Shoulder Painful arc + Neer + in at least

Normal ROM resisted ER 3/5 tests

Flexion 160-180° Posterior Pain felt 75.5 85
Extension 50-60° impingement: posteriorly
Abduction 170-180° apprehension
Adduction 50-75° position
Medial rotation 70-90° Instability
Lateral rotation 80-100° Relocation Relief of 96.7 78
apprehension
Myotomes: Apprehension Apprehensive 98.3 71.6
C4 Shoulder elevation feeling
C5 Shoulder abduction Load and shift Increased 71.7 89.9
translation of
C6 Elbow flexion, wrist extension
humeral head
C7 Elbow extension, wrist flexion
anteriorly
C8 Thumb abduction & extension
Release Sudden 91.7 83.5
T1 Finger abduction
apprehension
Dermatomes:
Sulcus Increased 28-72 86-97
C4 Clavicle to AC joint
translation of
C5 Lateral deltoid humeral head
C6 Anterior arm, radial side of hand to thumb & inferiorly
index finger Posterior Increased 50-91 85-100
C7 Lateral arm & forearm to index, middle and ring subluxation test translation of
fingers humeral head
C8 Medial arm and forearm to middle, ring and little posteriorly
fingers SLAP and biceps related injury
Speed’s Pain: ?long-head 54 81
Reflexes: of bicep tear
C5 nerve root Biceps brachii O’Brien Pain: ?SLAP tear 61 84
C6 nerve root Brachioradialis Biceps load test Pain: ?SLAP tear 29 78
C7 nerve root Triceps Cluster Test of: Pain 25 92
Pathological Hoffman’s reflex Speed’s +
Pathological Inverted supinator reflex Apprehension +
O’Brien
Muscles and their movements: Passive Pain: ?SLAP tear 82 86
Flexion Deltoid, pec major, compression
coracobrachialis, biceps brachii test
Extension Deltoid, latissimus dorsi, teres Scapular Dyskinesis
major, triceps brachii Scapular Decreased pain 21-24 71-21
Abduction Deltoid, supraspinatus assistance test
Adduction Deltoid, pec major, lat dorsi, teres Scapular Increased 26- 33-70
major resistance test strength or 100
Internal rotation Deltoid, pec major, lat dorsi, teres decreased pain
major, subscapularis
External rotation Deltoid, infraspinatus, teres minor Causes of Referred Pain & Red Flags:
Somatic referred pain: Visceral referred pain:
Special Tests: cervical/thoracic spine, diaphragm, heart, spleen,
Testing Positive Sensitivity Specificity myofascial structures gall bladder, apex of lungs
for: result: Tumours Acute compartment
Rotator cuff pathology syndrome
Full Can Weakness and pain 59-89 54-82 Fractures Infection
Lift-Off Weakness: 50 88 Nerve/vascular Myocardial infarct (left
(Gerber) ?subscapularis tear compromise shoulder pain commonly
ER lag sign Weakness: 36 95 reported)
?infraspinatus tear Thoracic outlet syndrome Axillary/long thoracic nerve
Impingement injury
Cluster Test of: Pain 75 74
Jobe + Hawkins + reproduced
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Wrist and Hand Abduction Abductor pollicis longus, abductor
Wrist Normal ROM pollicis brevis
Flexion 0-80° Adduction Adductor pollicis
Extension 0-70° Opposition Opponens pollicis
Radial deviation 30°
Ulnar deviation 20° Special Tests:
Supination 60° Testing for: Positive result: Sensitivity Specificity
Pronation 40° Carpal Tunnel Syndrome
Phalen’s Reproduction of 92 88
Myotomes: symptoms
C6 Elbow flexion, wrist extension Tinel’s Electric shock 97 91
C7 Elbow extension, wrist flexion sensation or
C8 Thumb abduction & extension paraesthesia in
T1 Finger abduction median nerve
distribution
Dermatomes: Triangular fibrocartilage complex disruption
C6 Anterior arm, radial side of hand to thumb & Ulna foveal Tenderness ++ 95.2 86.5
index finger sign that replicates pt’s
pain
C7 Lateral arm & forearm to index, middle and ring
fingers Press test Axial ulnar load 100 NA
C8 Medial arm and forearm to middle, ring and little that reproduces
pt’s symptoms
fingers
Scapholunate Injury
T1 Medial side of forearm to the base of the little
finger Watson’s Reproduction of 69 66
scaphoid pain +/-
shift hypermobility
Wrist Muscles and their movements:
Flexion Flexor carpi radialis, flexor carpi
Outcome Measures:
ulnaris
Extension Extensor carpi radialis longus, Measure: Assesses:
extensor carpi radialis brevis, Patient Rated Wrist Pain and disability for wrist
extensor carpi ulnaris Evaluation pathology
Radial deviation Flexor carpi radialis, extensor carpi DASH & Quick DASH Physical function, symptoms
radialis longus, extensor carpi and quality of life for upper
radialis brevis limb disorders
Ulnar deviation Flexor carpi ulnaris, extensor carpi Grip Strength Grip strength…
ulnaris Mayo Wrist Score Objective and subjective Ax
of pain/function/ROM
Finger Muscles and their movements: Michigan Hand ADLs, pain, aesthetics and
Flexion at MCP Lumbricals, interossei, flexor digiti Outcomes Questionnaire satisfaction for hand
minimi pathologies
Flexion at DIP Lumbricals, flexor digitorum
superficialis Causes of Referred Pain & Red Flags:
Flexion at PIP Flexor digitorum profundus Carpal dislocation Radial epiphyseal stress
reaction (common in
Extension at MCP Extensor digitorum, extensor
indicis, extensor digiti minimi gymnastics)
Extension at DIP Lumbricals, interossei Scapholunate/perilunar Kienbock’s disease
and PIP dislocation
Lunotriquetral Carpal instability
Abduction at MCP Dorsal interossei, abductor digiti
dissociation
minimi
Adduction Palmar interossei Infections Fractures
Rheumatoid arthritis Peripheral neuropathy
Opposition Opponens digiti minimi
Peripheral vascular Lyme disease
disease
Thumb Muscles and their movements:
Tuberculosis Arthritides
Flexion Flexor pollicis longus, flexor pollicis
brevis
Extension Extensor pollicis longus, extensor
pollicis brevis
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Hip FADIR Pain 99 5
Hip Normal ROM Flexion internal Pain 96 25
Flexion 0-120° rotation
Extension 0-30° Gluteal Tendinopathy
Abduction 0-40° Trendelenburg Drop in the NWB 61 92
Adduction 0-30° pelvis
Internal rotation 0-45° Resisted internal Weakness and pain 55 69
External rotation 0-45° rotation
Resisted external Pain 88 97.3
Myotomes: de-rotation test
L2 Hip flexion Resisted hip Weakness and pain 71 84
L3 Knee extension abduction
S1 Hip extension Single leg stance for Pain in single leg 100 97.3
30sec stance
Dermatomes: Hip Osteoarthritis
L1 Lower back, over trochanter and groin Cluster test of: Lateral >3/5 variables NA NA
L2 Lower back, front of thigh to knee pain on active flexion + present = 68%
L3 Lower back, upper buttock, anterior thigh and positive Scour + pain chance of OA
with active extension +
knee, medial lower leg
passive internal 4-5/5 variables
L4 Medial buttock, lateral thigh, medial leg
rotation <25° + present = 91%
L5 Buttock, posterior and lateral thigh
Squatting aggravates chance of OA
S1 Buttock, thigh and posterior leg
symptoms
S2 Buttock, thigh and posterior leg
Outcome Measures:
Hip Muscles and their movements:
Measure: Assesses:
Flexion Iliacus, psoas major, rectus
International Hip Self-administered
femoris, sartorius, pectineus
Outcome Tool-33 questionnaire assessing
Extension Gluteus maximus,
symptoms and function in
semitendinosus,
younger patients
semimembranosus, biceps
Hip Dysfunction and Self-administered
femoris
Osteoarthritis Outcome questionnaire assessing
Abductors Gluteus maximus, gluteus
Score symptoms and function in
medius, gluteus minimus,
patients with hip OA or
tensor fascia latae, sartorius,
arthroscopy
piriformis
Copenhagen Hip and Self-administered
Adductors Adductor magnus, adductor
Groin Outcome Score questionnaire assessing
longus, adductor brevis, gracilis,
symptoms and function in
pectineus
patients with hip + groin pain
Internal rotation Gluteus medius, gluteus
6MWT, 10MWT, TUG Assessment of function and
minimus, tensor fascia latae
endurance
External rotation Gluteus maximus, quadratus
Harris Hip Score Assessment of patients post
femoris, piriformis, obturator
hip surgery
externus, obturator internus,
gemellus superior, gemellus
Causes of Referred Pain & Red Flags:
inferior, sartorius
Avascular necrosis of the Synovial chondromatosis
femoral head
Special Tests:
Slipped capital femoral Perthes disease
Testing for: Positive Sensitivity Specificity
epiphysis (adolescents)
result:
Tumours Fractured NOF
Non-specific Intra-articular Pathology
Nerve root compression Saddle paraesthesia
FABER Pain 92 88
Night pain Lumps/bumps
Scour Pain 50 29
Infection Inability to weight bear
Thomas test Pain and reduced 89 92
History of trauma Constipation or vomiting
range
Labral Tear
Painful clicking Clicking 100 85
in hip
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Knee Reverse Lachman’s Soft end feel for 63 89
Knee Normal ROM tibial translation
Flexion 0-140° Meniscal Tear
Extension 0-5° McMurray’s Palpable/audible 61 84
click or pain
Myotomes: Joint line Reproduction of 83 83
L2 Hip flexion tenderness patient’s pain
L3 Knee extension Apley’s test Pain 61 70
L5/S1 Knee flexion Patellar Instability
Patellar Orally expressed 100 89.2
Dermatomes: Apprehension Test apprehension or
L1 Lower back, over trochanter and groin decreased
L2 Lower back, front of thigh to knee quadriceps
L3 Lower back, upper buttock, anterior thigh and recruitment
knee, medial lower leg Patellofemoral Pain
L4 Medial buttock, lateral thigh, medial leg Squatting Pain 91 50
L5 Buttock, posterior and lateral thigh Stair climbing Pain 72 43
S1 Buttock, thigh and posterior leg Prolonged sitting Pain 72 57
S2 Buttock, thigh and posterior leg Kneeling Pain 84 50

Knee Muscles and their movements: Outcome Measures:

Flexion Semitendinosus, Measure: Assesses:
semimembranosus, biceps femoris, Ottawa Knee Rules Age >55, pain at head of
gastrocnemius, gracilis, sartorius, fibula, isolated patella pain,
plantaris, popliteus inability to flex >90, inability
Extension Rectus femoris, vastus lateralis, to WB >4 steps – 2/5 of
vastus intermedius, vastus these positive = imaging
medialis, TFL required
Tibial lateral Biceps femoris Knee Injury and OA Self-administered
rotation Outcome Score (KOOS) questionnaire assessing the
Tibial medial Semitendinosus, pt’s opinion of their knee
rotation semimembranosus, gracilis, Lower Extremity Self-administered
sartorius, popliteus Functional Scale questionnaire assessing
symptoms, function,
Special Tests: progress and outcome
Testing for: Positive Sensitivity Specificity 6MWT, 10MWT, TUG Assessment of function and
result: endurance
ACL Injury Cincinnati Knee Rating Assessment of patients post
Lachman’s Test Soft end feel for 81 81 System ACL reconstruction
tibial translation
Anterior >5mm anterior 38 81 Causes of Referred Pain & Red Flags:
Drawer tibial translation Tibial plateau fracture Avulsion fracture of the
Pivot shift Anterior 28 81 tibial spine
subluxation of Osteochondritis dissecans Complex regional pain
tibia (adolescents) syndrome
MCL Injury Quadriceps muscle Tumour
Valgus stress Pain 78 67 rupture
test at 30° Laxity 91 49 Nerve root compression, Fracture
LCL Injury pins & needles,
Varus stress test at Pain and/or laxity NA NA numbness
30° Referred pain from the Slipped capital femoral
PCL Injury hip epiphysis
Posterior sag sign Posterior sagging of 46- 100 Perthes’ disease Obvious deformity
tibia 100 Night pain Lumps/bumps
Posterior drawer >5mm posterior 22- 98 Infection Inability to weight bear
tibial translation 100 History of trauma Constipation or vomiting

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Ankle Impingement ankle Pain greater in 94.8 88
Ankle Normal ROM sign dorsiflexion than in
Dorsiflexion 15-20° plantarflexion
Plantarflexion 50-60° Achilles Tendon Rupture
Inversion 30-40° Thompson’s calf Ankle remains still 40 NA
Eversion 15-20° squeeze test
Calf squeeze test Ankle remains still 96 93
Myotomes: Matles test Neutral or 88 85
L4 Dorsiflexion dorsiflexed ankle
L5 Big toe extension Palpation of gap in Tendon gap 73 89
S1 Plantar flexion, foot eversion tendon palpable
S2 Toe flexion
Outcome Measures:
Dermatomes: Measure: Assesses:
L4 Medial buttock, lateral thigh, medial leg, dorsum Ottawa Ankle Pain at lateral malleolus, pain at
of foot and big toe Rules medial malleolus, pain at base of 5th
L5 Buttock, posterior and lateral thigh, medial half of metatarsal, pain at navicular,
sole, 1st – 3rd toes inability to weight bare more than 4
S1 Buttock, thigh and posterior leg steps 2/5 of these positive = imaging
S2 Buttock, thigh and posterior leg required
Foot and Ankle Self-administered questionnaire
Reflexes: Ability Measure assessing the pt’s ADLs and sporting
activities
Pathological Clonus
Pathological Babinski/plantar response Lower Extremity Self-administered questionnaire
Functional Scale assessing symptoms, function,
progress and outcome
Ankle Muscles and their movements:
6MWT, 10MWT, Assessment of function and
Dorsiflexion Tibialis anterior, extensor
TUG endurance
digitorum longus, extensor hallucis
Oxford Ankle Self-administered questionnaire
longus, peroneus tertius
Foot assessing disability in children with
Plantarflexion Gastrocnemius, soleus, plantaris,
Questionnaire foot and ankle injuries
peroneus longus, tibialis posterior,
American Self-administered questionnaire
flexor digitorum longus, flexor
Academy of assessing ankle symptoms and
hallucis longus, peroneus brevis
Orthopaedic function
Inversion Tibialis anterior, tibialis posterior
Surgeons Foot
Eversion Peroneus longus, peroneus tertius,
and Ankle
peroneus brevis
Module
Berg Balance Assesses balance
Special Tests:
Scale
Testing for: Positive Sensitivity Specificity
4-Point Balance Assesses balance
result:
Scale
Ligament Injury
Anterior Soft end feel +/- 32- 80
Causes of Referred Pain & Red Flags:
Drawer (ATFL) anterior 80
Referred neural pain Sever’s disease
translation
(adolescents)
>4mm
Metabolic condition Diabetic neuropathy
Talar tilt (CFL) Excessive 52 NA
DVT Tumour
inversion
Nerve root compression, Fracture
translation +/-
soft end feel pins & needles,
numbness
Eversion stress Excessive 96 84
test (deltoid eversion CRPS type 1 Greenstick fracture in
ligament) translation +/- children
soft end feel Syndesmosis injury Tarsal coalition
Syndesmosis Injury Night pain Navicular stress fracture
Squeeze Test Pain +/- laxity 30 93.5 Infection Inability to weight bear
Ankle Impingement History of trauma Constipation or vomiting

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