Would you like to view this video?

Shoulder Special Test: Compression Rotation Test

0

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.

0

Transcript

00:00:0400:00:06
This is Brent of the Brookbush Institute and in this video, we're
00:00:0400:00:06
...blank
00:00:0600:00:09
going over a special, or orthopedic test for
00:00:0900:00:09
the shoulder.
00:00:0900:00:12
This is the compression rotation test
00:00:1200:00:15
which is indicative of a slap lesion.
00:00:1500:00:17
That's a superior labral tear from
00:00:1700:00:19
anterior to posterior. I'm going to have my
00:00:1900:00:20
friend, Melissa, come out. She's going to help me
00:00:2000:00:24
demonstrate. Now, this test is done in supine
00:00:2400:00:27
position, and mechanically, it does make
00:00:2700:00:29
some sense. It takes a little bit of
00:00:2900:00:31
practice, but we're
00:00:3100:00:33
going to try to drive the humeral head into
00:00:3300:00:36
the glenoid fossa, and then try to catch
00:00:3600:00:40
a tear in the labrum by going through
00:00:4000:00:42
internal and external rotation. And what
00:00:4200:00:43
that's going to look like, is I'm going to
00:00:4300:00:46
passively bring Melissa into 90 degrees
00:00:4600:00:48
of abduction with 90 degrees of elbow
00:00:4800:00:51
flexion. I'm then going to use one hand to
00:00:5100:00:57
compress her humeral head into her glenoid fossa.
00:00:5700:00:59
And what I'm actually doing here, guys, I
00:00:5900:01:01
kind of cup the elbow, and then I just
00:01:0100:01:04
lean my my thigh into my hand, so that I'm
00:01:0400:01:06
not actually muscling the
00:01:0600:01:08
compression. And then what I'm going to do
00:01:0800:01:10
with my other hand is go through
00:01:1000:01:14
internal and external rotation with the
00:01:1400:01:17
intent of trying to catch this little
00:01:1700:01:21
tear or lesion, maybe pinch the lesion,
00:01:2100:01:25
maybe I'll find an area of pain.
00:01:2500:01:27
The actual positive for this test is a
00:01:2700:01:31
clicking or popping. So, you guys can
00:01:3100:01:33
see here how I'm going back and forth
00:01:3300:01:35
through internal and external rotation.
00:01:3500:01:38
It is suggested that both small movements
00:01:3800:01:42
as well as large movements are used to
00:01:4200:01:45
try to get a catch. You might go in
00:01:4500:01:49
little external rotation segments and then
00:01:4900:01:51
little internal rotation segments, and
00:01:5100:01:54
just try to be thorough as you think
00:01:5400:01:57
about scanning the labrum with the
00:01:5700:01:59
humeral head. I'm going to show you guys what the
00:01:5900:02:02
other side looks like here.
00:02:0400:02:07
So again, I'm going to kind of palm her
00:02:0700:02:10
elbow here and then just use my thigh,
00:02:1000:02:12
and it really doesn't matter which hand
00:02:1200:02:14
you use. You can you either hand
00:02:1400:02:16
as long as you're comfortable moving the
00:02:1600:02:22
arm with the other hand. I can go this
00:02:2200:02:27
way and just kind of scan that labrum,
00:02:2700:02:30
go to some good internal rotation
00:02:3000:02:31
here,
00:02:3100:02:35
do little scours this way, and then little
00:02:3500:02:39
scours this way.
00:02:4100:02:44
So, once again, guys, we're taking
00:02:4400:02:47
the humeral head and just rotating it
00:02:4700:02:49
against the labrum with a little bit of
00:02:4900:02:53
compression to try to irritate or catch
00:02:5300:02:56
a little tear, and a positive would be a
00:02:5600:02:58
popping or clicking. Now, we didn't have
00:02:5800:02:59
any popping or clicking here with
00:02:5900:03:02
Melissa, so that would be a negative test.
00:03:0200:03:06
Thank you, Melissa. Now, what I should mention
00:03:0600:03:07
about this test, which is going to
00:03:0700:03:12
surprise you, is this test probably has 0
00:03:1200:03:15
clinical significance. That is, the
00:03:1500:03:18
specificity and sensitivity are so low on
00:03:1800:03:19
this test according to research that we
00:03:1900:03:22
currently have, that it is probably not a
00:03:2200:03:25
great test by itself. So why am I showing
00:03:2500:03:26
it to you?
00:03:2600:03:27
Well, I'm showing it to you for two
00:03:2700:03:30
reasons. One, it is a commonly used test that
00:03:3000:03:32
I want you to be aware of in case
00:03:3200:03:34
you see a positive compression
00:03:3400:03:36
rotation test on somebody's
00:03:3600:03:38
assessment. I also want you to be aware of it
00:03:3800:03:40
if you're about to take your boards,
00:03:4000:03:41
because it could obviously be on board
00:03:4100:03:44
exams or other tests that you might take
00:03:4400:03:47
as you amass some credentials in your
00:03:4700:03:50
profession. But more than that, it is used
00:03:5000:03:54
in some of the testing clusters which
00:03:5400:03:55
we're going to go over in a separate
00:03:5500:03:59
video. And if I, personally, am going to
00:03:5900:04:02
use special tests at all, it is going to
00:04:0200:04:05
be in these clusters, which are the only
00:04:0500:04:09
way we seem to get good specificity and
00:04:0900:04:12
good sensitivity so that we have good
00:04:1200:04:15
reliability of our special testing, or
00:04:1500:04:17
diagnostic testing.
00:04:1700:04:18
I hope you guys enjoyed this video.
00:04:1800:04:21
Practice this test a little bit. The hand
00:04:2100:04:23
positioning is a little awkward, so I
00:04:2300:04:25
wouldn't just start in on a patient and
00:04:2500:04:27
and try this test for the first time.
00:04:2700:04:29
Grab some of your peers first. If you have
00:04:2900:04:31
any questions, please leave them in the
00:04:3100:04:32
comments box below.