AB, 30ﾟ horizontal AD, neutral rotation.

Closed Packed - max AB and ER

Capsular pattern

Joint mob direction

Convex humeral head + concave fossa = opposite direction. To improve internal rotation, perform posterior mobilization. To improve external rotation, perform anterior mobilization. To improve AB, perform inferior glide. To improve shoulder flexion, perform posterior inferior glide.

Front 2

Muscles That Act on the Shoulder

Back 2

N

Front 3

Scapulohumeral Rhythm

Back 3

After 30 to 60ﾟof elevation of the GH joint there will be a 2:1 ratio.

120° at the GH joint + 60 ° at the scapulothoracic joint.

Front 4

Upward Rotation vs. Downward Rotation of the Scapula

Back 4

Upper traps, lower traps, serratus anterior upwardly rotate the scapula when the arm goes overhead.

Rhomboids, levator scapula, pectoralis minor downwardly rotate the scapula when the arm comes down.

Front 5

Shoulder Dislocation

Back 5

H

Front 6

Apprehension Test

Back 6

Posterior test is testing for posterior instability.

The patient is supine or sitting, 90ﾟ of flexion. Examiner places posterior force with horizontal ADD and IR.

Any apprehension is a positive test

Anterior test - testing for traumatic instability.

Arm ABD to 90ﾟ. Clinician moves into ER.

Any apprehension is a positive test.

Front 7

Bicep Tendon Pathology

Back 7

H

Front 8

O'Brien's Test

Back 8

Testing for a slap lesion of the shoulder.

Patient is standing with 90ﾟ of flexion, max IR, press down. Repeat the test with max ER.

Any pain or painful clicking inside the shoulder during IR but not during ER equals positive finding.

Front 9

Yergason's Test

Back 9

Testing for a torn transverse humoral ligament / bicipital tendonitis or tendonosis.

Patient is sitting, elbow 90ﾟ of flexion, forearm pronated. Patient supinates against resistance.

Any tenderness in the bicipital groove is a positive test.

Front 10

Rotator Cuff Pathologies

Back 10

Impingement

Primary impingement - bony abnormality, hooking of the chromium.

Secondary impingement - functional abnormality, rotator cuff dysfunction or weaknes.

Rotator Cuff Tears

Front 11

Biceps Load Test

Back 11

H

Front 12

Hawkins Kennedy Impingement Test

Back 12

Testing for shoulder impingement.

Arm in 90ﾟof flexion and 90° elbow flexion. Examiner moves into internal rotation.

Any pain is a positive test.

Front 13

Neer Impingement Test

Back 13

Testing for overuse injury of the supraspinatus muscle or biceps tendon.

Patient is in full shoulder flexion.

Any pain is a positive test.

Front 14

Painful Arc

Back 14

Testing for subacromial impingements / AC joint.

Patient moves through full AB.

If there is pain at 60 to 120ﾟ= Subacromial Impingement Sundrome.

If there is pain at 170 - 180 = AC joint pain.

Front 15

Empty Can / Jobe Test

Back 15

H

Front 16

Speeds Test

Back 16

This is a test for a superior labral or tendonitis of the shoulder.

90° of shoulder flexion with full elbow extension and supination.

The examiner pushes downward.

Tenderness or pain in the biciptal groove is a positive test.

Front 17

Drop Arm Test

Back 17

Testing for rotator cuff tear (supraspinatus) Patient is upright, arm AB 90 - 120°. They are asked to slowly lower the arm. If the patient cannot return the arm slowly or has severe pain - positive test.

Front 18

Internal Rotation Lag Sign

Back 18

IR lag sign is testing for subscapularis tear (rotator cuff)

Patient is sitting and placed into IR.

If the patient is unable to maintain IR position once PT lets go - positive sign.

Front 19

Thoracic Outlet Syndrome

Back 19

H

Front 20

Adson Maneuver

Back 20

H

Front 21

Roos Test

Back 21

H

Front 22

Allen Test

Back 22

H

Front 23

Adhesive Capsulitis

Back 23

H

Front 24

Supraspinatus Test

Back 24

The ER lag sign is testing for a tear of the supraspinatus or infraspinatus tendon (rotator cuff)

The patient is sitting and put into ER.

If they're unable to maintain ER once the PT lets go, this is a positive test.

Front 25

Infraspinatus Test

Back 25

H

Front 26

Cozen's Test

Back 26

H

Front 27

Valgus / Varus Stress Test

Back 27

H

Front 28

Lateral Epicondylitis Test

Back 28

H

Front 29

Medial Epicondylitis Test

Back 29

H

Front 30

Epicondylitis

Back 30

H

Front 31

Elbow Ligament Instability

Back 31

H

Front 32

Elbow Joint Positions

Back 32

Loose packed

Open packed

Capsular Patten

Joint mobilization rule

Front 33

Muscles that act on the elbow

Back 33

H