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Physical Therapist (PT)
Musculoskeletal System
Shoulder Examination and Assessment
Shoulder Special Testing: SLAP Lesion Testing

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Shoulder Special Testing: SLAP Lesion Testing

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Shoulder Special Testing: SLAP Lesion Testing

Shoulder Special Test: SLAP Leeches
Shoulder Special Testing for SLAP (Superior Labral Anterior to Posterior) lesions involves a battery of diagnostic maneuvers designed to assess the integrity of the superior labrum in the shoulder joint. Yergason's Test evaluates the stability of the biceps tendon within the bicipital groove, Active Compression (O'Brien) Test assesses labral tears through resisted shoulder flexion, Biceps Load II Test gauges labral and biceps tendon injuries through resisted supination and elbow flexion, while Speed's Test examines biceps tendon pathology by assessing pain during resisted shoulder flexion. These tests collectively aid in diagnosing SLAP lesions and guide clinicians in developing appropriate treatment strategies for individuals experiencing shoulder pain and instability.
Yergason’s Test

The Yergason’s test is another test useful for identifying SLAP lesions but works primarily through testing of the long head of the biceps. Patients will begin sitting with their shoulder in neutral, stabilized against their trunk with the elbow flexed to 90 degrees and the forearm pronated. Clinicians will palpate the bicipital groove while asking the patient to resist supination of the forearm and external rotation of the shoulder. Resistance is provided by the clinician around the distal forearm above the wrist joint. A positive test can include “popping” of the biceps tendon out of its groove or pain along the long head of the biceps tendon. Either result is indicative of a possible bicep or SLAP lesion.

Active Compression (O’Brien) Test
Active-runner (O-Briar) Compression-by-vice

The O’Brien Test is utilized to identify SLAP lesions by placing the patient’s shoulder in 90 degrees of flexion and 30-45 degrees of horizontal adduction while standing or seated. The patient will then internally rotate the shoulder and pronate the elbow as much as possible. The clinician will stabilize distally along the forearm, and the patient will apply an upward force. This test is then repeated with the arm in external rotation. A positive test is indicated if there is pain reproduction or clicking in the shoulder with the first position that is absent with the second.

Biceps Load II Test
Bicycle-Bicep Load (2) Tutu

During the Biceps Load II Test, the patient will start in a supine position with the shoulder in 120 degrees of abduction, 90 degrees of elbow flexion, full external rotation, and forearm supination. The patient will then flex the elbow while the physical therapist provides resistance in the opposite direction. A positive test is indicated by pain during resisted elbow flexion.

Speed’s Test

The Speed Test is used to identify possible bicep tendonitis or SLAP lesions. The patient will be in a seated or standing position, after which the clinician will place the patient’s arm into 90 degrees of shoulder flexion, full external rotation, full elbow extension, and forearm supination. Next, the clinician will palpate the bicipital groove, then provide manual resistance in an inferior direction. A positive test is if there is tenderness or pain in the bicipital groove, which is indicative of biceps tendonitis or a SLAP lesion.


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