Common musculoskeletal tests
(cervical ,shoulder and elbow)
Cervical spine
Spurling’s test
Tests : nerve root compression.
Procedure: patient sitting. Extend neck and rotate head. Apply
downward pressure to head.
Positive sign: radiating pain into shoulder or arm on side to which the
head is rotated.
Distraction test
Tests : nerve root compression.
Procedure: patient in sitting. Place one hand under chin and other hand
under occiput. Gently lift patient’s head.
Positive sign: relief or decrease in pain.
, Shoulder
Active compression test (O’Brien)
Tests : labral pathology, acromioclavicular joint pathology.
Procedure: patient upright with elbow in extension and shoulder in 90°
flexion, 10–15° adduction and medial rotation.
Stand behind patient and apply downward force to arm. Repeat with
arm in lateral rotation.
Positive sign: pain/increased pain with medial rotation and decreased
pain with lateral rotation. Pain inside the glenohumeral joint indicates
labral abnormality. Pain over the acromioclavicular joint indicates
acromioclavicular joint abnormality.
Anterior drawer test
Tests : anterior shoulder stability.
Procedure: patient supine. Place shoulder in 80–120° abduction, 0–20°
forward flexion and 0–30° lateral rotation. Stabilize scapula. Draw
humerus anteriorly.
Positive sign: click and/or apprehension.
Anterior slide test
Tests : labral pathology.
Procedure: patient upright with hands on hips, thumbs facing
posteriorly. Stand behind patient and stabilize scapula and clavicle with
one hand. With the other, apply an anterosuperior force to elbow while
instructing the patient to gently push back against the force.
Positive sign: pain/reproduction of symptoms/click.
Apprehension test
Tests : glenohumeral joint stability.
Procedure: patient in standing or supine. Abduct shoulder to90°. Move it
into maximum lateral rotation. If movement well tolerated, apply a
(cervical ,shoulder and elbow)
Cervical spine
Spurling’s test
Tests : nerve root compression.
Procedure: patient sitting. Extend neck and rotate head. Apply
downward pressure to head.
Positive sign: radiating pain into shoulder or arm on side to which the
head is rotated.
Distraction test
Tests : nerve root compression.
Procedure: patient in sitting. Place one hand under chin and other hand
under occiput. Gently lift patient’s head.
Positive sign: relief or decrease in pain.
, Shoulder
Active compression test (O’Brien)
Tests : labral pathology, acromioclavicular joint pathology.
Procedure: patient upright with elbow in extension and shoulder in 90°
flexion, 10–15° adduction and medial rotation.
Stand behind patient and apply downward force to arm. Repeat with
arm in lateral rotation.
Positive sign: pain/increased pain with medial rotation and decreased
pain with lateral rotation. Pain inside the glenohumeral joint indicates
labral abnormality. Pain over the acromioclavicular joint indicates
acromioclavicular joint abnormality.
Anterior drawer test
Tests : anterior shoulder stability.
Procedure: patient supine. Place shoulder in 80–120° abduction, 0–20°
forward flexion and 0–30° lateral rotation. Stabilize scapula. Draw
humerus anteriorly.
Positive sign: click and/or apprehension.
Anterior slide test
Tests : labral pathology.
Procedure: patient upright with hands on hips, thumbs facing
posteriorly. Stand behind patient and stabilize scapula and clavicle with
one hand. With the other, apply an anterosuperior force to elbow while
instructing the patient to gently push back against the force.
Positive sign: pain/reproduction of symptoms/click.
Apprehension test
Tests : glenohumeral joint stability.
Procedure: patient in standing or supine. Abduct shoulder to90°. Move it
into maximum lateral rotation. If movement well tolerated, apply a
