Informative Resources

Video source Rationale: Puts the long head of biceps on maximal passive stretch and then pulls on its labral anchor. If the superior labrum is torn, that traction peels it away from the glenoid and reproduces deep joint pain. Technique Starting position: The arm is elevated to 150° in the coronal plane, with the elbow extended and the forearm supinated. The upper arm is stabilized so the humerus can’t rotate. The forearm is then gradually pronated. Positive sign: Pain deep in

Every orthopaedic special test comes with numbers attached. Sensitivity and specificity are the familiar ones, but likelihood ratios are the better way to judge whether a test can actually rule a condition in or out. Here's a short guide, with quick reference tables at the end. Sensitivity and specificity Sensitivity is the percentage of people with the condition who test positive. A highly sensitive test rarely misses the condition. Specificity is the percentage of people wi

Video source Rationale: Drives the humeral head straight backward against the posterior glenoid rim. Technique Starting position: 90-degree abduction and internal rotation of the glenohumeral joint, and 90-degree elbow flexion. The examiner applies axial force through the humerus. The tested shoulder is adducted while the axial force is maintained. The examiner stabilizes the scapula with another hand during this process. Positive sign: Sudden posterior shoulder pain and a c

Video source Rationale: Provocation through compression of the posteroinferior labrum Technique Starting position: 90-degree abduction and 90-degree elbow flexion. The examiner applies axial force through the humerus while also applying a downward and posterior force with another hand placed distal to the deltoid tuberosity. The tested shoulder is elevated diagonally while all these forces are maintained. Positive sign: Sudden posterior shoulder pain and a click in the should

Rotator cuff tear Source: Litaker et al., 2000 3 / 3 of the following Age > 65 Weakness in external rotation (0 degree abduction and elbow 90 degree position) Night pain Rotator cuff full-thickness tear Source: Park et al., 2005 4 / 4 of the following Age ≧ 60 Pain with infraspinatus external rotation test (0 degree abduction and elbow 90 degree position) Positive drop arm test Positive painful arc test Anterior Instability (after a discrete injury) Source: Farber et al., 200

Introduction - Tendon Pain Enigma You hurt yourself—maybe playing sports, or through repetitive strain at work or home. Your doctor told...