Orthopedic Special Tests

Shoulder
TESTING NAME OF TEST PT POSITION DESCRIPTION POSITIVE
Impingement
Neers Pt is seated Clinician stabilizes the Positive for rotator cuff tear
scapula with one hand and if pain is produced (Also
forces the pt’s arm into positive for subacromial
maximal elevation with the bursitis if pain is produced)
other hand.
Hawkins-Kennedy Pt can either be seated or Pt’s arm is passively flexed Positive for rotator cuff tear
standing to 90° and forcefully moved if pain is produced (also
into IR positive for subacromial
impingement if pain is
reproduced)
SLAP (Superior
Labrum Anterior and
Posterior) {Labral
Injuries)
O’Brien’s Pt stands and forward flexes -Pt then adducts the arm 10° Positive for labral tear if pain
the arm to 90° with the and IR’s the humerus. is elicited with the first
elbow in full extension -Clinician applies a maneuver and reduced with
downward force to the arm the second maneuver
as the pt resists.
-Pt then fully ER the arm and
then clinician applies
downward force
GH Instability
Sulcus Sign Seated with clinician Inferior traction force just Positive if see sulcus or devit
stabilizing at scapula proximal to elbow
Apprehension Relocation Pt is seated -Arm is at 90° abduction & Positive if you see a
Pt then moved to supine ER, clinician stabilizes “surprised” or apprehensive
scapula expression
-Monitor pt’s face
-Bring pt down to supine
with arm in 90° abduction &
ER

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Biceps Tendon
Speed’s Pt may be seated. -Pt forward flexes humerus Positive for biceps tendon
to 60° with elbow extended tear (also for subacromial
and forearm supinated. impingement) if pain is
-Pt holds this position while elicited
the clinician applies
resistance distally against
elevation
Yergason’s Pt may be seated or standing Pt’s elbow is flexed to 90° Positive for subacromial
with forearm in pronation impingement if pain is
(thumb up). elicited
-Pt is then instructed to
actively supinate forearm &
ER against resistance

Elbow
TESTING NAME OF TEST PT POSITION DESCRIPTION POSITIVE
Bony or Joint Injury
Elbow Extension Test Pt is seated with the arms ER Pt flexes their forward flexes Positive for bony or joint
to 90° and then extends both injury if the involved elbow
elbows has less extension than the
contralateral side
Cubital Tunnel
Syndrome
Pressure Provocative Test Pt may be seated or standing. Clinician applies pressure to Positive for cubital tunnel
Pt’s elbow is positioned in the ulnar nerve just proximal syndrome if the pt reports
20° of flexion and forearm to the cubital tunnel for 60 sx’s in the distribution of the
supination. seconds ulnar nerve.
Valgus Stress
Moving Valgus Stress Test Pt may be seated Pt’s shoulder is abducted to Positive if the pt experiences
90° with maximal ER. maximal medial elbow pain
-Clinician maximally flexes between 120° and 70° of
the elbow and applies a elbow flexion
valgus stress and then
quickly extends the elbow to
30°

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 Wrist & Hand
TESTING NAME OF TEST PT POSITION DESCRIPTION POSITIVE
Dequervain’s Syndrome

Finkelstein’s Test Patient is seated Patient flexes the thumb Positive if patient has
across the pal, and bends increased pain along the
fingers over the thumb. radial wrist area.
Patient ulnarly deviates the
wrist
Scaphoid Fracture
Scaphoid Fracture Test Patient is seated Clinician exerts overpressure Positive for a scaphoid fx if
into ulnar deviation of wrist pt reports pain in the
while forearm is pronated. anatomical snuffbox.
Longitudinal Compression of Patient is seated Clinician holds the pt’s Positive for a scaphoid fx if
Thumb thumb and applies a long pt reports pain in the
axis compression through the anatomical snuffbox.
metacarpal bone into the
scaphoid.
Intersection Syndrome
Patient is seated Compare isolated resisted Positive if the patient has
wrist extension, thumb pain that worsens.
extension vs resisted wrist
extension and thumb
extension
Carpal Tunnel
Syndrome
Carpal Compression Test Patient is seated with elbow Clinician places both thumbs Positive for carpal tunnel
flexed to 30°, the forearm over the transverse carpal syndrome if the pt has a
supinated, and wrist in ligament and applies 6 worsening of sx’s in the
neutral. pounds of pressure for a median nerve distribution.
maximum of 30 seconds
Tinel’s Sign Patient is seated The clinician taps the median Positive for carpal tunnel
nerve at the wrist 4-6 times. syndrome if pt reports pain
or paresthesia in the
distribution of the median

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 nerve.
Phalen’s Test Patient is asked to hold the Positive if sx’s are
wrist in complete flexion reproduced.
with the elbow extended and
the forearm pronated for 60
seconds.
Scaphoid Shift
Scaphoid Shift (Watson) Test Patient elbow is stabilized on With one hand, the clinician Positive for instability of the
the table with forearm in grasps the radial side of the scaphoid if the scaphoid
slight pronation. patient’s wrist with the shifts or the patient’s sx’s are
thumb on the palmar reproduced when the
prominence of the scaphoid. scaphoid is released.
With the other hand, the
clinician grasps the patient’s
hand at the metacarpal level
to stabilize the wrist. The
clinician maintains pressure
on the scaphoid tubercle and
moves the patient’s wrist into
ulnar deviation with slight
flexion. The clinician
releases pressure on the
scaphoid while the wrist is in
radial deviation and flexion.

Hip
TESTING NAME OF TEST PT POSITION DESCRIPTION POSITIVE
IT Band Syndrome
Ober’s Test Patient sidelying with the Extend and Abduct the hip Positive for ITB tightness if
unaffected leg on bottom joint the leg would remain in the
with their shoulder and Slowly lower the leg toward abducted position and the
pelvis in line. The lower hip the table -adduct hip- until patient would experience
and knee can be in a flexed motion is restricted Ensure lateral knee pain.
position to take out any that the hip does not
lordosis of the lumbar spine internally rotate during the
test and the pelvis must be
stabilized to maintain

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 position
Lateral Hip or Groin
Pain (Capsular
Tightness, Adhesions,
Myofascial Restrictions
{Loss of congruency})
Quadrant/Scour Test Patient is supine, hip at 90° Clinician passively flexed the Positive if it causes lateral
and knee is flexed symptomatic hip to 90°, hip pain or groin pain.
adduct the hip towards the
opposite shoulder and
compress down in the joint.
Hip Dysfunction
FABER (figure-4 test AKA Patient is supine with leg in Clinician flexes, abducts, and Positive for hip dysfunction
Patrick’s Test) figure 4 position ER’s the involved hip so the if it reproduces the pt’s sx’s.
lateral ankle is placed just
proximal to the contralateral
knee. While stabilizing the
ASIS, the involved leg is
lowered toward the table to
end range.
Acetabular Labrum Tear
Thomas Test Patient is supine Clinician extends involved Positive if pt has pain.
extremity from the flexed
position.

Knee
TESTING NAME OF TEST PT POSITION DESCRIPTION POSITIVE
ACL Stability
(Deficiency)
Lachman’s Patient is supine. Knee joint is flexed between Positive for ACL deficiency
10° and 20°, and femur is if there is a lack of end feel
stabilized with one hand. for tibial translation or
subluxation.
Anterior Drawer Patient is supine. Knee is flexed between 60° Positive for ACL deficiency
and 90° with the foot on the if increased anterior tibial

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 plinth. The clinician draws displacement compared with
the tibia anteriorly. the opposite side.
Pivot Shift Patient is supine. Knee is placed in 10° to 20° Positive for ACL deficiency
of flexion, and the tibia is if lateral tibial plateau
rotated internally while the subluxes anteriorly.
clinician applies a valgus
force.
MCL & LCL Stability
Valgus Stress Test Patient is supine. Clinician places pt’s knee in Positive for MCL injury if
20° of flexion and applies a pain or laxity is present.
valgus stress to the knee.
Varus Stress Test Patient is supine. Clinician places pt’s knee in Positive for LCL injury if
20° of flexion and applies a pain or laxity is present.
varus stress to the knee.
Meniscus Tears
Apley’s Compression or Patient is prone with knee Clinician places downward Positive for meniscal tear if
Apley’s Grind Test flexed to 90° pressure on the foot, tibial rotation reproduces the
compressing the knee while pt’s pain.
internally and externally
rotating the tibia.
McMurray Test Patient is supine. Clinician brings the leg from Positive for meniscal tear if
extension into 90° of flexion there is a palpable clunk.
while the foot is held first in
IR, and then in ER.
ITB Friction Syndrome
Ober’s Test Patient sidelying with the Extend and Abduct the hip Positive for ITB tightness if
unaffected leg on bottom joint the leg would remain in the
with their shoulder and Slowly lower the leg toward abducted position and the
pelvis in line. The lower hip the table -adduct hip- until patient would experience
and knee can be in a flexed motion is restricted Ensure lateral knee pain.
position to take out any that the hip does not
lordosis of the lumbar spine internally rotate during the
test and the pelvis must be
stabilized to maintain
position

Ankle

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 TESTING NAME OF TEST PT POSITION DESCRIPTION POSITIVE
Achilles Tendon
Rupture
Thompson Test Patient is prone Clinician squeezes the If no PF then the Achilles
gastrocnemius and soleus to tendon is ruptured.
get the muscles to contract
(PF).
Anterior Talofibular
Ligament Tear
Anterior Drawer Patient is supine Clinician maintains the ankle Positive for anterior
in 10° to 15° of PF while talofibular ligament tear if
drawing the heel gently talus rotates out of the ankle
forward. mortise anteriorly (whole
bottom of section will pull
forward).
Deltoid or Calcaneal
Fibular Ligament Laxity
Talar Tilt Patient is supine or sitting Clinician stabilizes the distal Positive for CF ligament
leg in a neutral position and laxity or possibly
inverts the ankle (for CF anterior/posterior TF
ligament & possibly ligament laxity if whole foot
anterior/posterior TF tilts in when inverted.
ligaments) and inverts the Positive for Deltoid ligament
ankle (for Deltoid ligament). laxity if whole foot tilts in
when everted.

SI Joint
TESTING NAME OF TEST PT POSITION DESCRIPTION POSITIVE
SIJ Dysfunction
Gaenslen Test Pt is supine with both legs The leg being tested is Positive if pain is
extended. passively brought into full reproduced.
knee flexion, while the
opposite hip remains in
extension. Overpressure is *Think edge of table hip
then applied to the flexed flexor stretch*
extremity.

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 Patrick’s Sign (FABER) Patient is supine with leg in Clinician flexes, abducts, and Positive if buttock and groin
figure 4 position ER’s the involved hip so the pain is reproduced.
lateral ankle is placed just
proximal to the contralateral
knee. While stabilizing the
ASIS, the involved leg is
lowered toward the table to
end range.
Thigh Thrust Test (posterior Patient is positioned in Clinician cups the sacrum Positive if familiar sx’s are
shear) supine with hip flexed 90° with one hand and with the reproduced or increased.
and slightly adducted. other applies a posteriorly
directed force to the femur.
Posterior Gapping (of the Patient is sidelying. Clinician applies firm Positive for Ankylosing
SIJ) downward pressure to the Spondylitis if pain over the
contralateral ilium. sacrum or into the buttocks is
provoked
Anterior Gapping (of the SIJ) Patient is positioned supine. Clinician applies cross-over Positive if there is a
pressure at both ASIS’s production or increase in
familiar sx’s.
(Lateral) Compression Test Patient is positioned in Clinician applies a force Positive for SIJ dysfunction
sidelying, involved side up, vertically downward on the if there is a reproduction or
with the hips flexed anterior superior iliac crest an increase in familiar sx’s.
approximated 45°and the
knees flexed approximately
90°.
Sacral Thrust Test Pt is prone on the plinth Clinician applies downward Positive if it reproduces the
pressure on the center of the pt’s sx’s.
sacrum.
Load Transfer through
the Pelvis
Active Straight Leg Raise Supine. Clinician asks pt to lift each Positive if it’s easier to
(ASRL) leg separately, ask how does perform when stabilized they
it feel (Difficult, pain, etc)? are positive for SI instability.
Then clinician stabilizes and
compresses ASIS, then asks
pt to lift each leg separately.
(In this position you can
check to see if TA is
activating)

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 Lumbar Joint
TESTING NAME OF TEST PT POSITION DESCRIPTION POSITIVE
Disk Herniation
Detection
SLR Pt is supine, the knee fully Clinician then passively Positive if the sensitizing
extended, and the ankle in flexes the hip while maneuvers exacerbate the
neutral DF. maintaining the knee extn to sx’s.
the point where pain or
paresthesia is experienced in
the back or lower limb.
Various sensitizing
maneuvers (DF of the ankle
and flexion of the cervical
spine) are then added.
Slump Test Pt is seated, slouched Clinician asks pt to DF Positive if sx’s are
forward with neck flexed testing side and extend their reproduced and if sx’s
forward, and hands behind knee (ask if any paresthesia – diminish when head is
back. if so have pt bring head back returned to neutral.
to neutral), test the
contralateral side.
Lower Lumbar
Instability
Prone Instability Test Pt is prone with hips and legs Clinician applies downward Positive if pt has pain in
off edge of table with feet pressure on the lower lumbar resting position with
touching the floor. spine and then lets up and downward pressure on spine
asks patient to lift both legs and no pain when pt actively
into hip extension level with extends bilateral hips with
spine and then again the therapist pressure in lower
therapist puts downward lumbar spine.
pressure on lower spine.
Femoral Nerve Root
Irritation
Prone Knee Flexion Pt is prone. Clinician brings knee into Positive if pain in lower
flexion and applies back.
overpressure for 45 seconds.

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 Cervical Spine
TESTING NAME OF TEST PT POSITION DESCRIPTION POSITIVE
Spurling (1) Patient is seated and side Clinician applies Positive if pain or tingling
bends and extends the neck. compression. starts in the shoulder and
radiates distally to the elbow.
Spurling (2) Patient is seated. Clinician side bends the neck Positive if sx’s are
toward the ipsilateral side, reproduced.
and applies 7 kg
overpressure.
Neck Compression Test Patient is seated. Clinician side bends and Positive if test aggravates
slightly rotates pt’s head. A radicular pain, numbness, or
compression force of 7 kg is paresthesia.
exerted.
Shoulder Abduction Test Patient lifts the hand above Positive if sx’s are reduced
the head. or disappears.

Women’s Health
TESTING NAME OF TEST PT POSITION DESCRIPTION POSITIVE

Neurodynamic Testing
TESTING NAME OF TEST PT POSITION DESCRIPTION POSITIVE

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 Balance, Proprioception & Coordination Testing
TESTING NAME OF TEST PT POSITION DESCRIPTION POSITIVE

Vestibular
TESTING NAME OF TEST PT POSITION DESCRIPTION POSITIVE

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