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Continuing Education1 Credit

Special Tests: Shoulder Impingement Syndrome (SIS)

Special tests for shoulder impingement. The Park et al. Shoulder Impingement Testing Cluster, Hawkin's Kennedy, Infraspinatus Strength Test, Painful Arc Test, Michiner et al. Shoulder Impingement Testing Cluster, Neer's Test, Empty Can Test, Supine Impingement Test (Screening Tool). The reliability, specificity, sensitivity, validity, safety, and screening for shoulder pain, rotator cuff tears, SLAP tears, supraspinatus pathology, bicep tendon tears, shoulder impingement syndrome (SIS), labrum (labral) tears, and general arm/shoulder pathology.

Course Description: Special Tests: Shoulder Impingement

Special Tests Covered in this Lesson:

Shoulder impingement syndrome (SIS) may result from repetitive use injury, or trauma, or may occur in conjunction with other diagnoses. For example, repetitive use may result in biceps tendonitis, subacromial bursitis, or rotator cuff tendinopathy. Acute trauma such as strains, rotator cuff tears, and dislocations can result in impingement pain due to changes in glenohumeral (shoulder) joint arthrokinematics and generalized inflammation of the glenohumeral and acromioclavicular (AC) joint tissues. The diagnosis of shoulder impingement syndrome (SIS), sounds "specific", but should be considered a broad diagnosis of anterior shoulder pain, especially with shoulder flexion or shoulder abduction. Clinical professionals (physical therapists, physical therapy assistants, chiropractors, occupational therapists, athletic trainers, etc.) should be aware of the signs and symptoms of SIS and the special tests that may aid in diagnosing and screening patients and clients. However, the special tests for SIS should likely only be used with additional special tests to "rule out" other diagnoses. Most often SIS is best treated with exercise and interventions intended to improve lower cervical and thoracic mobility, scapular (shoulder blade) dyskinesis, and shoulder mobility and strengthening.

Special Note on Shoulder Impingement Syndrome (SIS):

  • Impingement is a diagnosis given to those experiencing anterior shoulder pain, which is usually dull and achy, and made worse by arm elevation. This type of shoulder pain is common to so many shoulder diagnoses, that "impingement" or "SIS" becomes a very broad label in practice, and may inadvertently encompass issues other than the compression and irritation of subacromial tissues (e.g. rotator cuff tear, labrum tear, anterior instability, etc.). Because these symptoms are common to many diagnoses, special tests for impingement generally suffer from a lack of specificity. A diagnosis of SIS may be most accurately reached when "a test-item cluster demonstrates a high likelihood of impingement and is accompanied by negative tests results for other diagnoses". When considering practice and evaluation, this may imply that shoulder impingement special tests are unnecessary, have little if any predictive value, and may not significantly influence practice (28).

Brookbush Institute Recommendation:

For an Introduction to Special Tests

  • For an introduction to Special Tests including definitions of specific terminology, what special tests measure, accuracy (specificity, sensitivity, reliability, etc.), how we chose the tests in each special test course lessons, and best practice recommendations:
  • Special Tests: Introduction

Courses covering Special Tests for the Shoulder Girdle

Introduction

Hawkins-Kennedy

Infraspinatus/External Rotation Resistance Test

Painful Arc Test

Neer Test

Empty Can Test

Test-item Clusters

Screening Tool

Bibliography

Copyright

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