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