PTMS 2112 : MUSCULOSKELETAL 1

SPECIAL TESTS

Test Structures Patient Evaluation procedure Positive findings Ilustration

tested position

Empty can Supraspinatus sitting/ Abduct shoulder to 90°. Reproductive of

Test tendon standing. Horizontally flex to 30° and symptoms or
pathology medially rotate (thumbs point weakness
downward). Resist patient’s
attempt to abduct.

Drop arm Rulling in Sitting with Examiner grasp the patient’s If patient demonstrate
test supraspinatus examiner arm, passively abduct to 90 inability to lower his
tear standing to the with instructions to slowly or her arm in a
(supraspinatus front. lower the arm. smooth, controlled
integrity) movement.

Apley scarf Acromioclavicul Patient upright Horrizontally adduct the arm Pain around
test/ ar joint (sitt/stand) as far as possible acromioclavicular
Crossed-arm pathology joint.
adduction
test/ Cross-
over
Impingement
Test
 PTMS 2112 : MUSCULOSKELETAL 1
SPECIAL TESTS

Neer Impingement of Patient sitting Passively elevate arm Reproduction of

impingement supraspinatus or standing through forward flexion and symptoms/
test tendon medial rotation provocation of pain

Hawkins- Impingement of Patient is in a Passively shoulder flexion Patient’s shoulder

kennedy test supraspinatus seated 90. Examiner applies forced pain is reproduced.
tendon position. humeral internal rotation.
Therapist
stands infront
of involved
shoulder.
Speed’s test Biceps tendon Patient is Patient’s shoulder forward Increase pain in
pathology seated with flexion, forearm supinate and bicipital groove.
arm flexed to elbow extend. Patient is
90, elbow asked to resist downward
extended, and force applied by examiner.
forearm fully
supinated.
 PTMS 2112 : MUSCULOSKELETAL 1
SPECIAL TESTS

Yergason’s Biceps Patient Patient’s elbow is flexed to Increase pain in

Test Tendinopathy sitt/stand. 90, and forearm is in a bicipital groove.
Examiner pronated position. Patient is
stands infront instructed to supinate arm
of patient. while examiner concurrently
resists forearm supination at
wrist

Finkelstein Tenosynovitis Sit/ stand Patient makes a fist with Pain/ reproduction of
test of abductor upright thumb inside. Passively move symptoms
pollicis longus wrist into ulnar deviation.
and extensor
pollicis brevis
tendons (De’
Quervain)

Phalen’s test Median nerve Sit/ stand Place dorsal aspect of hands Tingling in median
pathology/ upright together with wrists flexed. nerve distribution.
carpal tunnel Hold for 1 minute.
syndrome
 PTMS 2112 : MUSCULOSKELETAL 1
SPECIAL TESTS

Tinel’s sign Median nerve Sit/ stand Tap over carpal tunnel Tinggling or
pathology/ upright parasthesia in hand
carpal tunnel (median nerve
syndrome distribution area)

FABER test Detecting hip/ Supine lying The leg to be tested is Pain/limited range
(Patrick test) sacroiliac joint passively placed in a ‘figure over hip joint – hip
mobility four’ position. The ankle is pathology
impairement placed just above the
opposite knee. Examiners Pain over lower back
provides gently downward – sacroiliac joint
pressure on knee (side to be pathology
tested) while hand to stabilize
on opposite ASIS.
Ober’s test Iliotibial band / Side lying with Examiner prepositions the Upper leg remains
tensor fascia leg to be knee into flexion. Examiner anducted and does
latae thightness tested at stabilizes pelvis at iliac crest. not lower to plinth; or
uppermost Passively abduct and extend
Lower to plinth but
hip with knee flex 90. Then,
does not able to
allow it to drop towards plinth.
maintain knee in
flexion.
Thomas test Hip flexion Supine lying. Patient hugs on knee to Opposite leg lifts off
contracture/ chest. plinth.
rectus femoris
thightness
 PTMS 2112 : MUSCULOSKELETAL 1
SPECIAL TESTS

Trendelen- Stability of hip; Stand upright Stands on one leg side to be pelvis on opposite
lenburg’s strength of hip tested. side drops.
sign abductors
(gluteus
medius)

Piriformis Piriformis Side lying Patient side lying on edge of Localised pain over
test thighness/ bed with test leg uppermost. muscle/ pain elicited
piriformis Flex hip to 60 with knee in the muscle : tight
involvement in flexed. Stabilize hip and apply piriformis; pain over
sciatic pain downward pressure to knee. buttock with
radiation : sciatic
nerve impingement
by tight pififormis.

Anterior Anterior Supine lying Patient’s hip flexed to 45 and Excessive anterior
drawer test cruciate knee flexed to 90. Stabilize translation of tibia on
ligament foot. Therapist’s hands grasp femur; soft end feel.
over proximal leg; thumb over
tibial tuberosity. Apply
posteroanterior force to tibia.

Lachman’s Anterior Supine lying Knee flexed 0-30. Stabilize Excessive anterior
test cruciate femur. Apply posteroanterior translation of tibia on
ligament force to tibia. femur; soft end feel.
 PTMS 2112 : MUSCULOSKELETAL 1
SPECIAL TESTS

Posterior Posterior Supine lying Hip flex to 45 and knee flex Excessive posterior
drawer test cruciate to 90. Stabilize foot translation of tibia
ligament (examiner sits on patient’s
toes). Grasp proximal leg.
Apply anteroposterior force to
tibia. Examiner palpate over
joint line with thumbs.
McMurray Medial Patient supine Examiner grasp patient’s heel Audible or palpable
test meniscus and and passively flex knee to ‘thud’ (snap) /’click’.
lateral end range with one hand
meniscus injury while palpating the joint line.
To test medial meniscus,
examiner rotates tibia into
external rotation and
passively extend the knee.

To test lateral meniscus,

examiner flex knee again,
internal rotates tibia and
extend knee.

Apley’s Meniscus injury Prone lying Knee flex to 90. Medially and Pain provocation
grinding test laterally rotate tibia – first with symptom
distraction and then
compression.
 PTMS 2112 : MUSCULOSKELETAL 1
SPECIAL TESTS

Valgus Medial Supine lying Valgus stress (medial Pain or laxity

stress test collateral pressure) is applied to knee
ligament at 0 and then at 20-30.

Varus stress Lateral Supine lying Patient’s knee is passively Pain or laxity
test collateral flexed to 20. Varus stress
ligament (lateral pressre) is applied to
knee at 0 and then at 20-
30.

90-90 test Hamstring Supine lying Passively flex hip at 90 and Unable to extend
tightness knee flex 90. Then, in hip knee to within 20 of
flexion position, slowly extend full extension
knee passively.