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Speed's Test - Shoulder Special/Orthopedic Test for Biceps Tendon, Transverse Ligament and Labrum Integrity

This video demonstrates how to perform Speed's Test - a shoulder orthopedic test used to assess the integrity of the biceps tendon, transverse ligament and labrum. Watch the step-by-step instructions to get detailed instruction how to assess the function of the shoulder in the clinic.

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Transcript

00:04 - 00:06This is Brent of the Brookbush Institute, and
00:06 - 00:07in this video we're going over the
00:07 - 00:09Speed's Test. It's a special, or
00:09 - 00:11orthopedic test that helps us in the
00:11 - 00:15diagnosis of labral tears, slap lesions,
00:15 - 00:17which is a type of label tear, biciptal
00:17 - 00:20tendinosis, and/or transverse
00:20 - 00:22ligament ruptures. I'm going to have
00:22 - 00:23my friend, Brian, come out. He's going to
00:23 - 00:25help me demonstrate the Speed's Test. Now,
00:25 - 00:28this isn't a complicated test. All I'm going to have
00:28 - 00:30Brian do is go ahead and turn his palm up,
00:30 - 00:33lock his elbow, and with palm up and
00:33 - 00:35elbow locked have him raise his
00:35 - 00:37arm against my resistance. I'm going to
00:37 - 00:39resist the first 60 degrees of flexion, and then I'll
00:39 - 00:44ask Brian, "How did that feel?" No pain. No
00:44 - 00:48pain. So, as long as he didn't get pain in
00:48 - 00:52his bicipital groove, that's considered a
00:52 - 00:54negative test. If you guys aren't quite sure
00:54 - 00:56where your bicipital groove is, here's a really
00:56 - 01:00quick tip for palpation. If you put
01:00 - 01:03your thumb over the anterior humorous,
01:03 - 01:07internally and externally rotate the arm,
01:07 - 01:10you'll start to feel these two bumps
01:10 - 01:12come under your thumb. Those two bumps, or
01:12 - 01:14your tubercles, are your greater and
01:14 - 01:16lesser tubercles, and they'll just kind of
01:16 - 01:18thump-thump, thump-thump underneath your
01:18 - 01:21thumb. Right between those two would
01:21 - 01:23be your bicipital groove, so I
01:23 - 01:25can feel his bicipital groove right there.
01:25 - 01:27Alright, so I'm going to keep my thumb
01:27 - 01:29there and just go ahead and do this test one
01:29 - 01:33more time. Go ahead. Palm up, elbow locked.
01:33 - 01:35Go ahead and push up. I'm going to resist
01:35 - 01:38that first 60 degrees of flexion. Now,
01:38 - 01:41let's say this time Brian said that hurt.
01:41 - 01:44That hurt. Where did it hurt? Right there.
01:44 - 01:46Right there. Okay, so that's a positive
01:46 - 01:49Speed's Test. I can further confirm my
01:49 - 01:51findings by having him
01:51 - 01:56turn palm down, keep elbow locked, and do
01:56 - 01:59the same thing.
02:00 - 02:03How'd that feel? Less pain. If he says
02:03 - 02:05less pain, that's actually further
02:05 - 02:06confirming our findings, at least
02:06 - 02:09according to certain texts. Most research
02:09 - 02:14only uses the 60 degrees of flexion test
02:14 - 02:17by itself, noting that if somebody has
02:17 - 02:20pain in their bicipital groove, that is
02:20 - 02:24a positive indicator of something going
02:24 - 02:26on here involving either the labrum or the
02:26 - 02:29biceps tendon. Let's give you guys a lateral
02:29 - 02:31view. One thing you do have to be
02:31 - 02:32careful with- you guys notice I take this
02:32 - 02:34hand and I kind of stabilize the scapula
02:34 - 02:37and torso and then put my thumb over
02:37 - 02:39that bicipital groove, that's so I
02:39 - 02:43obviously know if he's feeling pain
02:43 - 02:44there. I can kind of just point to my
02:44 - 02:46thumb and ask, "Do you feel pain under my
02:46 - 02:48thumb?" And then I can use this hand to
02:48 - 02:50prevent him from cheating, because what
02:50 - 02:52you'll see is sometimes when people have
02:52 - 02:53shoulder pain, they do something that
02:53 - 02:55looks a little bit like that cheat curl
02:55 - 02:57that you've seen in the gym. This
02:57 - 02:59whole thing. We want to make sure he
02:59 - 03:01stays up and he's just raising up at the
03:01 - 03:03arm so that we are testing shoulder
03:03 - 03:08flexion here. How'd that feel? Fine. Fine,
03:08 - 03:10alright. So, we're pretty sure that
03:10 - 03:13Brian has a negative Speed's test altogether.
03:13 - 03:16Thanks, Brian. Now, if I'm doing
03:16 - 03:17the Speed's Test, please understand
03:17 - 03:20that I've probably done a subjective
03:20 - 03:21evaluation that's given me some
03:21 - 03:24indication that a labral tear is
03:24 - 03:26possible. So, we're probably thinking more
03:26 - 03:28towards acute injuries than chronic
03:28 - 03:30injuries. We're probably thinking
03:30 - 03:31something that would have to do with
03:31 - 03:36either throwing, landing on a shoulder or
03:36 - 03:39some sort of impact injury. Brian's
03:39 - 03:42and Jiu Jitsu, which isn't necessarily a
03:42 - 03:44throwing sport, but you do end up with
03:44 - 03:47your arm locked back in this position.
03:47 - 03:49It's very easy to end up in some
03:49 - 03:52sort of acute trauma where you land on
03:52 - 03:54that shoulder, so we definitely have a
03:54 - 03:56possibility with Brian. I probably would
03:56 - 03:59have already taken him through my
03:59 - 04:02Impingement Clusters, my rotator cuff
04:02 - 04:07cluster, and I'm getting a set of
04:07 - 04:09positives and negatives that I'm just
04:09 - 04:12not happy with. So, now I'm looking for a
04:12 - 04:16better diagnosis than what I currently
04:16 - 04:18have, which would where these labral tests
04:18 - 04:21come in. Now, labral tests, in general, for
04:21 - 04:23human movement professionals are kind of
04:23 - 04:26a screening. We're going to see if this
04:26 - 04:29person can actually be helped by us or if
04:29 - 04:32we should refer out for further
04:32 - 04:35diagnostic testing, for example, maybe an
04:35 - 04:39MRI. If somebody does have a labral tear,
04:39 - 04:42these are often things that have to be
04:42 - 04:45surgically treated. So, there you guys
04:45 - 04:48have it. Speed's Test is one of several
04:48 - 04:51labral tear tests that we're going to go
04:51 - 04:53over in the next several videos. If you
04:53 - 04:55have any questions, please leave them in
04:55 - 04:57the comments section below. I look
04:57 - 04:59forward to hearing from you.
05:05 - 05:07

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