Painful Arc

Pain occuring at 60-120 degrees classic for shoulder involvement/pathology (impingement, bursitis, rotator cuff tear, etc.). Pain at end range abduction (170-180 degrees) could indicate AC involvement.

Codman’s Drop Arm

Inability to keep arm abducted, unable to control lowering the arm, or hiking up the shoulder as compensation. Classic for: Full thickness tear of Rotator Cuff.

Hawkin’s Kennedy

Reproduction of pain. Classic for: shoulder involvement (impingement, bursitis, tendinosis, labral tear, etc.).

Neer’s

Reproduction of pain. Classic for: shoulder involvement (impingement, bursitis, tendinosis, labral tear, etc.).

Empty Can Ext Rot Strength test

Reduced strength with external rotation test should cluster with pain and reduced strength during Empty Can Test. Classic for: Shoulder impingement.

Posterior Impingement Sign

Posterior or deep familiar pain. Classic for: Posterior shoulder impingement.

Yergason’s

Reproduction of pain. Classic for: SLAP lesion and/or biceps pathology.

Speed’s

Reproduction of pain at top or deep in shoulder. Classic for: SLAP lesion. If pain in biceps groove, classic for: biceps pathology

Upper Cut Test

Reproduction of pain in Biceps groove. Classic for: Biceps Pathology.

Apley’s Scratch

Observation of general mobility of shoulder to determine need for supportive interventions.

Shrug Sign

Elevated scapula as compensation. Classic for: Rotator Cuff Tear, most often full thickness tear.

Coracoid pain test (clinical sign)

Differentiates true from pseudo-frozen shoulder when pain scale difference of 3+ from coracoid vs AC joint and/or subacromial space.

Cross Body Adduction

Reproduction of pain at top of shoulder. Classic for: AC joint related problem.

O’Brien/Active Compression Test

Deep pain with first motion. Classic for: SLAP lesion. Pain at top of shoulder in second position indicative of AC Joint problem.

Paxino’s Sign/Test

 Reproduction of pain. Classic for: AC joint pathology.

Load and Shift

Significant humeral head shift over the fossa either anteriorly or posteriorly. Classic for: Multidirectional instability and/or SLAP Lesion.

Apprehension & Relocation Test(surprise/anterior release)

Apprehension, concern, or resistance. Classic for: Anterior instability of the shoulder. Relocation test-reduction in the apprehension would improve the likelihood ratio of anterior shoulder instability. Surprise test- Apprehension sign upon releasing Relocation Test would also increase likelihood of anterior shoulder instability.

Crank

Clunk, click, shift or pain. Classic for: Labral Tear.

Kim

Clunk or posterior pain. Classic for: SLAP lesion.

Kim II/Biceps Load Test II

Pain during movement. Classic for: SLAP lesion.

Jerk Test

Posterior pain or click during movement. Classic for: SLAP lesion.

Rent

Rent, or divet, felt. Classic for: Severe Rotator Cuff Tear.

Lift-off

Inability to lift hand off back or compensatory movements. Classic for: Subscapularis Tear.

Dugas

Unable to reach across to opposite shoulder or inability to bring elbow down and compress after reaching to opposite shoulder. Classic for: Anterior Dislocation of Shoulder.

Dawbarn’s pushbutton

Reproduction of pain at greater tubercle with a reduction of pain with shoulder abduction. Classic for: Shoulder bursitis

Transverse Humeral Ligament Test

Tendon displaced/popped from groove. Classic for: Biceps Tendinopathy.

AC resisted extension

Reproduction of pain at the top of AC joint. Classic for: AC Joint Related Problem.

Bear Hug

Examiner able to lift patient hand off shoulder. Classic for: Subscapularis Tear.

Belly Press

Posterior movement of elbow or flexion of wrist only and no arm involvement. Classic for: Subscapularis Tear.

Mill’s

Reproduction of pain at insertion point. Classic for: Lateral Epicondylosis.

Cozen’s

Reproduction of symptoms. Classic for: Lateral Epicondylosis.

Moving Valgus

Reproduction of symptoms in ulnar collateral region. Classic for: Ulnar collateral ligament pathology.

Varus Stress (elbow)

Lack of end point, or excessive laxity when compared bilaterally assessing integrity of bone (at 0 degrees) and capsular ligamentous structures (at 30 degrees).

Valgus Stress (elbow)

Lack of end point, or excessive laxity when compared bilaterally assessing integrity of bone (at 0 degrees) and capsular ligamentous structures (at 30 degrees).

Chair / Book Lift Test

Pain, apprehension, clicking, or locking at elbow. Classic for: Posterolateral rotary instability of elbow.

Reverse-Cozen’s

Reproduction of symptoms. Classic for: Medial Epicondylosis.

Maudsley’s

Reproduction of symptoms. Classic for: Lateral Epicondylosis.

Elbow Flexion Test

Reproduction of symptoms. Classic for: Cubital tunnel syndrome.

Tinel’s Sign (elbow)

Reproduction of symptoms. Classic for: Ulnar nerve irritation.

Froment’s sign

Thumb flexes to grip during assessment. Classic for: Ulnar nerve palsy.

Hook

Inability to feel/hook aponeurosis. Classic for: Distal biceps tendon tear and lowered aponeurosis integrity.

Bicipital aponeurosis flex test

Inability to feel/hook aponeurosis. Classic for: Distal biceps tendon tear and lowered aponeurosis integrity.

Posterolateral rotary drawer instability test

Dimpling and pain. Classic for: Instability and subluxation of radial head.

Distal Radial Ulnar Joint (DRUJ) Ballottement  AKA Shear test AKA Compression

Click, clunk, shift, or pain. Classic for: Instability of distal radial ulnar joint interosseus ligaments.

Phalen’s and Modified Phalen’s

Reproduction of median nerve symptoms. Classic for: Carpal Tunnel Syndrome.

Reverse Phalen’s

Reproduction of median nerve symptoms. Classic for: Carpal Tunnel Syndrome.

Tinel’s Sign at wrist

Reproduction of median nerve symptoms. Classic for: Carpal Tunnel Syndrome.

Carpal Compression Test

Reproduction of median nerve symptoms. Classic for: Carpal Tunnel Syndrome.

Thumb Grind Test AKA Thumb scour

Crepitus, grinding, and pain. Classic for: Thumb sprain or osetoarthritis of carpometacarpal joint.

Finkelstein’s

Reproduction of symptoms along radial aspect of forearm. Classic for: De Quervain’s Tenosynovitis .

Watson’s scaphoid test

Click or pop. Classic for: Scaphoid instability.

Ulnar Fovea Sign 

Intense pain in area. Classic for: Ulnotriquetral injury.