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Shouldder Special Test: Full Can and Empty Can Test

This video shows how to do the Shoulder Special Test, which includes the Full Can and Empty Can Tests. Learn how to properly assess shoulder joint flexion, abduction and external rotation functions.

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00:04 - 00:06This is Brent of the Brookbush Institute,
00:06 - 00:07and in this video we're going over two
00:07 - 00:09special, or orthopedic tests for the
00:09 - 00:11shoulder. We're going to go over the
00:11 - 00:13empty can test and the full can test.
00:13 - 00:15These are generally used as indicators
00:15 - 00:20of impingement and/or rotator cuff tears,
00:20 - 00:22specifically the supraspinatus. I'm
00:22 - 00:23going to have my friend, Melissa, come out.
00:23 - 00:25She's going to help me demonstrate. Now,
00:25 - 00:26we're going to start with the empty can
00:26 - 00:29test, because this test was around first.
00:29 - 00:30I'm going to go ahead and have Melissa
00:30 - 00:32hold her arms out to 90 degrees of
00:32 - 00:34abduction. What I'm going to do is I'm
00:34 - 00:36going to press down. I'm going to note
00:36 - 00:39how strong is Melissa into abduction,
00:39 - 00:42especially on the symptomatic side.
00:42 - 00:45I'm then going to have her turn her
00:45 - 00:47thumbs down. I'm going to bring her into
00:47 - 00:50the scapular plane, which is 30 degrees
00:50 - 00:53of horizontal adduction, and I'm going
00:53 - 00:56to press down again. If I press
00:56 - 01:00down again, and this position is weaker
01:00 - 01:03on her symptomatic side, this may be an
01:03 - 01:07indicator of impingement and/or rotator
01:07 - 01:08cuff damage, specifically to the
01:08 - 01:11supraspinatus. I could add a little bit
01:11 - 01:12more provocation to this by just simply
01:12 - 01:16asking, "Does this replicate your symptoms?"
01:16 - 01:20Now, my guess is that the idea behind
01:20 - 01:23this test was in this position, maybe
01:23 - 01:25your deltoid couldn't contribute to as
01:25 - 01:28much abduction, and that that would place
01:28 - 01:31more stress on your supraspinatus. But,
01:31 - 01:34that's not exactly how things work out.
01:34 - 01:36Your deltoids and supraspinatus
01:36 - 01:38are both very involved in
01:38 - 01:40abduction in both positions. And what we
01:40 - 01:43find is that the full can test, which
01:43 - 01:46was actually the first part of this test,
01:46 - 01:50is just as specific and sensitive as the
01:50 - 01:51empty can test. So, we're going to start
01:51 - 01:54over and show just the full can portion.
01:54 - 01:57Go ahead and bring your arms up.
01:57 - 01:58She's at 90 degrees with her thumbs
01:58 - 02:01pointing up. I'm going to press down- a
02:01 - 02:03little different than the empty can test,
02:03 - 02:05I'm going to try to note differences
02:05 - 02:09between her symptomatic and asymptomatic
02:09 - 02:12sides. I'm going to ask her, "Does this
02:12 - 02:15provoke pain?
02:15 - 02:18Does this provoke your symptoms?" No. So, in
02:18 - 02:20Melissa's case, this is not her
02:20 - 02:22concordance sign. She has a negative full
02:22 - 02:25can test. We also notice she had a
02:25 - 02:29negative empty can test. Now, as I said
02:29 - 02:33before, guys, these two tests have very
02:33 - 02:36similar specificity and sensitivity. I
02:36 - 02:39don't see a reason to use one over the
02:39 - 02:40other, unless you happen to be putting
02:40 - 02:43these tests inside of a testing cluster
02:43 - 02:46and it asks for one of them specifically.
02:46 - 02:49Personally, I probably would not use the
02:49 - 02:52empty can test, because it's just more
02:52 - 02:56steps, and it's more complexity that may
02:56 - 02:58actually reduce my test
02:58 - 03:02reliability. When you're doing any sort
03:02 - 03:05of special testing, you have to keep in
03:05 - 03:08mind that this is just one clue in a
03:08 - 03:11whole battery of tests, as well of as
03:11 - 03:13our subjective assessment that's going
03:13 - 03:15to help give us some indicators of
03:15 - 03:18whether or not this is impingement,
03:18 - 03:23rotator cuff damage, etc. Now, if that was
03:23 - 03:26her concordance sign- this was the test
03:26 - 03:27that as soon as I put my hands down, she
03:27 - 03:31was like, "That's it. That's my pain," that's
03:31 - 03:32the stuff you guys need to put an
03:32 - 03:35asterisk by, because that's the quick
03:35 - 03:37test that we'll use session after session.
03:37 - 03:41Put your arms up. Does that hurt? Ow, yes. Okay,
03:41 - 03:43that hurts. Great. I'm going to do some
03:43 - 03:45interventions. I'm going to kind of work
03:45 - 03:48through that hypothesis. And then, even
03:48 - 03:50after a couple interventions, go ahead
03:50 - 03:52and have her throw her arms back up. "Does
03:52 - 03:55that feel any better?" Yes. Good. Those
03:55 - 03:57interventions were successful. Alright,
03:57 - 04:00so there you have it- the full can
04:00 - 04:03test and the empty can test. Make sure you
04:03 - 04:06keep in mind that these tests are only
04:06 - 04:10clues and should be used within clusters
04:10 - 04:11of exams
04:11 - 04:13and be rated against your subjective
04:13 - 04:16assessment and your hypothesis. I hope
04:16 - 04:17you guys learned a lot from this video.
04:17 - 04:20I'll talk to you soon.
04:26 - 04:28

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