Name: Shoulder Special Test: Kim's Test for Posterior Inferior Lesion of the Labrum
Uploaded: 2023-04-26T01:01:42.000Z
Duration: 6 min 15 s
Description: A video providing step-by-step instruction and tips towards performing Kim's Test to assess a posterior inferior lesion of the labrum. A must-watch for shoulder specialists and orthopedic professionals.

English captions

https://stream.mux.com/yTK00ISYmA01299yBHQemwp1elYycjm400aUay1rWiMAb00.m3u8

A video providing step-by-step instruction and tips towards performing Kim's Test to assess a posterior inferior lesion of the labrum. A must-watch for shoulder specialists and orthopedic professionals.

Introduction to Kim's Test for Labral Lesions

Understanding Proper Test Execution

Detailed Procedure for Conducting Kim's Test

Interpreting Test Results and Diagnosis

Final Thoughts on Clinical Application of Kim's Test

Shoulder Special Test: Kim's Test for Posterior Inferior Lesion of the Labrum

This is Brent of the Brookbush Institute, in this video we're going over another special or orthopedic test for the shoulder, this is the Kim's test for posterior inferior labral lesions. Now I do have to admit that I referred to several texts before putting this down on video, and the reason being is every time I open to text, the written instructions didn't match the picture. Which sounds like a fairly simple almost juvenile problem,but it's not and you'll see why when i have my friend Melissa come out. So posterior inferior labral lesion. I believe the intent of this test is to okay if this is my glenoid fossa, I'm going to take your humeral head and I'm going to grind it in to your posterior inferior labrum, hoping to catch a tear or irritate a tear that has been created. We're going to say that you came in after landing on an outstretched arm, you felt some sudden pain in your shoulder and hasn't gone away. These are good indicators of some sort of labral issue. Now if i use the written instructions, they say 90 degrees of abduction. Well if i'm going to create compression, posterior and inferior glide. This doesn't totally make sense actually, because i end up pushing the humeral head kind of out of the glenoid fossa. Now all the pictures show this, this isn't 90 degrees of abduction, this is 90 degrees of flexion. Then they say grab the mid-humerus and create a posterior and inferior force; that actually makes a little bit more sense, although we lose a lot of that compressive force now, because now our force is directed straight that way. It doesn't get any easier when they describe the test either, because they mentioned elevation of the arm. The elevation of the arm is generally a term used when flexion or abduction will do. What I think they're trying to get at here, is if I kind of go here I go to like 45 degrees, and then I posteriorly and inferiorly push on the humerus at mid-humerus, while elevating the arm into further somewhere between flexion and abduction; that's when i'll end up with a posterior and inferior force, as well as a little bit of compression. So this is the pictures, this is the written instructions, and this is what i'm suggesting. We got that clear it's a little complicated, so let's go over it one more time. What I'm going to have you guys do, is if somebody comes in and they're subjective evaluation is pointing towards some labral issues. The anterior labrum test or the SLAP lesion test came back negative. I'm starting to think okay let's look a little outside of the box, lets look at the posterior inferior labrum. You're going to elevate your patient's arm right, we're going to stay in that 45 degree plane. You're going to grab mid-humerus, you're going to push posterior and inferior while pulling the arm up this way, which is then going to create a posterior and inferior glide, forcing the humeral head into the posterior labrum. And since we're at 45 degrees, we'll be in good position to help keep a little bit of compression as well, so that we maintain force against the labrum. That's going to look something like this. Now a positive Kim's test, would be the sudden onset of pain in the posterior shoulder. So I'd go, hey is that the symptoms you're talking about? Yeah where do you feel those? In the back of your shoulder, that would be a positive Kim's test. All right so we're going to go ahead and bring the arm up to 90 degrees here of somewhere between abduction and flexion, grab mid-humerus, I'm pushing down that way while using this hand to pull up this way. Once again where do you feel that? In the back, thanks Melissa. With all of our tests with all of our diagnostic tests, remember that they're not that strong by themselves. These are clues so I'm going to want that subjective assessment, that subjective evaluation to be pointing me in the right direction; and then I'm going to back it up with not one diagnostic test, but several diagnostic tests. So if the Kim test is positive, and let's say the Jerk test is positive, and my SLAP tests were negative, but maybe some of my impingement tests are coming back a little positive, so that we know there's some definite dysfunction in the shoulder. Now I'm starting to think well, if it is a labral tear, I'm probably going to want to refer out for imaging first, and let the Physician decide whether conservative treatment should be tried first, before we even look at surgical options. Or is the damage so bad that we expect PTs, ATC's, Chiro's not to be able to have that much of an effect with conservative treatment to get this person back to their normal level of function. If you guys have any questions please feel free to drop me a line in the comment section underneath this video. You guys can go ahead and look up this test, and see the funny little discrepancy between the pictures and the written descriptions but don't let it persuade you. Use the test as I recommend it, and once again only use it as a clue. And I think within the body of evidence that you're trying to create to support your diagnosis or assessment, you'll be doing a great job. I look forward to talking to you guys soon. you Subtitles by the Amara.org community

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