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Shoulder Special Test: Compression Rotation Test
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The Compression Rotation Test is a clinical special test used to evaluate the shoulder for pain in the rotator cuff muscles. In this test the patient’s arm is held in a slightly flexed neutral position, then the arm is compressed downward towards the shoulder and rotated at the shoulder. The test assesses shoulder pain with movement, as well as weakness of the shoulder muscles. This is a useful assessment tool in determining the cause of shoulder pain or injury.
Transcript
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This is Brent of the Brookbush Institute and in this video, we're
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...blank
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going over a special, or orthopedic test for
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the shoulder.
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This is the compression rotation test
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which is indicative of a slap lesion.
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That's a superior labral tear from
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anterior to posterior. I'm going to have my
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friend, Melissa, come out. She's going to help me
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demonstrate. Now, this test is done in supine
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position, and mechanically, it does make
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some sense. It takes a little bit of
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practice, but we're
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going to try to drive the humeral head into
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the glenoid fossa, and then try to catch
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a tear in the labrum by going through
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internal and external rotation. And what
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that's going to look like, is I'm going to
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passively bring Melissa into 90 degrees
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of abduction with 90 degrees of elbow
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flexion. I'm then going to use one hand to
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compress her humeral head into her glenoid fossa.
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And what I'm actually doing here, guys, I
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kind of cup the elbow, and then I just
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lean my my thigh into my hand, so that I'm
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not actually muscling the
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compression. And then what I'm going to do
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with my other hand is go through
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internal and external rotation with the
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intent of trying to catch this little
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tear or lesion, maybe pinch the lesion,
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maybe I'll find an area of pain.
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The actual positive for this test is a
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clicking or popping. So, you guys can
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see here how I'm going back and forth
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through internal and external rotation.
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It is suggested that both small movements
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as well as large movements are used to
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try to get a catch. You might go in
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little external rotation segments and then
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little internal rotation segments, and
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just try to be thorough as you think
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about scanning the labrum with the
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humeral head. I'm going to show you guys what the
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other side looks like here.
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So again, I'm going to kind of palm her
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elbow here and then just use my thigh,
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and it really doesn't matter which hand
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you use. You can you either hand
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as long as you're comfortable moving the
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arm with the other hand. I can go this
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way and just kind of scan that labrum,
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go to some good internal rotation
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here,
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do little scours this way, and then little
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scours this way.
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So, once again, guys, we're taking
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the humeral head and just rotating it
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against the labrum with a little bit of
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compression to try to irritate or catch
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a little tear, and a positive would be a
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popping or clicking. Now, we didn't have
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any popping or clicking here with
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Melissa, so that would be a negative test.
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Thank you, Melissa. Now, what I should mention
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about this test, which is going to
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surprise you, is this test probably has 0
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clinical significance. That is, the
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specificity and sensitivity are so low on
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this test according to research that we
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currently have, that it is probably not a
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great test by itself. So why am I showing
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it to you?
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Well, I'm showing it to you for two
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reasons. One, it is a commonly used test that
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I want you to be aware of in case
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you see a positive compression
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rotation test on somebody's
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assessment. I also want you to be aware of it
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if you're about to take your boards,
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because it could obviously be on board
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exams or other tests that you might take
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as you amass some credentials in your
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profession. But more than that, it is used
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in some of the testing clusters which
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we're going to go over in a separate
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video. And if I, personally, am going to
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use special tests at all, it is going to
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be in these clusters, which are the only
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way we seem to get good specificity and
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good sensitivity so that we have good
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reliability of our special testing, or
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diagnostic testing.
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I hope you guys enjoyed this video.
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Practice this test a little bit. The hand
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positioning is a little awkward, so I
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wouldn't just start in on a patient and
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and try this test for the first time.
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Grab some of your peers first. If you have
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any questions, please leave them in the
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comments box below.
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