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Shouldder Special Test: Full Can and Empty Can Test
The Shoulder Special Test: Full Can and Empty Can Test is a clinical assessment used to identify pathological shoulder pain and determine which structures of the shoulder are involved. To perform the test, the patient squeezes a can filled with a fixed amount of liquid while the examiner pulls the patient's arm. This is followed by the same procedure with an empty can to assess any differences in the patient's response. The results of the test allow the practitioner to determine the source of pain and any potential pathology
Transcript
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This is Brent of the Brookbush Institute,
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...blank
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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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of exams
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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.
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