Orthopedic Exam / Special Tests for Physical Therapy: SHOULDER
ULTT 1 – Upper Limb Tension Test 1: (Median nerve, Anterior Interosseous nerve (C5,C6,C7)
The median nerve originates from the lateral and medial cords of the brachial plexus. It innervates: (1) the palmar surface of three and half fingers, (2) muscles in the front, anterior, part of the forearm, (3) muscles of the thumb, (4) muscles that flex and extend the fingers; the lumbricals.
Extending the elbow and wrist, two key components of the upper limb tension test, puts the median nerve under tension. Rotating the head and neck to the opposite side puts the nerve under increasing stretch. If the entrapment is in the inter scalene triangle then raising the arm above the head usually increases the response.
Special Test: ULTT 1 – Upper Limb Tension Test 1
PURPOSE:
- To test for C5, C6, C7 nerve roots and median nerve as the source of the patient’s painful shoulder and arm .
Video Demo Instructions, Procedure, Positive Test:
ULTT 1 – Upper Limb Tension Test 1: Video Demo (Procedure below)
ULTT 1 – Upper Limb Tension Test 1: PROCEDURE:
• Patient is supine ,with their side being tested at the edge of the table
• Examiner applies a depressive force to the patient’s affected shoulder
• With examiner’s other hand, hold the patient’s wrist and Abduct their affected humerus to 110°
• Extend patient’s arm to 10° below the coronal plane and, to 60° of external rotation
• Slowly extend patient’s wrist and fingers
• Fully supinate patient’s forearm then slowly extend their elbow
• ( Examiner may flex patient’s neck laterally to the opposite side if the above does not show up positive)
ULTT 1 – Upper Limb Tension Test 1: POSITIVE SIGN:
- Recurrence of their shoulder and arm pain.