Orthopedic Exam / Special Tests for Physical Therapy: SHOULDER
Special Test: SPEED’S TEST
BACKGROUND: Biceps Tendinitis/ Bicipital Tendinitis/ Biceps Tendonitis:
Bicipital tendonitis is an inflammatory process of the long head of the biceps tendon and is a common cause of shoulder pain due to its position and function. Disorders of the biceps tendon can result from impingement or as an isolated inflammatory injury. Other causes are secondary to compensation for rotator cuff disorders, labral tears, and intra-articular pathology. Pain in the front of the shoulder and weakness are common symptoms of
biceps tendonitis. They can often be relieved with rest and medication.
In some cases, surgery is necessary to repair the tendon.
Long head of biceps tendonitis is an inflammation or irritation of the upper biceps tendon. This strong, cord-like structure connects the upper end of the biceps muscle to the bones in the shoulder. The long head of the biceps originates from the supraglenoid tubercle just below the shoulder joint, from where its tendon passes up along the intertubercular groove of the humerus into the joint capsule of the shoulder joint.
When the humerus is in motion, the tendon of the long head is held firmly in place in the intertubercular groove by the greater and lesser tubercles and the overlying transverse humeral ligament. During the motion from external to internal rotation, the tendon is forced medially against the lesser tubercle and superiorly against the transverse ligament. The tendon of the short head runs adjacent to the tendon of the coracobrachialis and likewise attaches to the coracoid process. Both heads join on the middle of the humerus, usually near the insertion of the deltoid, to form a common muscle belly.
Special Test: SPEEDS TEST
- To test for the presence of Biceps Tendonitis.
Video Demo Instructions, Procedure, Positive Test:
Special Test: Speeds Test: Video Demo (Procedure below)
Special Test: Speeds Test: PROCEDURE:
• Patient is seated
• Patient completely extends their elbow then supinates their arm
• Therapist stabilizes at the shoulder
• Patient attempts to flex the elbow while the therapist holds client’s forearm and applies resistance.
Special Test: Speed’s Test: POSITIVE SIGN:
- Pain at the biceps tendon area during resistance