Acromioclavicular (AC) Joint Cross Body Test

The Acromioclavicular (AC) Joint Cross Body Test is a physical test used to assess shoulder stability. This test is performed by placing the arm in an abdudction position and then applying a force across the body of the shoulder joint. This will test the stability of the acromioclavicular joint and other supporting structures. The test should be done slowly and carefully to avoid over-stretching the muscles. It is an important test for detecting any disorders

Transcript

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This is Brent of the Brookbush Institute,
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...blank
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in this video we're going over
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the special or orthopedic test for the
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acromioclavicular joint, the crossbody or
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horizontal adduction test. I'm going to
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have my friend Melissa come out, she's
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going to help me demonstrate this test.
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Now this like our other AC joint test is
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a fairly simple test, all I'm going to do
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is start with Melissa 90 degrees of
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shoulder flexion, and then I'm going to
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passively take her into end range
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horizontal adduction, and give her a
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little over pressure. The next thing I'm
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going to ask is, is that the symptoms you
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were talking about? That was the was the
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pain you had huh, and as long as that
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pain is localized over the top of the AC-
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joint, then it's a positive test. Let me
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show you guys a couple other views here.
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So I'm going to have you turn forward
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here, so notice guysI get my elbows up
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nice and high so that I can not have to
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use my internal rotators to try to
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create some force; but I can use my
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stronger deltoids and PEC muscles and I
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is passively bring her in here, and you
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guys want to be kind of gentle with this
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motion, it's not comfortable for anybody.
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And then I'm going to push, give her a
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little over pressure. Is that the
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symptoms you were talking about? Alright
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i'm going to show you guys one more view.
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Here once again i used that same kind of
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brace that i used for a lot of these
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shoulder and AC joint special tests,
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which is my fingers curved over the top
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of the trap here, and then my palm over
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the back of the scapula, so I have nice
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control over scapula shoulder and torso.
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And then I'm going to use my other hand
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over her elbow, elbows nice and high, pull
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all the way into horizontal adduction,
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put a little over pressure. Is that the
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symptoms you're talking about? Alright
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let me have you go ahead and face this
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way. Now we do have a little bit of a
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problem with this test putting somebody
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in to complete horizontal adduction is
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likely to cause pain for anybody who has
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AC joint issues. It's also likely to
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cause pain in anybody who has shoulder
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impingement issues, so what can I do?Well
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I can cluster this test, which we're
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definitely going to cluster all of our
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special tests, we've been
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talking about that throughout all of our
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special testing videos. But let's say
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this was, she says yeah I have pain, well
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I could then follow up with palpation
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which is a special test unto itself,
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although not one that I would use by
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itself, but if I then palpated her AC-
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joint and I said, hey does that hurt, and
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she said yes; okay good I can keep going
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with my AC joint test. Maybe add a couple
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more of these special tests, create an AC
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joint cluster, and that will give me a
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better indication of what's going on
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with her AC joint. If she said no when I
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was palpating, alright so go ahead and no
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no okay if I said no, palpation is
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actually very sensitive, not very
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specific but very sensitive, so a
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negative test result is probably a
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pretty good clearance that things are
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not happening at the AC joint. And then
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rather than going down the AC joint
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cluster, maybe I should go down my
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shoulder impingement cluster. Alright so
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just to review that one more time if she
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was positive for this test in that it
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gave her pain, and then I pushed down on
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her AC joint and she said no, I would
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probably go down the shoulder
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impingement path. If she said yes I go
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down my AC joint path and add a couple
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more AC joint tests. Thank you Melissa. So
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there you guys have it another test to
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add to your toolbox. I hope by now with
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all the special tests that we've gone
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through you guys are starting to get a
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good idea of not only how to use or
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what these special tests are, a good
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repertoire of special tests, but how to
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use them, how to cluster them to build a
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case towards accurate diagnosis. I look
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forward to talking with you guys soon,
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please leave your comments in the box