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This is Brent of the Brookbush Institute,
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and in this video we're going over two
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special, or orthopedic tests for the
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shoulder. We're going to go over the
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empty can test and the full can test.
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These are generally used as indicators
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of impingement and/or rotator cuff tears,
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specifically the supraspinatus. I'm
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going to have my friend, Melissa, come out.
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She's going to help me demonstrate. Now,
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we're going to start with the empty can
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test, because this test was around first.
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I'm going to go ahead and have Melissa
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hold her arms out to 90 degrees of
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abduction. What I'm going to do is I'm
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going to press down. I'm going to note
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how strong is Melissa into abduction,
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especially on the symptomatic side.
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I'm then going to have her turn her
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thumbs down. I'm going to bring her into
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the scapular plane, which is 30 degrees
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of horizontal adduction, and I'm going
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to press down again. If I press
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down again, and this position is weaker
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on her symptomatic side, this may be an
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indicator of impingement and/or rotator
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cuff damage, specifically to the
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supraspinatus. I could add a little bit
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more provocation to this by just simply
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asking, "Does this replicate your symptoms?"
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Now, my guess is that the idea behind
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this test was in this position, maybe
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your deltoid couldn't contribute to as
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much abduction, and that that would place
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more stress on your supraspinatus. But,
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that's not exactly how things work out.
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Your deltoids and supraspinatus
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are both very involved in
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abduction in both positions. And what we
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find is that the full can test, which
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was actually the first part of this test,
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is just as specific and sensitive as the
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empty can test. So, we're going to start
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over and show just the full can portion.
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Go ahead and bring your arms up.
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She's at 90 degrees with her thumbs
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pointing up. I'm going to press down- a
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little different than the empty can test,
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I'm going to try to note differences
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between her symptomatic and asymptomatic
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sides. I'm going to ask her, "Does this
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provoke pain?
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Does this provoke your symptoms?" No. So, in
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Melissa's case, this is not her
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concordance sign. She has a negative full
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can test. We also notice she had a
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negative empty can test. Now, as I said
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before, guys, these two tests have very
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similar specificity and sensitivity. I
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don't see a reason to use one over the
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other, unless you happen to be putting
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these tests inside of a testing cluster
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and it asks for one of them specifically.
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Personally, I probably would not use the
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empty can test, because it's just more
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steps, and it's more complexity that may
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actually reduce my test
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reliability. When you're doing any sort
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of special testing, you have to keep in
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mind that this is just one clue in a
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whole battery of tests, as well of as
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our subjective assessment that's going
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to help give us some indicators of
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whether or not this is impingement,
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rotator cuff damage, etc. Now, if that was
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her concordance sign- this was the test
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that as soon as I put my hands down, she
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was like, "That's it. That's my pain," that's
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the stuff you guys need to put an
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asterisk by, because that's the quick
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test that we'll use session after session.
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Put your arms up. Does that hurt? Ow, yes. Okay,
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that hurts. Great. I'm going to do some
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interventions. I'm going to kind of work
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through that hypothesis. And then, even
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after a couple interventions, go ahead
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and have her throw her arms back up. "Does
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that feel any better?" Yes. Good. Those
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interventions were successful. Alright,
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so there you have it- the full can
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test and the empty can test. Make sure you
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keep in mind that these tests are only
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clues and should be used within clusters
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and be rated against your subjective
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assessment and your hypothesis. I hope
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you guys learned a lot from this video.
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I'll talk to you soon.