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Shoulder Painful Arc Test
The Shoulder Painful Arc Test is a physical examination to evaluate shoulder pain. It evaluates the tenderness, range of motion, and strength in the shoulder region. This test is used to diagnose shoulder impingement and labral tears, and could help doctors determine the cause of shoulder pain.
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 to go over the
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special or orthopedic test known as the
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Painful Arc Test. This is part of our
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shoulder evaluation for impingement syndrome.
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I'm going to have my friend Melissa
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come out, she's going to help me demonstrate.
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Now, we're going to pretend
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for a second that you're having pain in your right shoulder.
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What I'm going to have you do is I'm going to
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have you go ahead and raise your arm up
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like this. Good. Did that hurt?
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-Yes.
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From here we want to try to get a little
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bit more out of Melissa because just
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saying "this hurt" is good, but a
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positive Painful Arc test is actually
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pain between 60 and 120 degrees of
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abduction, and then a decrease or absence
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of pain at the top. So what I want you to
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do is slowly raise your arm this time. I
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want you to tell me where the pain
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starts, where it's at its worst, and if it
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gets better as you start moving further
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and further into (this is called)
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abduction. Go ahead and try that for me.
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-Pain.
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So, pain started there.
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-Worse.
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Okay. What about there?
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-Gone.
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So, that would be a very common finding for a
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positive painful arc, that they have
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pain starting about here it gets worse,
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and worse, and worse,
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and then all of a sudden, as they get up
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in here, it gets better again. Now, just as
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we've talked about with all of these tests,
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this is not a particularly sensitive or
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specific test, as many of our impingement
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tests aren't. This is a test that we
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use in a whole lot of clusters and I
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think it's because it's one of those
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subjective findings we hear from
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patients a lot. They talk about " it
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hurts when I'm raising my arm, but then
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when my arm is up here it doesn't hurt
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as much. I've just got to get through this
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part here and then I'm okay."
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That's a great subjective finding,
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something we
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can definitely work on, but as it goes
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for the research side of this,
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specificity and sensitivity is fairly
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low. With all of these impingement tests
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we tend to cluster them, and
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unfortunately, despite this not being a
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great test, it is found in all of the
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impingement testing clusters.
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So, how would I use this test in a cluster?
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And, of course, is this their
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concordant sign? Is this the one test that I can
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keep coming back to, that "boom", there's
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their symptoms and I can use it as a pre
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and post-test in between interventions?
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I want to show you guys what this looks
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like from the front again.
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Once again Melissa, we're going to go
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ahead and have you raised this arm. I
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want you to tell me when it starts
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hurting, when the pain is at its worst,
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and when it starts dissipating or
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disappears.
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-Pain.
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-Worse.
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-Gone.
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Okay, maybe a little simplified I'm sure you guys can
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get a little bit more information out of your patients,
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but Melissa here does not have
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impingement on her right side. Once again
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guys, step up your assessment game.
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It really is going to be what makes you a
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marquis professional. The more tests you
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have, the more clusters of tests you
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bring in, the stronger your hypothesis,
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and if you can get a strong hypothesis
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together, that's where you can start
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building some very sophisticated
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interventions.
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I'll talk with you guys soon.
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...blank
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