To test specifically for an anterior impingementsyndrome The Neer test is performed by internally rotatingand passively flexing the patient’s shoulder while keeping thearm inthe scapular plane . This maneuver reduces the spacebetween the acromion and greater tuberosity and may elicitpain in rotator cuff tendonitis. Pain is typically elicited at greaterthan 90° of flexion.In the Yocum test, the patient’s shoulder is abducted to 90°,and the elbow is flexed to about 60°. Using the hand and elbowas a fulcrum, the arm is forcibly put into internal rotation(Photo 12). This maneuver jams the supraspinatus tendon intothe anterior surface of the coracoacromial ligament andacromion process. Pain is elicited in supraspinatus tendonitis.When bicipital tendonitis is suspected, Speed’s test isperformed. In this test, the patient is instructed to supinate thearm, and the examiner resists the patient’s shoulder flexion. The test is repeated with thepatient’s elbow flexed to 90°(Photo 13). The test is positive when pain is elicited in thebicipital grooveTo test more specifically for a SLAP lesion, and to differentiate itfrom an AC joint injury, the O’Brien test is performed. In thistest, the patient stands with the shoulder flexed to 90° and theelbow in full extension. The patient’s shoulder is then put into10–15° of adduction. With the patient’s hand supinated, theexaminer puts an inferiorly directed force on the patient’s hand.The patient is then instructed tofully pronate the hand (suchthat the thumbs are pointing own) andthe examiner againplaces an inferiorly directed force onto the patient’s forearm(Photo 15). When the maneuver elicits pain insidethe shoulderwhen the hand is in supination, but not when the hand is inpronation, a SLAP lesion is suspected. However, thismaneuveralso stresses the AC joint. Therefore, if this maneuver elicits pain in the AC joint, pathology should be suspected in the AC joint and not in the labrum.