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The shoulder
Published in David Silver, Silver's Joint and Soft Tissue Injection, 2018
The patient complains of pain over the tip of the shoulder. To distinguish this pain from that due to rotator cuff tendinosis, examination of the shoulder will reveal: Tenderness on palpation over the bicipital groove.Pain at the tip of the shoulder on resisted supination (Yergason’s test) of the wrist.
The shoulder and pectoral girdle
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Bicipital tendinitis usually occurs together with rotator cuff impingement; rarely, it presents as an isolated problem in young people after unaccustomed shoulder strain. Tenderness is sharply localized to the bicipital groove. Two manoeuvres that often cause pain are: resisted flexion with the elbow straight and the forearm supinated (Speed’s test)resisted supination of the forearm with the elbow bent (Yergason’s test).
Upper limb symptoms and signs
Published in Kevin G Burnand, John Black, Steven A Corbett, William EG Thomas, Norman L Browse, Browse’s Introduction to the Symptoms & Signs of Surgical Disease, 2014
Kevin G Burnand, John Black, Steven A Corbett, William EG Thomas, Norman L Browse
Alternatively, the elbow is flexed at 90°, and the patient is asked to supinate actively against resistance from a pronated position (Yergason’s test) (Fig. 7.9).
Treatment of individuals with chronic bicipital tendinopathy using dry needling, eccentric-concentric exercise and stretching; a case series
Published in Physiotherapy Theory and Practice, 2020
Amy W. McDevitt, Suzanne J. Snodgrass, Joshua A. Cleland, Mary Becky R Leibold, Lindsay A. Krause, Paul E. Mintken
ROM of the shoulder was assessed and measured actively and passively according to Norkin and White (2009) and in some patients, a goniometric measurement of active shoulder flexion was taken at the point in the range that created a reproduction of anterior shoulder pain symptoms. Muscle length testing included assessment of pectoralis minor and pectoralis major, latissimus dorsi, and shoulder rotators (Kendall and Provance, 1993). Strength assessment was performed using the graded manual muscle tests described by Kendall and Provance (1993) and included scapular stabilizers (i.e., middle trapezius, lower trapezius, and serratus anterior) and glenohumeral muscles (i.e., shoulder flexors and extensors, shoulder lateral and medial rotators as a group). Pathoanatomic special tests for the shoulder utilized in the examination included: Speed’s test (Magee, 2008); Yergason’s (Magee, 2008); Neer impingement (Magee, 2008); Hawkins Kennedy (Magee, 2008); and palpation in the region of the LHBT (Kibler et al., 2002; Michener, Walsworth, Doukas, and Murphy, 2009). Speed’s test (sensitivity 32%, specificity 75% for biceps pathology) was performed by having the clinician extend the elbow, supinate the arm and elevate the humerus with resistance to approximately 60°; a positive test is pain in the bicipital groove region (Calis et al., 2000; Holtby and Razmjou, 2004; Magee, 1992). Yergason’s test (sensitivity 43%, specificity 79% for biceps pathology) was performed by having the clinician flex the elbow to 90° with a pronated forearm. The clinician would then have the patient resist supination with pressure at the patient’s wrist. A positive test is pain in the area of the bicipital groove (Magee, 2008; Razmjou, Holtby, and Myhr, 2004). The Neer test (sensitivity 81% specificity 54% for subacromial impingement) was performed by having the clinician stabilize the scapula in a downward fashion while concurrently flexing the humerus maximally with the addition of overpressure; a positive test was reproduction of pain in the region of the superior shoulder (Calis et al., 2000; Michener, Walsworth, Doukas, and Murphy, 2009; Neer, 1983). The Hawkins-Kennedy test (sensitivity 63%, specificity 62% for subacromial impingement) was performed by having the clinician flex the humerus to 90°, followed by internally rotating the humerus maximally with the addition of overpressure; a positive test was reproduction of familiar symptoms (Calis et al., 2000; Hawkins and Kennedy, 1980; Michener, Walsworth, Doukas, and Murphy, 2009).