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It identifies the presence of a pathology involving the biceps tendon or glenoid labrum. The specific positive findings to the test include pain in the bicipital groove indicating biceps tendinitis, [2] [3] subluxation of the long head of the biceps brachii muscle, [3] and presence of a SLAP tear. [4]
The characteristic finding of a biceps tendon rupture is the Popeye sign. Patients often report an audible pop at the time of injury as well as pain, bruising, and swelling. Provocative physical exam maneuvers to assess for a rupture include Ludington's test, Hook test, and the Ruland biceps squeeze test.
The Neer impingement test is a test designed to reproduce symptoms of rotator cuff impingement through flexing the shoulder and pressure application. Symptoms should be reproduced if there is a problem with the supraspinatus or biceps brachii. [1] This test is also associated with the Hawkins-Kennedy Test and Jobe's Test. [2]
Sometimes, with a very flexible patient, the Thomas test will be normal despite a psoas dysfunction being present. However, in the patient with a normal hip joint, a positive test is a good indicator of psoas hypertonicity. [2] Other signs from the Thomas test: opposite/ contralateral hip flexes without knee extension- tight iliopsoas
Thomas test for tight hip flexors both performed by the provider holding the unaffected leg to the chest and leaving the affected leg on the table. If the affected leg cannot lie flat on the table it is a positive test. [1] the Kendall test is similar, but the patient holds the unaffected leg to their chest. [1]
As a general rule, abnormal pain experienced during any of these tests will indicate a positive result, or a tear of the glenoid labrum. All of the tests take advantage of the fact that the labrum meets the tendon of the long head of the biceps muscle, and thus will normally produce pain in the region if a tear is present.
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Gaenslen test - This pain provocation test applies torsion to the joint. With one hip flexed onto the abdomen, the other leg is allowed to dangle off the edge of the table. Pressure should then be directed downward on the leg in order to achieve hip extension and stress the sacroiliac joint. [1] [2]
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