Neer Test: The examiner should stabilize the patient's scapula with one hand, while passively

flexing the arm while it is internally rotated. If the patient reports pain in this position, then the
result of the test is considered to be positive for subacromial impingement syndrome.
Hawkins / Kennedy Impingement Test: The examiner places the patient's arm shoulder in 90
degrees of shoulder flexion with the elbow flexed to 90 degrees and then internally rotates the
arm. The test is considered to be positive for subacromial impingement syndrome if the patient
experiences pain with internal rotation.
Painful Arc: With the patient in either sitting or standing the patient should be instructed to
abduct the arm in the scapular plane. While abducting the arm, if the patient experiences any
pain in and around the glenohumeral joint the patient must tell the physiotherapist what they are
experiencing. Once there is an onset of pain the physiotherapist will instruct the patient to
continue abducting the arm as high as they can. One the patient gets to approximately 120
degrees of abduction there should be a reduction in the amount of pain being experienced.
Following completion of the abduction movement the patient should then slowly reverse the
motion, bring the arm back to neutral position via the movement of adduction. This test is
considered to be positive subacromial impingement syndrome if the patient experiences pain
between 60 and 120 degrees of abduction which reduces once past 120 degrees of abduction.
Drop Arm Test: Stand behind the seated patient and passively abduct the patient's extended
arm to 900 and full external rotation, while supporting the arm at the elbow. Release the elbow
support and ask patient to slowly lower the arm back to neutral. It is a positive test if there is a
sudden dropping of the arm or weakness in maintaining arm position during the eccentric part of
abduction. There may also be pain present while lowering the arm, suggesting a full thickness
tear to the supraspinatus
Empty Can Test: The patients arm is actively abducted to 90 degrees. the examiner applies
downward resistance to the abducted arm. With the patient's hand in a fist, and the thumb
sticking out, the shoulder is actively internally rotated, and angled forward to 30o, so that their
thumb is in a downward facing direction (empty can position), in the scapular plane.
supraspinatus condition
Speeds Test: To perform the Speed's Test, the examiner places the patient's arm in shoulder
flexion, external rotation, full elbow extension, and forearm supination; manual resistance is
then applied by the examiner in a downward direction.[1] The test is considered to be positive if
pain in the bicipital tendon or bicipital groove is reproduced.
Yergason's Test: The patient should be seated or standing in the anatomical position, with the
humerus in a neutral position and the elbow in 90 degrees of flexion in a pronated position. The
patient is asked to externally rotate and supinate their arm against the manual resistance of the
therapist produced by wrapping the hand around the distal forearm (just above the wrist joint).[2]
Yergason's Test is considered positive if the pain is reproduced in the bicipital groove and a
biceps or a SLAP lesion is suspected. If a "clicking" sensation familiar to the patient is produced
during the test, damage to the transverse humeral ligament (which overlies the intertubercular
sulcus) should be suspected too
Tinel’s sign (lightly tapping over the nerve to see if it generates a tingling sensation)
Phalen’s test (pushing the dorsal surface of hands together and holding 30 – 60 seconds)

Carpal Compression Test: This is done by applying firm pressure directly over the carpal tunnel
for 30 seconds. The test is positive when paresthesias, pain, or other symptoms are
reproduced. The test is positive if the patient responds with numbness and tingling within 30
seconds.)

Clinical Prediction Rules of Carpal Tunnel Syndrome

1. Shaking hands to relieve symptoms
2. Wrist ratio >.67
3. Symptom Severity Scale > 1.9
4. Diminished sensation in median sensory field 1 (thumb)
5. Age > 45 years old

Technique:
Wrist ratio index: as described by Johnson et al,[6] is measured by using a pair of sliding
calipers to measure the antero-posterior (AP) wrist width and the medio-lateral (ML) wrist width
at the distal wrist crease. Wrist ratio index is then calculated by dividing the AP wrist width by
the ML wrist width in centimeters. Ratios greater than .70 were found to be a predisposing factor
for carpal tunnel syndrome. [6]
Median nerve sensation: was measured on the pad of thumb with the end of a straightened
paper clip and compared to sensation at the proximal thenar eminence. Sensory tests were
graded as absent, reduced, normal or hyperesthestic
Symptom Severity Scale: The symptom severity scale was published in 1993 by Levine et al [7].
It is an 11 item questionnaire that examines the six critical domains for the evaluation of CTS:
pain, paresthesia, numbness, weakness, nocturnal symptoms and overall functional status.
Each question is scored from 1 (mildest symptoms) to 5 (most severe symptoms); therefore, a
higher score indicates a more severe case of CTS. The SSS has been shown to have good
reliability, validity and responsiveness.

Anterior Drawer Test: The patient lies supine on a plinth with their hips flexed to 45 degrees,
his/her knees flexed to 90 degrees and their feet flat on the plinth. The examiner sits on the toes
of the tested extremity to help stabilise it. The examiner grasps the proximal lower leg, just
below the tibial plateau or tibiofemoral joint line and attempts to translate the lower leg
anteriorly. The test is considered positive if there is a lack of end feel or excessive anterior
translation relative to the contralateral side.[2]Theoretically, the anterior translation if less than
6mm. If it is more than 6mm, the test is considered positive.
Ely’s test or Duncan-Ely test is used to assess rectus femoris spasticity or tightness: The patient
lies prone in a relaxed state. The therapist is standing next to the patient, at the side of the leg
that will be tested. One hand should be on the lower back, the other holding the leg at the heel.
Passively flex the knee in a rapid fashion. The heel should touch the buttocks. Test both sides
for comparison. The test is positive when the heel cannot touch the buttocks, the hip of the
tested side rises up from the table, the patient feels pain or tingling in the back or legs.
Lachman Test: Before testing the integrity of the ACL, the integrity of the PCL should be
assessed first as a torn PCL will affect the results of the ACL test[1].
With patient in supine, place their knee in about 20-30 degrees flexion. This can be achieved
through placing a towel under the patient's knee, or by the therapist placing their own knee on
the bed under the patient's. According to Bates' Guide to Physical Examination, the leg should
also be externally rotated slightly. The examiner should place one hand behind the tibia and the
other on the patient's thigh. It is important that the examiner's thumb be on the tibial tuberosity.
On pulling the tibia anteriorly, an intact ACL should prevent forward translational movement of
the tibia on the femur ("firm end-feel").
Anterior translation of the tibia associated with a soft or a mushy end-feel indicates a positive
test. More than about 2mm of anterior translation compared to the uninvolved knee suggests a
torn ACL ("soft end-feel"), as does 10mm of total anterior translation. An instrument called a
"KT-1000" can be used to determine the magnitude of movement in millimeters.
McMurrays Test:

 Patient Position: Supine lying with knee completely flexed.

 Therapist Position: on the side to be tested.
 Proximal Hand: holds the knee and palpates the joint line, thumb on one side and fingers
on the other
 Distal Hand: holds the sole of the foot and acts to support the limb and provide the
required movement through range.
 Procedure: From a position of maximal flexion, extend the knee with internal rotation (IR)
of the tibia and a VARUS stress, then return to maximal flexion and extend the knee with
external rotation (ER) of the tibia and a VALGUS stress.[4][5][6].
The IR of the tibia followed by extension, the examiner can test the entire posterior horn to the
middle segment of the meniscus. The anterior portion of the meniscus is not easily tested
because the pressure to that part of the meniscus is not as great.
IR of the tibia + Varus stress = lateral meniscus
ER of the tibia + Valgus stress = medial meniscus
Positive findings: Pain, Snapping, audible clicking,locking

Silfverskiold Test: It measures the dorsiflexion (DF) of the foot at the ankle joint (AJ) with knee
extended & flexed to 90 degrees. The test is considered positive for isolated gastrocnemius
contracture when DF at the AJ is greater with knee flexed than extended.
Talar tilt: Patient is seated with foot and ankle unsupported. The foot is positioned in 10-20
degrees of plantarflexion. The distal lower leg is stabilized with one hand just proximal to the
malleloi and the hindfoot is inverted with the other hand. The lateral aspect of the talus is
palpated to determine if tilting occurs. The laxity is compared to the contralateral side.
Thompson Test: The patient lies prone with his foot over the end of the table. Alternatively, the
patient could lie prone with his knee flexed to 90°. The examiner squeezes the calf muscles,
specifically the gastrocnemius - soleus complex, with his hand. Squeezing the calf should cause
contraction of the Achilles tendon, resulting in plantar flexion. If the Achilles tendon is completely
ruptured, there will not be any apparent plantar flexion.