Master Shoulder Special Testing: SLAP Lesion Testing with Picmonic for Physical Therapy

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.

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.

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.

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.