You can only view 3 videos without an account. Become a Member to access all videos on the website.
Acromioclavicular (AC) Joint Resisted Extension Test
The Acromioclavicular (AC) Joint Resisted Extension Test is a clinical orthopedic test used to assess the integrity of the Acromioclavicular ligaments which connect the distal clavicle to the acromion. This test is usually used when evaluating shoulder injuries such as shoulder impingement syndrome or a rotator cuff tear. During the test, the patient is asked to extend the arm away from the body and is then resisted by downward pressure against
Transcript
00:00:0400:00:06
This is Brent of the Brookbush Institute,
00:00:0400:00:06
...blank
00:00:0600:00:07
and in this video we're going over the special
00:00:0700:00:09
orthopedic test for the
00:00:0900:00:11
acromioclavicular joint, the resisted
00:00:1100:00:13
extension test. I'm going to have my
00:00:1300:00:14
friend Melissa come out, she's going to
00:00:1400:00:17
help me demonstrate. Now I think you guys
00:00:1700:00:19
are going to see a small nomenclature or
00:00:1900:00:21
wording error in this test as we start
00:00:2100:00:24
to set it up. This test goes, I'm going to
00:00:2400:00:26
use one hand to brace her torso, so I'm
00:00:2600:00:28
going to do that fingers over the top of
00:00:2800:00:30
the scapula and then palm over the back
00:00:3000:00:31
of the scapula thing that you've seen in
00:00:3100:00:33
a lot of the videos we've done on
00:00:3300:00:35
special tests, and I'm going to use this
00:00:3500:00:39
hand to resist her arm once I put it in
00:00:3900:00:42
90 degrees of flexion, 90 degrees of
00:00:4200:00:44
horizontal adduction, 90 degrees of
00:00:4400:00:47
internal rotation, and 90 degrees of the
00:00:4700:00:49
elbow flexion. So this very squared up
00:00:4900:00:51
posture right, we got a nice little right
00:00:5100:00:53
angle here at her elbow, and then her
00:00:5300:00:55
elbow is both in line and level with
00:00:5500:00:57
her shoulder. Now here's where the
00:00:5700:00:59
nomenclature issue comes in, this is
00:00:5900:01:01
called the resisted extension test but
00:01:0100:01:03
what you're actually resisting is
00:01:0300:01:07
horizontal abduction. So if Melissa
00:01:0700:01:11
pushes her elbow out towards me that's
00:01:1100:01:14
the test right, this would be extension
00:01:1400:01:16
extensions a sagittal plane joint
00:01:1600:01:18
action, this is horizontal abduction or
00:01:1800:01:20
horizontal extension. So I'm not really
00:01:2000:01:22
sure what happened with the naming of
00:01:2200:01:25
this test, but make a note guys so that
00:01:2500:01:27
if you are using this test you don't get
00:01:2700:01:29
confused on where you should be
00:01:2900:01:33
resisting. So once again brace, resist,
00:01:3300:01:36
I'm just going to have a push out, ask
00:01:3600:01:38
her that telltale question, is that the
00:01:3800:01:39
symptoms you were talking about? That
00:01:3900:01:42
would be a positive if that replicates
00:01:4200:01:44
your symptoms, specifically if it
00:01:4400:01:47
replicates her symptoms at her AC joint
00:01:4700:01:50
that would be a positive. So i'm going to
00:01:5000:01:51
show you guys what that looks like at
00:01:5100:01:52
another angle, let me have you face that
00:01:5200:01:57
way. So again bring her up to elbow in
00:01:5700:01:59
line and level with your shoulder, and
00:01:5900:02:00
then 90 degrees of elbow flexion here,
00:02:0000:02:04
brace your torso, go ahead and resist,
00:02:0400:02:08
does that replicate your symptoms? Ok i'm
00:02:0800:02:10
going to show you guys the other way,
00:02:1000:02:14
good, you guys can see that brace hand. So
00:02:1400:02:17
I'm going to do this, this, so now I have
00:02:1700:02:19
control of her torso, I can push Melissa
00:02:1900:02:21
around a little bit, I've just got to be
00:02:2100:02:23
careful because she'll push back. Alright
00:02:2300:02:25
and then I'm going to use this hand to
00:02:2500:02:27
resist, you guys can see how I'm set up
00:02:2700:02:28
nice and strong, you guys can see I'm in
00:02:2800:02:31
a staggered stance. Go ahead and push out
00:02:3100:02:33
Melissa, good does that replicate your
00:02:3300:02:36
symptoms? All right I'm going to turn you
00:02:3600:02:38
guys back around one more time to see
00:02:3800:02:40
this view just to go over one other
00:02:4000:02:45
tendency I have. If Melissa had for
00:02:4500:02:48
example had a negative test result right,
00:02:4800:02:51
so I had to go ahead and push out, she's
00:02:5100:02:52
super strong and I go does that
00:02:5200:02:55
replicate your symptoms and she goes no,
00:02:5500:02:59
and then what I'll do is palpate the AC
00:02:5900:03:04
joint, so no pain there huh, and she says
00:03:0400:03:07
no after palpating the AC joint, a lot of
00:03:0700:03:09
times I'll sneak in that palpation
00:03:0900:03:12
because it is a very sensitive but not
00:03:1200:03:15
very specific test, which means if i get
00:03:1500:03:18
negatives for both her resisted
00:03:1800:03:22
extension test, and no pain when i'm
00:03:2200:03:25
pushing down on her AC joint I have a
00:03:2500:03:28
really good chance that it's not AC
00:03:2800:03:32
joint pathology. So tests that have high
00:03:3200:03:34
sensitivity of low specificity can be
00:03:3400:03:39
useful as screens if you get a negative
00:03:3900:03:41
test result. If I got a positive test
00:03:4100:03:43
result and I would probably want to add
00:03:4300:03:45
another couple other AC joint testing,
00:03:4500:03:47
we're going to talk about the AC joint
00:03:4700:03:50
cluster in another video. Thank You
00:03:5000:03:52
Melissa. As with all of these special
00:03:5200:03:55
orthopedic test guys we never use just
00:03:5500:03:57
one test, hopefully you guys now
00:03:5700:03:59
understand the technique behind this
00:03:5900:04:01
test, and you have one more tool in your
00:04:0100:04:05
arsenal as you start bringing tests
00:04:0500:04:08
together to build your case towards
00:04:0800:04:11
accurate diagnosis, hypothesis generation,
00:04:1100:04:14
and optimal intervention. I look forward
00:04:1400:04:16
to seeing your questions in the comments
Related Videos
Acromioclavicular (AC) Joint Resisted Extension Test
Acromioclavicular (AC) Joint Test-item Cluster
Acromioclavicular (AC) Joint Cross Body Test
Femoral Nerve Neurodynamic Tests
Slump Test
Straight Leg Raise Test and Well Leg Raise Test
Modified Sharp Purser Test
Cervical Distraction Test
Lumbar Movement Assessment
Upper Body Movement Assessment