Special test for Shoulder - Test for Massage Therapist

To test Thoracic Outlet Syndrome(TOS)

Anterior Scalene Syndrome : Brachial plexus and subclavian artery are compressed between the Ant. and Middle sclane. It causes neck pain and radiating down to the arm a
1. Adson’s Test
  1. Extend and slightly externally rotate the affected arm, then monitor the radial pulse of the arm
  2. Rotate the head towards affected side, to slightly elevate chin and to take a deep breath, holding it the breath –> This action make compress the neurovascular bundle aginst the tight the anterior scalene muscle
  3. Positive sign : diminished radial pulse and/or numbness, tingling on the hands and fingers
2. Travell’s Test
  1. Extend and slightly externally rotate the affected arm, then monitor the radial pulse of the arm
  2. Rotate the head away from the affected side and to take a deep breath, holding it the breath –> This action make compress the neurovascular bundle aginst the tight the middle scalene muscle
  3. Positive sign : diminished radial pulse and/or numbness, tingling on the hands and fingers
Costoclavicular Syndrome: Brachial plexus and subclavian artery/vein are compressed between the 1st rib and clavicle
1. Eden’s Test
  1. Monitor the affected arm’s radial pulse
  2. Client bring the shoulders as fas into retraction and depression as possible
  3. Positive sign : diminished radial pulse and/or numbness, tingling on the hands and fingers
2. Costoclavicular Test
  1. Monitor the affected arm’s radial pulse
  2. Passively depress and retract the shoulder of the affeced arm
  3. Positive sign : diminished radial pulse and/or numbness, tingling on the hands and fingers
Pectoralis minor Syndrome : Brachial plexus and Axillary artery/vein are compressed by pectoralis minor
1. Wright’s hyperabduction Test
  1. Passively fully abduct the client’s affented arn to 180 degree and then slightly extend the arm.
  2. Monitor the radial pulse as the arm is held in hyperabduction
  3. Positive sign : diminished radial pulse and/or numbness, tingling on the hands and fingers
If TOS caused by cervical rib
1. The fourth type of thoracic outlet syndrome, cervical rib syndrome, cannot be reliably assessed with orthopedic testing, although it will usually show positive with Adson’s test. A cervical rib is usually assessed/diagnosed via radiography (X-ray). When large enough, a cervical rib can be palpable.
Roos test

Upper Limb Tension Test = The Brachial Plexus Tension or Elvey Test

To determine whether cervical nerve roots and peripheral nerves are the source of the client’s houlder or arm pain. The main reason for using a ULTT is to check cervical radiculopathy.
These tests are both diagnostic and therapeutic.
Place the client is a supine position for all four tests, with the side to be tested close to the edge of the table. With one hand, grasp the client’s shoulder and apply a constant depressive forece to it. With the other hand, hold the client’s wrist and move the arm into the various positions
Neurodynamic Assessment – Physiopedia (physio-pedia.com)

Rotator cuff pathology

Empty Can Test = Supraspinatus strength test, AR
1. To assess for supraspinatus tendinities, strain or weakness
  1. Jobe / Empty Can Test | Subacromial Pain Syndrome (SAPS) – YouTube
  2. Positive result : Pain or weakness
Drop Arm test
Infraspinatus Strength Test, AR
1. To assess the infraspintus for tendinits, strain or weakness
  1. Abduct the humerus to 90° and flex the elbow to 90° —> Apply pressure to the client’s wrist in the direction of internal rotation, while the client attempts to externally rotate the humerus
  2. Examination of the Rotator Cuff – Infraspinatus Test – Clinical Examination – YouTube
  3. Positive : pain along infraspinatus or weakness
Subscapularis Strength Test, AR
1. To assess the subscapularis for tendinitis, strain or weakness
  1. flex the elbow to 90° —> Apply pressure to the client’s wrist in the direction of external rotation, while the client attempts to internally rotate the humerus
  2. Positive : Pain along subscapularis or weakness
Lift off test
1. To assess Subscapularis tear or weakness or tendonitis

Shoulder Impingement

Neer Test
1. To assess for overuse injury to the supraspinatus tendon
2. Passively full flex the client’s humerus
3. Positive : Pain
Hawkins-Kennedy test
1. To assess supraspinatus tendon
2. Flex the client’s arm to 90°, then internally rotate the humerus
3. Positive : Pain
Painful Arc test

Biceps Tendinopathy

AC joint pathology

Adhesive capsulitis = Frozen shoulder

Apley’s scratch test

Shoulder Instability

Shoulder Apprehension Test,(CRANK test)
- To assess anterior instability of GH joint
Posterior drawer test
- To assess posterior instability of GH joint
Sulcus sign : inferior instability of gh joint

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