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This is Brent of the Brookbush Institute and in this video, we're
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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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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.