Upper Extremity Special Tests

If you are having difficulty with using your arms normally due to pain, loss of range of motion (ROM) or decreased strength, you may benefit from physical therapy to help you return to full functional mobility. Your PT may perform an examination of your condition to determine what is wrong and to get started on the right treatment for you. One component of that examination includes performing upper extremity special tests.

Special tests are often performed to assist in diagnosing musculoskeletal disorders. There are various special tests, each specific for a certain diagnosis. Disorders of muscles, joints, tendons, and ligaments can all be confirmed with a positive finding if the correct special test is performed. This step-by-step program includes three different upper extremity special tests to determine what may be causing your condition. Check in with your doctor, and visit your physical therapist to learn about your particular condition and to maintain optimal mobility and wellness.

Yergason's Test

A therapist stretching a patient's shoulder.
Passive Shoulder ROM can be performed by your physical therapist. DNY59

The Yergason's test is a screening tool for diagnosing bicipital tendonitis.

The test is performed as follows:

  • Stabilize the patient's arm against their body
  • Flex the elbow to a 90-degree angle
  • Palpate the bicipital tendon
  • Have the patient supinate and externally rotate the arm against resistance
  • This test is positive if there is pain in the bicipital groove, or the tester feels the tendon slip out of the groove.

If Yergason's test is positive, your therapist can work with you to decrease your pain and improve the way your rotator cuff muscles work to support your shoulder. This typically takes pressure off your biceps tendon and can help treat your condition.

Empty Can Test

The Empty Can test is a screening tool for tears of the supraspinatus muscle or tendon.

The test is performed as follows:

  • Abduct the patient's arm to 90 degrees and angle the arm forward 30 degrees at the shoulder joint.
  • Have the patient internally rotate at the shoulder as if pouring a can on the floor
  • Resist the patient in abduction from this position and assess for weakness or pain
  • The test is positive if there is significant pain or weakness on resistance.

If you have a positive empty can test, your PT may work with your to attempt to strengthen other supporting muscles to improve the function of your shoulder.

Adson's Test

The Adson's test is done to assess compression of the subclavian artery. This artery supplies blood to your arm, and compression of the artery may cause loss of feeling in your upper extremity.

The test is performed as follows:

  • Monitor the patient's radial pulse at the wrist while you abduct, extend, and externally rotate the upper extremity at the shoulder joint (keeping the elbow straight)
  • Have the patient take a deep breath, rotate, and extend their head TOWARD the side being tested
  • The test is positive if there is a marked decrease or absence of the radial pulse.

If you have a positive Adson's test, you should see your doctor right away to determine the cause of the compression of your artery.

If you have any upper extremity difficulty, you should see your doctor, and then get working with your physical therapist to return to optimal function right away.

Edited by Brett Sears, PT

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