There are a limited number of special tests physical therapist assistants may perform for the purpose of gauging progress. However, PTAs should be familiar with tests more routinely performed by physical therapists as part of the initial evaluation.

Shoulder

Apprehension Test

(Anterior glenoid humeral stability)

The patient should be position in supine. The therapist will flex the patient's elbow to 90 degrees and abducts the patient's shoulder to 90 degrees. The examiner then slowly applies an external rotation force to the arm to 90 degrees while carefully monitoring the patient. Patient apprehension from this maneuver, not pain, is considered a positive test.

Clunk Test

(used for detecting shoulder labral tears)

In supine, place one hand on the posterior shoulder and the other hand on the humerus above the elbow. Fully abduct the arm over the patient’s head, and then push anteriorly with the hand over the humeral head while the other hand rotates the humerus into external rotation. A clunk or grinding sound is a positive test, and can indicate a tear of the labrum.

Drop Arm Test

(diagnosis of full-thickness tears of the supraspinatus and infraspinatus tendons)

Performed in standing or sitting. Bring the affected arm into 90 degrees of abduction and external rotation passively. Then tell your patient to hold this position and release your supporting hand. Positive if patient is unable to slowly control adduction.

Hawkins-Kennedy Impingement

(indicative of impingement between the greater tuberosity of the humerus against the coraco- humeral ligament)

Performed in sitting with 90°of examiner supported shoulder and elbow flexion. The examiner then stabilizes proximal to the elbow with their outside hand and with the other holds just proximal to the patient's wrist. They then quickly move the arm into internal rotation. Positive if painful.

Yergason’s Test

(integrity of the transverse ligament)

UE placed in adduction against the trunk and forearm in full pronation. Examiner resists supination and external rotation while palpating over the transverse ligament. Displacement of long head of biceps or palpable click is positive.