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Speed's Test - Shoulder Special/Orthopedic Test for Biceps Tendon, Transverse Ligament and Labrum Integrity
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Speed's Test is a special/orthopedic test used to assess shoulder integrity and to evaluate shoulder stability. Specifically, this test is used to assess the condition of the biceps tendon, transverse ligament, and labrum (or glenoid labrum). The patient's shoulder is stretched by the examiner in order to place the shoulder in specific positions in order to evaluate stability and integrity. In some cases, this test is used as part of an orthopedic assessment to evaluate
Transcript
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This is Brent of the Brookbush Institute, and
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...blank
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in this video we're going over the
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Speed's Test. It's a special, or
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orthopedic test that helps us in the
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diagnosis of labral tears, slap lesions,
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which is a type of label tear, biciptal
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tendinosis, and/or transverse
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ligament ruptures. I'm going to have
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my friend, Brian, come out. He's going to
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help me demonstrate the Speed's Test. Now,
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this isn't a complicated test. All I'm going to have
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Brian do is go ahead and turn his palm up,
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lock his elbow, and with palm up and
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elbow locked have him raise his
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arm against my resistance. I'm going to
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resist the first 60 degrees of flexion, and then I'll
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ask Brian, "How did that feel?" No pain. No
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pain. So, as long as he didn't get pain in
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his bicipital groove, that's considered a
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negative test. If you guys aren't quite sure
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where your bicipital groove is, here's a really
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quick tip for palpation. If you put
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your thumb over the anterior humorous,
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internally and externally rotate the arm,
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you'll start to feel these two bumps
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come under your thumb. Those two bumps, or
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your tubercles, are your greater and
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lesser tubercles, and they'll just kind of
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thump-thump, thump-thump underneath your
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thumb. Right between those two would
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be your bicipital groove, so I
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can feel his bicipital groove right there.
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Alright, so I'm going to keep my thumb
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there and just go ahead and do this test one
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more time. Go ahead. Palm up, elbow locked.
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Go ahead and push up. I'm going to resist
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that first 60 degrees of flexion. Now,
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let's say this time Brian said that hurt.
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That hurt. Where did it hurt? Right there.
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Right there. Okay, so that's a positive
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Speed's Test. I can further confirm my
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findings by having him
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turn palm down, keep elbow locked, and do
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the same thing.
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How'd that feel? Less pain. If he says
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less pain, that's actually further
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confirming our findings, at least
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according to certain texts. Most research
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only uses the 60 degrees of flexion test
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by itself, noting that if somebody has
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pain in their bicipital groove, that is
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a positive indicator of something going
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on here involving either the labrum or the
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biceps tendon. Let's give you guys a lateral
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view. One thing you do have to be
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careful with- you guys notice I take this
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hand and I kind of stabilize the scapula
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and torso and then put my thumb over
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that bicipital groove, that's so I
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obviously know if he's feeling pain
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there. I can kind of just point to my
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thumb and ask, "Do you feel pain under my
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thumb?" And then I can use this hand to
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prevent him from cheating, because what
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you'll see is sometimes when people have
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shoulder pain, they do something that
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looks a little bit like that cheat curl
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that you've seen in the gym. This
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whole thing. We want to make sure he
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stays up and he's just raising up at the
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arm so that we are testing shoulder
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flexion here. How'd that feel? Fine. Fine,
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alright. So, we're pretty sure that
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Brian has a negative Speed's test altogether.
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Thanks, Brian. Now, if I'm doing
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the Speed's Test, please understand
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that I've probably done a subjective
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evaluation that's given me some
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indication that a labral tear is
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possible. So, we're probably thinking more
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towards acute injuries than chronic
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injuries. We're probably thinking
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something that would have to do with
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either throwing, landing on a shoulder or
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some sort of impact injury. Brian's
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and Jiu Jitsu, which isn't necessarily a
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throwing sport, but you do end up with
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your arm locked back in this position.
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It's very easy to end up in some
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sort of acute trauma where you land on
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that shoulder, so we definitely have a
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possibility with Brian. I probably would
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have already taken him through my
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Impingement Clusters, my rotator cuff
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cluster, and I'm getting a set of
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positives and negatives that I'm just
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not happy with. So, now I'm looking for a
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better diagnosis than what I currently
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have, which would where these labral tests
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come in. Now, labral tests, in general, for
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human movement professionals are kind of
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a screening. We're going to see if this
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person can actually be helped by us or if
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we should refer out for further
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diagnostic testing, for example, maybe an
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MRI. If somebody does have a labral tear,
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these are often things that have to be
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surgically treated. So, there you guys
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have it. Speed's Test is one of several
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labral tear tests that we're going to go
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over in the next several videos. If you
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have any questions, please leave them in
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the comments section below. I look
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forward to hearing from you.
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