SPECIAL TESTS

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SPECIAL TESTS 
STUDYBUDDYMATERIAL 
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PATRICKS 
(FABER TEST) 
 
Supine - 
flex,abd and 
ER >>ankle 
rests in opp 
knee 
>>>>lower test 
leg down 
toward table 
surface 
Identifies dysfunction of hip such as mobility restriction 
 
Positive 
 
Involved knee unable to 
assume relax position 
 
Reproduction of painful 
symptoms 
GRIND 
(SCOURING 
TEST ) 
Identifies DJD of hip 
 
Supine —-hip 90 flexion ——knee max flex—-provide 
compressive load to femur via knee joint —-thereby loading 
the hip joint 
 
 
 
 
 
 
May reproduce pain 
within hip and refer 
pain to knee or 
elsewhere 
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OBERS TEST Identifies tightness of ITB/TFL 
 
Side lying —- lower limb flexed at hip and knee—-passively 
extend and abduct hip with knee flexed to 90 degree 
 
Modified OBERS —-starts with legs extended and rest is 
same as above 
 
Positive if upper limb 
not able to go below 
horizontal 
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ELY’S TEST Identifies tightness of rectus femurs 
 
Prone —- with knee flexed —-observe hip of testing limb 
 
 
 
 
 
 
 
 
 
Positive if hip of testing 
limb flexes 
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90 - 90 
HAMSTRING 
TEST 
Identifies tightness of hamstring 
 
Supine with hip and knee in 90 flexion ——passively extend 
knee until barrier encountered 
 
 
Positive if knee lacks 
10 degree extension 
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PIRIFORMIS 
TEST 
Identifies piriformis syndrome 
 
Supine — foot of test leg placed passively lateral to the opp 
knee ——test hip is adducted ——observe position of 
testing knee relative to opposite knee 
 
 
Positive - testing kneee 
if unable to pass over 
the resting knee and / 
or reproduction of pain 
in the buttock, and / or 
along the sciatic nerve 
distribution 
LEG LENGTH 
TEST 
Identifies true LLD 
 
Supine - pelvis balanced aligned with trunk and LL 
 
Measure distance from ASIS to medial /lateral malleolus 
 
 
Diff in length identifies - 
true LLD 
 
This test determines 
whether the LLD is 
true/functional 
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CRAIGS TEST Identifies abnormal femoral ante torsion angle 
 
Prone ——knee flexed to 90 deg 
 
palpate Greater trochanter —-slowly move hip through IR 
AND ER 
 
when GREATER TROCHANTER feels more lateral ,stop 
and measure the angle of leg relative to a line perpendicular 
to the table surface 
 
 
Finds anteverted 
/retroverted hip 
 
Normal angle - 8-15 hip 
IR 
 
15 - ANTEVERTED 
HIP 
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FADDIR/FADIR 
TEST 
Identifies 
 
1.anterior superior impingement 
 
2.iliopsoas tendinopathy 
 
3.anterior labral tears 
 
supine >>>>>FADIR 
 
 
Reproduction of pain 
with or without click 
HIP 
IMPINGEMEN
T 
 
PINCER 
 
CAM 
 
COMBINED 
 
 
 
 
 
 
 
 
 
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KNEE SPECIAL TESTS 
COLLATERAL 
LIGAMENT 
INSTABILITY 
TEST 
For medial and lateral stability 
 
identifies ligament laxity or restriction 
 
Supine —-entire LL supported and stabilized and knee 
placed in 20 - 30 flexion. 
 
Valgus stress tests - medial collateral ligament 
 
Varus force - lateral collateral ligament 
 
 
Valgus at 30 with pain 
 
Valgus at 30 deg with 
laxity 
 
Primary finding is 
laxity but pain may be 
noted as well 
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LACHMAN 
STRRES TEST 
Indicates integrity of ACL 
 
Supine —- test knee flexed 20-30 deg —— stabilize femur 
and passively glide tibia anterior 
 
 
Excessive anterior 
glide of tibia 
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POSTERIOR 
SAG TEST 
Indicates integrity of PCL 
 
Supine —- hip flex to 45 degree and knee flex to 90 deg 
 
See whether tibia sags posteriorly in this position 
 
 
 
Positive - sag of tibia 
relative to femur 
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POSTERIOR 
DRAWER 
TEST 
indicates integrity of PCL 
 
Same position as for sag test mentioned above 
 
Passively glide tibia posteriorly 
 
 
 
Positive - excess 
posterior glide 
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REVERSE 
LACHMAN 
Indicates integrity of PCL 
 
PRONE with knees flexed to 30 deg 
 
Stabilise femur —- passively try to glide tibia posterior 
 
 
Positive - ligament 
laxity 
MC MURRAY 
TEST 
Identifies meniscal tears 
 
Supine —— teting knee in max flexion ——passively IR and 
extend the knee >>>>tests lateral meniscus 
 
Same procedure as above with external rotation test medial 
meniscus 
 
 
Positive - reproduction 
of click and / or pain in 
the knee joint 
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APLEYS TEST Helps differentiate between meniscal tears and ligamentous 
lesions 
 
Prone >> testing knee flexed to 90 deg ——stabilise patients 
thigh to the table with your knee——passively distract the 
knee joint and then slowly rotate tibia internally and externally 
 
Next apply compressive load to the knee joint ——slowly 
rotate tibia internally and externally 
 
 
MENISCAL 
DYSFUNCTION - pain 
or decreased motion 
during compression 
 
LIGAMENTOUS 
DYSFUNCTION - pain 
or increased motion 
during distraction 
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HUGHTONS 
PLICA TEST 
Identifies dysfunction of plica 
 
Supine and testing knee is flexed with tibia internally rotated 
 
Passively glide patella medially , while palpating medial 
femoral condyle 
 
Feel for popping as you passively flex and extend the knee 
 
 
Positive - pain or 
popping noted during 
the test 
PATELLAR 
APPREHENSI
ON TEST 
Indicates past history of patellar dislocation 
 
Supine —-patella passively glided laterally 
 
Patient does not allow or does not like patella to move 
laterally to stimulate sublimation or dislocation 
 
 
 
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CLARKES 
SIGN 
 
Patellar 
grinding test 
Indicates patellofemoral dislocation 
 
Supine —— knee extension resting on the table ——push 
posterior on superior pole of patella —ask patient to perform 
active contraction of quadriceps muscle 
 
 
 
 
Pain 
BALLOTABLE 
PATELLA 
 
Patellar tap 
test 
Indicates infra patellar effusion 
 
Supine —- knee in extension resting on the table —- apply 
soft tap over the centre of the patella 
 
 
Perception of patella 
floating (dancing 
patella ) 
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FLUCTUATIO
N TEST 
Indicates knee joint effusion supine —— knee in extension 
resting on the table 
 
One hand - supra patellar pouch 
 
Other hand —- anterior aspect of knee joint 
 
Alternate pushing down with one hand at a time 
 
 
Fluctuation of fluid 
noted during the test 
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Q ANGLE 
MEASUREME
NT 
Angle between qceps muscle and patellar tendon 
 
Normal 
 
13 - men 18 - female . 
 
Angles greater or lesser >>>>>> knee or biomechanics 
dysfunction 
 
 
 
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NOBLE 
COMPRESSIO
N TEST 
Identifies whether distal ITB friction syndrome is present 
 
Supine —- hip flex 45 —— knee flex 90 
 
Apply pressure to lateral femoral condyle and then extend 
knee 
 
 
Pain over lateral 
femoral condyle at 
approx 30 deg flexion 
TINELS SIGN Identifies dysfunction of common fibular nerve 
 
Tap posterior to fibula head where nerve passes 
Tingling or 
paraesthesia in to the 
leg 
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WILSONS 
TEST 
Identifies osteochondritis dissecans of the medial femoral 
condyle 
 
 
Pain at 30 deg medial 
rotation but no pain at 
30 with lateral rotation 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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SPECIAL TESTS 
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CERVICAL SPINE SPECIAL TESTS 
VERTEBRAL 
ARTERY TEST 
Assess integrity of vertebrobasilar artery system 
 
Supine —-head supported over the end of the table —-eyes 
open 
 
1.passively extend head and neck and hold it for 30 sec ——
no symptoms —- progress to passive rotation and side 
bending with extension in both directions 
 
Hold each position for 30 sec 
 
Causes reduction of lumen of vertebral artery —-resulting 
dec blood flow to contralateral side 
 
symptoms include dizziness, nausea, syncope, dysarthria, 
dysphagia and disturbances of hearing and vision ,paresis or 
paralysis of patients with VBI 
 
 
 
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FLEXION 
ROTATION 
TEST 
IDENTIFIES cervical contributions to head ache 
 
Supine —— passively perform max flexion —- fully rotate 
head in each direction 
 
 
Reproduction of 
headache symptoms 
 
Loss of 10 deg ROM 
from one side 
TRANSVERSE 
LIGAMENT 
STRESS TEST 
IDENTIFIES INTEGRITY OF TRANSVERSE LIGAMENT 
 
Supine —- head supported on table —-glide C1 anterior — 
should be firm end feel 
 
 
Soft end feel 
 
Dizziness 
 
Nystagmus 
 
Lump sensation in 
throat 
 
Nausea 
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ANTERIOR 
SHEAR TEST 
Assess integrity of upper cervical spine ligaments and 
capsules 
 
Supine —- head supported on table —— glide C2-C7 
anterior 
 
Should be firm end feel 
 
 
Laxity of ligament s 
 
Dizziness 
 
Nystagmus 
 
Nausea 
 
Lump sensation in 
thoat 
FORAMINAL 
COMPRESSIO
N TEST 
 
SPURLING 
TEST 
Identifies dysfunction of cervical nerve root 
 
Sitting — head bent towards good side —- pressure through 
head straight down 
 
Repeat with head bent to the involved side 
 
 
Pain / paraesthesia in 
dermatomal pattern 
for involved nerve root 
MAX 
CERVICAL 
COMPRESSIO
N TEST 
IDENTIFIES compression of neural structures at 
intervertebral foramen and / or facet dysfunction 
 
Sitting ——-passive move head to side bending and rotation 
toward non painful side followed by extension 
 
Repeat this on painful side 
 
 
 
Localized tenderness 
>>>> facet joint 
pathology 
 
radiation of symptoms 
—- intervertebral 
foramen problem 
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DISTRACTION 
TEST 
Compression of neural structures at the IV foramen or facet 
joint dysfunction 
 
Sitting —- with head passively distracted 
 
 
Dec in symptoms in 
neck 
 
Dec in upper limb 
pain 
 
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SHOULDER 
ABDUCTION 
TEST 
Indicates compression of neural structures within 
intervertebral foramen 
 
Sitting and asked to place one hand on top of the head 
 
Repeat with opposite hand 
 
 
Dec in symptoms into 
the upper limb 
LHERMITTES 
SIGN 
Identifies dysfunction of spinal cord and / or UMN elision 
 
Long sitting —passively flex patients one hip and head —— 
while keeping knee in extension 
 
Repeat with other hip 
 
 
Pain down the spine 
and into upper or 
lower limbs 
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ALAR 
LIGAMENT 
TEST 
Identifies integrity of alar ligament 
 
Sitting —- passively slight flex the upper cervical spine—- 
apply firm pincer grip to C2 spinous process 
 
Palpate movement at C2 during passive upper cervical 
bending and / or rotation 
 
 
Positive - inability to 
palpate C2 moving in 
conjunction with C1 
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MODIFIED 
SHARP 
PURSER TEST 
Identifies integrity of transverse ligament 
 
Sitting —- passively, slightly flex upper cervical spine —- 
apply firm pincer grip to C 2 spinous process 
 
Apply posterior translation and extension force through 
forehead while assessing for excessive linear translation or 
reproduction of myelopathy symptoms 
 
 
 
 
 
Positive - myelopathy 
symptoms with upper 
cervical flexion 
 
Dec in symptoms or 
excessive translation 
during the posterior 
translation 
 
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LUMBAR SPINE SPECIAL TESTS 
 
SLUMP TEST Identifies dysfunction of the neurological structures supplying the 
lower limb 
 
Sitting on edge of the table with knees flexed 
 
Patient slump sits while maintaining neutral position of the head 
and neck 
 
Following progression is followed 
 
1.passively flex patients head and neck—-no reproduction of 
symptoms —- move to next step 
 
2.passively extend one of the patients knees ——- no 
reproduction of symptoms —-move to next step 
 
3.passively dorsiflex ankle of limb with extended knee 
 
4.repeat flow with opposite leg 
 
 
Reproduction of 
pathological 
neurological 
symptoms 
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LASEGUES 
TEST (SLR ) 
Identifies dysfunction of neurological structures that supply the 
lower limb 
 
Supine —- legs resting on the table 
 
Passively flex hip of one leg with knee extended until patient 
complaints of shooting pain into lower limb. 
 
Slowly lower limb until pain subsides ,then passively dorsiflex foot 
 
 
Reproduction of 
pathological 
neurological 
symptoms when 
foot is dorsiflexed 
 
 
 
SLR HIP KNEE ANKLE FOOT TOES NERVE BIAS 
BASIC SLR Flexion and 
abduction 
Extension DF N/A N / A Sciatic and 
tibial nerves 
SLR 2 Flexion Extension DF Eversion Extension Tibial nerve 
SLR 3 Flexion Extension DF Inversion N /A Sural nerve 
SLR 4 Flex and IR Extension Plantar 
flexion 
Inversion N /A common 
fibular nerve 
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SLR 5 Flexion Extension Dorsiflexion N /A N/ A Spinal nerve 
root 
 
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FEMORAL NERVE 
TRACTION TEST 
Patient lies on good side with trunk in neutral —— 
head flexed slightly—- and lower limbs hip and knee 
flexed 
 
Passively extend hip while knee of the painful hip is in 
extension 
 
If no reproduction of symptoms —— flex knee of 
painful leg 
 
 
 
 
Positive - 
neurological pain in 
anterior thigh 
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VALSALVAS 
MANEUVER 
CAN BE USED TO IDENTIFY SPACE OCCUPYING 
LEISION 
 
Sitting —- instruct patient to take a deep breath and 
hold while they bear down as if having a bowel 
movement 
 
Increases pressure in middle ear and in the chest 
 
Used when bracing to lift heavy objects 
Increased LBP or 
neurological 
symptoms into the 
lower extremity 
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PRONE INSTABILITY 
TEST 
Tests instability of lumbar spine 
 
Prone —— torso resting on the splint ——legs off the 
edge with feet supported on the ground 
 
Apply PA springing throughout the lumbar spine until 
a painful segment is identified 
 
Instruct patient to lift their legs a few inches off the 
ground then perform spring testing again on painful 
segments 
 
 
 
positive - dec pain 
during PA springing 
with legs raised 
compared to when 
the feet where 
supported to the 
ground 
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QUADRANT TEST Identifies compression of neural structures at 
intervertebral foramen and facet dysfunction 
 
Patient standing 
 
INTERVERTEBRAL FORAMEN : cue patient to side 
bend to the left,rotate to the left and extension to 
maximally close the vertebral foramen n the left side 
 
FACET DYSFUNCTION : cue patient to side bend on 
the left ,rotation to the right and extension to maximally 
compress the facet joint on left 
 
Repeat on other side 
 
 
pain/ paraesthesia in 
the dermatomal 
pattern in the 
involved nerve root 
or localized pain if 
facet dysfunction 
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STORK STANDING 
TEST 
Identifies spondylolisthesis 
 
Patient standing on one leg ——cue patient into true 
extension 
 
Repeat with opposite leg on the ground 
 
 
Positive - pain in the 
low back with 
ipsilateral leg on the 
ground 
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Mc Kenzies side glide 
test 
Differentiates between scoliotic curvature versus 
neurological dysfunction causing abnormal curvature 
of the trunk 
 
Test is performed if lateral shift of the trunk is noted 
 
Standing —-therapist stands on the side of the patient 
so that upper trunk is shifted towards you 
 
Place therapists shoulders into patient upper trunk and 
wrap your arms around patient pelvis 
 
Stabilize upper trunk and pull pelvis , to bring pelvis 
and trunk into proper alignment 
 
 
Reproduction of 
neurological 
symptoms as 
alignment of trunk is 
corrected 
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BICYCLE (VAN 
GELDERENS TEST ) 
Differentiates between intermittent claudication and 
spinal stenosis 
 
Patient seated on stationary bicycle ——patient rides 
bike while sitting erect —- time how long the patient 
can ride at a set pace /speed 
 
after sufficient rest period have patient ride the 
bike at same speed while in a slumped 
position 
 
 
Determination is 
based on the 
time patient can 
ride bike in 
sitting upright vs 
slumped 
 
If pain related to 
spinal stenosis, 
patient should 
ride bike longer 
when slumped 
WELL SLR IDENTIFIES HERNIATED NUCLEUS PULPOSUS OR 
NEURAL TENSION / RADICULOPATHY 
 
Supine with head ,neck torso in neutral position —- 
maintain knee extension and neutral dorsiflexion and 
lift the leg to the point of symptom provocation 
 
Perform on the C/ L non involved lower extremity 
 
 
 
 
positive - 
reproduction of low 
back pain during 
SLR of the non 
involved lower 
extremity 
 
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GILLETS TEST 
 
 
SACROILIA
C JOINT 
TESTS 
Assessing posterior movement of ilium relative to sacrum 
 
Standing ——place thumb of hand under PSIS of limb to be tested 
—- place other thumb on centre of sacrum at same level as thumb 
under PSIS 
 
FLEX hip and knee as if bringing knee to the chest 
 
Assess movement of PSIS via comparison of the position of 
thumbs 
 
PSIS SHOULD MOVE IN AN INFERIOR DIRECTION 
 
 
No movement of 
PSIS as 
compared to the 
sacrum 
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IPSILATERAL 
ANTERIOR 
ROTATION 
TEST 
Assesssing ant movement of ilium relative to sacrum 
 
Thumb under PSIS of limb ——other thumb on the centre of the 
sacrum at same level as of thumb under PSIS—ask patient to 
extend hip of the limb being tested 
 
Assess movement of the thumbs via comparing the position of the 
thumbs 
 
PSIS SHOULD MOVE IN SUPERIOR DIRECTION 
 
 
No identified 
movement of 
PSIS compared 
to sacrum 
GAENSLENS 
TEST 
Identifies SIJ dysfunction 
 
Side lying —— bottom leg in max hip and knee flexion (knee to 
chest ) 
 
Stand behind the patient passively extend hip of uppermost limb—
-places stress on the SI joint associated with uppermost limb 
 
 
Pain in SI joint 
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LONG SITTING 
-SUPINE TO 
SIT TEST 
Identifies dysfunction of SI joint that might be the cause for 
functional LLD 
 
Supine with correct alignment of trunk ,pelvis and lower limbs 
 
Stand at edge of the table near patients feet —-palpating medial 
malleolus to assess symmetry (one longer than the other ) 
 
Have patient come into long sitting position —-assess leg length , 
making comparison between supine and long sitting 
 
 
abnormal finding 
is reverse in limb 
lengths between 
supine and long 
sitting 
 
ALPS - 
ANTERIOR 
LONG 
POSTERIOR 
SHORT 
 
SPLASH - in 
sitting posterior 
long and 
anterior short 
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GOLDWAITHS 
TEST 
Differentiates dysfunction in lumbar spine versus SIJ 
 
Supine with examiners fingers between spinous process of lumbar 
spine 
 
With the other hand passively perform a SLR 
 
 
 
If pain presents 
prior to 
palpation of 
movement in 
lumbar 
segments 
dysfunction is 
related to SI 
JOINT 
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SIDE LYING 
ILIAC 
COMPRESSIO
N TEST 
IDENTIFIES SI joint dysfunction 
 
Side lying —- with painful side up and baseline symptoms 
gathered 
 
Examiner places hands on the iliac crest ——applies force through 
ilium in the downward direction 
 
Examiner may hold the position for 30 seconds and apply 
continued force 
 
 
Positive - 
patients chief 
complaints 
reproduced 
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SUPINE ILIAC 
GAPPING 
IDENTIFIES SI JOINT DYSFUNCTION 
 
Supine —- examiner crossest arms —— places each hand on the 
medial aspect of the patients ASIS ——applies posterior and 
lateral force 
 
Examiner may hold the position for 30 sec and apply continued 
force 
 
 
Reproduction of 
patients chief 
complaints 
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SHOULDER SPECIAL TESTS 
 
YERGASON
S TEST 
Tests integrity of the transverse ligament 
 
May also identify bicipital tendonosis/tendinopathy 
 
Sitting —- shoulder neutral stabilization against the trunk—-elbow 
90 ——forearm pronated 
 
Resist supination of forearm and ER of shoulder 
 
 
Tendon of long 
head of biceps will 
pop out of the 
groove 
 
May also 
reproduce pain in 
long head of 
biceps tendon 
 
 
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SPEEDS 
TEST 
Identifies biceps tendinosis/ tendinopathy 
 
Sitting /standing —-UL full extension and forearm in supination —
—resist shoulder flexion 
 
May also place shoulder in 90 flexion and push UL into extension 
causing eco contraction of biceps 
 
 
 
Reproduces 
symptoms in long 
head of biceps 
tendon 
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NEERS 
IMPINGEM
ENT TEST 
For impingement of soft tissue structures of the shoulder complex 
(long head of biceps and supraspinatus tendon ) 
 
Sitting —-shoulder passively internally rotated , then fully abducted 
 
 
Reproduces 
symptoms of pain 
within shoulder 
region 
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SUPRA 
SPINATUS 
EMPTY 
CAN TEST 
Identifies tear / impingement of supraspinatus tendon or possible 
supra scapular nerve neuropathy 
 
Sitting —— shoulder at 90 deg no rotation ——-resist shoulder 
abduction 
 
Place shoulder in empty can position which is IR and 30 deg 
fwd(horizontal adduction ) and resist abduction 
 
Differentiate whether pain is present between 2 positions 
 
 
Reproduces pain in 
supraspinatus 
tendon and / or 
weakness in empty 
can position 
 
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DROP ARM 
TEST 
Identifies tear and / or full rupture of rotator cuff 
 
Sitting ——— shoulder passively abducted to 120 —-patient 
instructed to slowly bring arm down to theside 
 
Guard patients arm from falling in case its gives away 
 
 
Patient unable to 
lower arm back to 
the side 
POST 
INTERNAL 
IMPINGEM
ENT TEST 
Identifies impingement between rotator cuff and greater tuberosity 
or post glenoid and labrum 
 
Supine —-shoulder 90 abduction ——max ER —— 15-20 deg 
horizontal adduction 
 
 
 
Reproduction of 
pain in the 
posterior shoulder 
during the test 
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CLUNK 
TEST 
Identifies glenoid labrum tear 
 
Supine ——- shoulder full abduction ———-push humeral head 
anterior while rotating humerus externally 
 
 
Audible clunk is 
heard 
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POSTERIO
R 
APPREHEN
SION SIGN 
Identifies past history of posterior shoulder dislocation 
 
Supine —- shoulder abducted to 90 ( in plane of scapula ) ——— 
with scapula stabilized by the table 
 
Place post force through shoulder via force on patient elbow while 
simultaneously moving shoulder into medial rotation and horizontal 
adduction 
 
 
 
 
 
Patient does not 
like or does not 
allow to move in 
the direction to 
stimulate posterior 
dislocation 
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ANTERIOR 
APPREHEN
SION SIGN 
Identifies past history of anterior shoulder dislocation 
 
Supine ——shoulder 90 abduction ——slowly take shoulder into 
ER 
 
 
Same as above 
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AC SHEAR 
TEST 
Identifies dysfunction of AC JOINT (arthritis,separation) 
 
Sitting —— arm resting at the side —-examainer clasps hands and 
places heel of one hand on spine of scapula ——heel of other 
hand on clavicle 
 
squeeze hands together causing compression of AC joint 
 
 
 
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ADSONS 
TEST 
IDENTIFIES PATHOLOGY OF STRUCTURES THAT PASS 
THROUGH THORACIC INLET 
 
Sitting —— find radial pulse of extremity being tested ——-rotate 
head towards extremity being tested ,then extend and externally 
rotate the shoulder while extending the head 
 
 
Neurological and / 
or vascular 
symptoms 
(disappearence of 
pulse ) will be 
reproduced in 
upper extremity 
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COSTOCLA
VICULAR 
SYNDROM
E 
 
MILITRY 
BRACE 
TEST 
1. Identifies pathology of structures passing through thoracic inlet 
 
Patient sitting —- find radial pulse of extremity being tested ——- 
move involved shoulder down and back 
 
 
Same as adsons 
test 
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WRIGHT 
HYPER 
ABDUCTIO
N TEST 
IDENTIFIES PATHOLOGY OF structures that pass through 
thoracic inlet 
 
Sitting —- find radial pulse ——move shoulder into max abduction 
and ER taking deep breaths and rotating head opposite to side 
being tested may accentuate symptoms 
 
 
 
 
Same as above 
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ROOS 
ELEVATED 
ARM TEST 
Identifies pathology of structures passing through thoracic inlet 
 
Standing with shoulders fully ER, 90 abducted and slightly 
horizontally abducted 
 
Elbows flexed to 90 deg and patient opens / closes hands for 3 
mins slowly 
 
 
Same as above 
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HAWKINS 
KENNEDY 
TEST 
Identifies sub acromial impingement 
 
Examiner places the patient shoulder into 90 deg of shoulder 
flexion with elbow flexed to 90 deg . 
 
Therapists then passively internally rotates the patients arm 
 
 
 
Positive - pain with 
IR 
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ALLENS 
MANEUVER 
Identifies TOS 
 
PATIENT relaxed sitting position —- arm tested in 90 abduction 
and full ER, elbow 90 flexion 
 
Examiner palpates the radial pulse and the patient rotates the head 
to the side opposite to the arm being tested 
 
Examiner palpates the radial pulse continuously as the patient 
moves through the sequence of movements 
 
 
+ve if radial pulse 
is diminished or 
absent after 
rotation of the head 
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ACTIVE 
COMPRESS
ION 
(LABRUM) 
 
O BREIN 
TEST FOR 
LABRAL 
TEAR 
Identifies labral tear / AC lesion 
 
Sitting / standing : shoulder 90 flex and 10 adduction >>> arm 
active IR so that the thumb is pointing downward 
 
Instructor >>> applies inferior directed force (into shoulder 
extension ) , first with thumb pointing down and second with the 
thumb pointing up 
 
 
+ ve for 
 
AC leision - 
localized pain in 
AC joint with 
thumb pointing 
down and a dec in 
pain with thumb 
pointing up( 
supinates forearm ) 
 
 
Labral tear - painful 
clicking in the joint 
with the thumb 
pointed down , 
which is reduced or 
eliminated when 
the patient resists 
the inferior force 
with the thumbs 
up( supinates 
forearm ) 
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RENT SIGN RC tear or RC impingement 
 
Sitting with arms relaxed at the side >>> examiner stands to the 
rear of the patient 
 
Examiner palpates anterior to anterior edge of the acromion with 
one hand while holding the patients flexed elbow with the other 
 
Examiner passively extends the shoulder while slowly rotating the 
shoulder into IR and ER 
 
 
If RC TEAR —- 
greater tuberosity 
will be prominent 
and a depression 
of about 1 finger 
width will be felt 
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CRANK 
TEST 
Used to eval different GH ligaments / anterior 
shoulder instability / labral tear 
 
Standing —- examiner places distal hand on the subjects elbow 
 
Proximal hand —- subjects proximal humerus 
 
Then passively elevates subjects shoulder to 160 in scapular plane 
 
With distal hand —-examiner applies a load along the long axis of 
the humerus , while proximal hand IR and ER the humerus 
 
 
+ ve - if pain is 
present with or 
without a click in 
the shoulder 
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BICEPS 
LOAD 2 
Identifies presence of glenohumeral labral tears ( 
SLAP LEISION ) 
 
Patient supine — examiner brings patients shoulder into 120 
abduction , max ER , 90 elbow flexion and forearm supination 
 
Examiner holds onto patient wrist with one hand and stabilizes the 
elbow with the second hand 
 
Patient then instructed to perform elbow flexion against examiners 
resistance 
 
 
+ ve - if symptoms 
inc during resisted 
biceps contraction 
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BEAR HUG 
TEST 
Identifies subscapularis tear 
 
Sitting / standing —-with their hand placed to opposite shoulder 
with elbow anterior to the body 
 
Examiner then applies ER force while the patient attempt to 
maintain hand on the shoulder 
 
 
+ve if patient 
cannot hold the 
hand against the 
shoulder as 
examiner applies 
an ER force 
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BELLY 
COMPRESS
ION TEST 
Identifies subscapularis leision - especially for patients who are not 
able to MR the shoulder enough to take it behind the back 
 
Sitting / standing —- examiner places a hand on the abdomen so 
that he or she can feel how much pressure the patient is applying 
to the abdomen. 
 
Patient places the hand of the shoulder being tested on the 
examiners hand and pushes as hard as he can into the stomach 
 
Patient also attempts to bring the elbow forward in the scapular 
plane causing greater medial rotation 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
+ve if patient is 
unable to maintain 
the pressure on the 
examiners hand 
while moving the 
elbow forward / 
extends the 
shoulder 
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HORIZONT
ALADDUCTIO
N 
Identifies presence of AC joint dysfunction / subacromial 
impingement 
 
Examiner stands behind the side being tested —- grasp the 
patients arm just distal to the elbow and passively flex the patients 
shoulder to 90 —- then maximally adduct the shoulder ( bring it 
across to the other shoulder ) 
 
 
 
 
 
 
 
 
 
 
 
 
+ ve if patient 
reports pain during 
adduction / 
localized pain over 
AC JOINT 
HORN 
BLOWERS 
SIGN 
 
Tests infraspinatus 
/ tires minor 
muscles 
 
With arm abducted 
to 90 and elbow 
flexed ask patient 
to ER shoulder 
against resistance 
.if the patient is 
unable to do this 
the test is positive 
 
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ELBOW, WRIST ANKLE TESTS 
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LIGAMENT 
INSTABILIT
Y TESTS 
Identifies lig laxity or restriction 
 
Sitting / supine 
Entire upper extremity supported and stabilized 
and elbow placed in 20- 0 degree flexion . 
 
Valgus force placed through elbow tests ulnar 
collateral ligament 
 
Varus force —- radial collateral ligament 
 
 
Laxity and 
sometimes 
pain 
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TENNIS 
ELBOW TEST 
Identifies lateral epicondylitis 
 
Sitting with elbow in 90 flexion and supported . 
 
Resist wrist extension , radial deflation and 
forearm pronation , with fingers fully flexed . 
 
 
pain at 
lateral 
epicondyle 
GOLFERS 
ELBOW TEST 
Identifies medial epicondylitis 
 
Sitting with elbow in 90 flexion . 
 
Passively supinate forearm , extend elbow , extend 
wrist 
 
 
Pain at 
medial 
epicondyle 
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PRONATOR 
TERES 
SYNDROME 
TEST 
Identifies median nerve entrapment within 
pronator terms 
 
Sitting with elbow in 90 flexion 
 
Resist forearm pronation and elbow extension 
simultaneously 
 
 
Tingling / 
paraesthesia 
within 
median 
nerve 
distribution 
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ELBOW 
FLEXION 
TEST 
Identifies cubital tunnel syndrome 
 
Supine >>>>performed bilaterally with the shoulder 
in full ER and the elbow actively held in maximal 
flexion with wrist extension for one minute 
 
 
 
 
pain in 
medial 
aspect of the 
elbow 
,numbness 
and tingling 
in ulnar 
distribution 
on the 
involved 
side 
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BUNNEL 
LITTLER 
TEST 
Identifies tightness in structures surrounding MCP 
JOINTS . Differentiates btwn tight capsule and tight 
intrinsic muscles . 
 
MCP stabilized in slight extension while PIP joint 
is flexed .then MCP is flexed and PIP is flexed . 
Flexion 
limited in 
both cases 
>>>> capsule 
is tight 
 
If more PIP 
flexion with 
MCP flexion 
>>>>intrinsic 
muscles 
tight 
TIGHT 
RETINACUL
AR TEST 
identifies tightness around proximal 
interphalangeal joint .diffrentiates between tight 
capsule and tight reticular structures 
 
PIP stabilized in neutral >>>>DIP is flexed 
 
Then PIP is flexed and then DIP is flexed 
 
Flexion 
limited in 
both cases 
>>>>tight 
capsule 
 
If more DIP 
flexion with 
PIP flexion 
>>> reticular 
ligaments 
are tight 
LIGAMENTO
US 
INSTABILIT
Y TEST 
identifies ligament laxity or restriction 
 
Fingers supported and stabilized . 
 
Valgus / varus force applied to PIP joints of all 
digits . Repeated at DIP joints 
 
 
Primarily 
laxity but 
pain may be 
noted as 
well 
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FROMENTS 
SIGN 
Identifies ulnar nerve dysfunction 
 
Grasp paper btwn first and second digits of the 
hand . 
 
Pull paper out and look for IP flexion of the 
thumb >>>>>>flexion of thumb is compensation for 
weakness of adductor pollicis 
 
 
 
Patient 
unable to 
perform test 
without 
compensatio
n indicates 
ulnar nerve 
pathology 
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PHALENS 
TEST 
IDENTIFIES COMPRESSSION OF MEDIAN NERVE IN 
CARPAL TUNNEL 
 
max flexion of B/L wrist holding them against 
each other for 1 minute >>>> tingling / paraesthesia 
into hand following median nerve distribution 
 
 
 
 
 
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2 POINT 
DISCRIMINA
TION TEST 
Identifies level of sensory innervation within hand 
that correlates with functional ability to perform 
certain tasks involving grasp 
 
Sitting —-hand stabilized —-with 2 point 
discriminator check patients ability to distinguish 
btwn 2 points of testing device 
 
Normal amount that can be discriminated is 
generally less than 6 mm 
 
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ALLENS 
TEST 
Identifies vascular compromise 
 
 
 
Identify radial / ulnar arteries at wrist 
 
Have patient open / close fingers quickly several 
times and then make a closed fist . 
 
Compress ulnar artery and have the patient open 
the hand .observe palm of the hand and then 
release the compression of the artery and observe 
for vascular filling 
 
Perform same procedure with radial artery 
Positive 
finding >>> 
abnormal 
filling of 
blood within 
hand during 
test . 
 
Normal 
circumstanc
es >>>> 
change in 
color from 
white to 
normal 
appearance 
on palm of 
hand 
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FLICK TEST Identifies carpal tunnel syndrome 
 
Sitting / standing >>>> patient moves hand like 
shaking down a thermometer 
 
Patient performs the shaking movement to reduce 
the symptoms at wrist 
 
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ANKLE 
NEUTRAL SUBTALAR 
POSITIONING 
Identifies abnormal rear foot / 
forefoot positioning 
 
Prone with foot over the edge of the 
table 
 
palpate dorsal aspect of talus on both 
sides with one hand , and grasp lateral 
forefoot with other hand >>>> gently 
dorsiflex foot until resistance is felt , 
then gently move through supination 
and pronation 
 
 
 
Neutral posiiton is 
the point at which 
you feel foot fall 
off easier to one 
side or the other 
 
At this point 
compare rear foot 
to forefoot and 
rear foot to leg 
 
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ANTERIOR DRAWER 
TEST 
Identifies ligamentous instability 
 
Particularly ANTERIOR TALOFIBULAR 
LIGAMENT 
 
Supine >>> with heel just off the edge of 
the table in 20 degree plantar flexion 
>>>> stabilize lower leg and grasp foot 
>>>> pull talus anterior 
 
 
 
Pain or excessive 
anterior glide of 
the talus 
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TALAR TILT Identifies ligamentous instability 
particularly 
 
CALCANEOFIBULAR LIGAMENT 
 
Sidelying with knee slightly flexed 
and ankle in neutral >>>>> move foot 
into adduction testing calcaneofibular 
ligament and into abduction testing 
DELTOID LIGAMENT 
 
 
 
PAIN / EXCESSIVE 
ABDUCTION OR 
ADDUCTION 
 
 
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THOMPSONS TEST Evaluates integrity of the achilles 
tendon 
 
Prone >>> foot off the edge of the table 
>>>>squeeze calf muscles 
Positive finding - 
no movement of 
foot while 
squeezing 
 
 
MORTONS TEST Identifies stress # / neuroma in 
forefoot 
 
Supine with foot supported on the table 
>>>> grasp around metatarsal heads and 
squeeze 
Pain in forefoot 
 
 
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KLEIGER TEST Identifies integrity of distal 
tibiofibular syndesmosis and also the 
deltoid ligament 
 
Seated on edge of the table with knee 
flexed to 90 >>>> examiner rotates the 
foot laterally while holding tibia in 
neutral position 
 
 
Positive if 
symptoms / visiblejoint gapping is 
reproduced 
 
WINDLASS Identifies windlass effect of plantar 
fascia 
 
Weight bearing test ——patient stands on 
step with toes positioned over the edge 
of the step and equal weight bearing . 
 
The examiner then passively extends 
the first MTP joint 
 
NWB test : seated in NWB position with 
knee flexed to 90 >>>> examiner 
stabilizes the ankle and passively 
extends the patients first MTP 
 
Positive test is 
reproduction of 
plantar fascia 
symptoms 
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