yogabook / tests
Tests for the most important joints and muscles of the musculoskeletal system are described shere. Most of these tests are functional tests or pain provocation tests. The latter in particular must of course be carried out with care.
The tests are listed below, first sorted by body region or joint, then alphabetically by name.
All tests related to the function of a joint can now also be found on the joint page.
Tests – by body part:
Spine. ISG. Shoulder joint. Elbow joint. Wrist joint. Hip joint. Knee joint. Ankle joint
Spine
SI-joint
ISG | Spine test, 3-phase test, Patrick test, suspension test, Menell sign, Derbolowsky sign, compression test | ISG blockage, arthrosis |
ISG ligament test Maigne test, spine test, standing bent over test | Insufficiency of the pelvic ligaments | |
Laslett, van der Wurff Cluster | Test cluster |
Shoulder
Elbow
Function-oriented | Hyperflexion test, supination stress test, supination/pronation: definite yoga dumbbell supinations- and pronation test, triceps: definite yoga triceps-strength-test overhead, definite yoga triceps caput longum-shortening test, extension deficit: definite yoga elbow-extension test in 90° frontal abduction | Indications of possible diseases of the elbow joint |
Epicondylitis | Mill test, Cozen test, movement stress test, Bowden test, Maudsley test, definite yoga tennis elbow test cluster | Lateral epicondylitis (tennis elbow) |
Reverse Cozen test, Golf ellbow test, definite yoga golfer’s elbow test cluster | Medial epicondylitis (golfer’s elbow) | |
Nerve bottleneck syndromes | Tinel test, elbow flexion test | Sulcus ulnaris (cubital tunnel) syndrome |
Supinator compression test | Supinatorlogen syndrome | |
Tapes | Modified Milking Maneuver (medial/ulnar collateral ligament), varus stress test | Ligament damage |
Biceps approach | Reverse Popeye-Sign |
Wrist
Tendosynovitis | Hand flexor tendon test, Muckard test, Finkelstein test, Linburg sign | Tendosynovitis (inflammatory rheumatic) |
Grind test(Muckard test, Finkelstein test) | Thumb saddle joint arthrosis | |
Motor function test | Pointed handle, key handle, coarse handle, hollow handle, handle thickness | Osteoarthritis, tendosynovitis (rheumatic-inflammatory), instability, vertebral lesion |
Contractures | Bunnell-Littler test | Contractures of the palm muscles (Volkmann contracture) |
Nerve bottleneck syndromes | Radialis rapid test, thumb extension test, supination test | Radial nerve lesion |
Hoffmann-Tinel sign, Medianus rapid test, Carpal tunnel sign, Phalen test, Circular sign (nail sign), Reverse Phalen test, Provocation wrist flexion test | Median nerve lesion | |
Froment sign, rapid ulnar nerve test, intrinsic test, O-test | Ulnar nerve lesion | |
Stability test | Watson test, scapholunar ballottement test | Scapholunate instability |
dorsal os capitatum displacement test | Instability, osteoarthritis os capitatum | |
Reagent test | luno-triquetral instability | |
Stability test for ulnar collateral ligament rupture | Ski thumb | |
Shuck finger extension test | radiocarpal, intercarpal scaphoid instability | |
Watson | Instability of the scaphoid bone |
Hip joint
Knee joint
Ankle / foot
Tests – by name
- (Lateral) Pivot Shift Test (MacIntosh)
- 4-character test:
- Achilles tendon tap test
- Active Compression Test
- Active Piriformis Test
- Adson test
- Allen test
- Anterior Labral Tear Test
- Anterior apprehension test
- Anterior ankleimpingement test
- Anvill test
- Apley scratch test (Dawbarns test)
- Apley Grinding Test
- Apprehension test according to Fairbank (Smilie test)
- External rotation stress test Kleiger
- Bakody shoulder abduction test
- Beatty Maneuver
- Belly press test
- Biceps Load 2 Test
- Biceps load test
- Birkele sign
- Blumberg point
- Böhler mark
- Bounce test
- Bowden
- Bragard sign
- Brudzinski sign
- Brush test
- Chest circumference test
- Bunnell-Littler test
- Chair test
- Clarke (Patella Grind) Test
- Cluster of Wainner (Cervical Radiculopathy Provocation Tests)
- Codman handle
- Coleman side block test
- Cotton test
- Cozen test
- Cross-Crichton
- Derbolowsky
- Dial test
- Dorsiflexion test
- Dorsiflexion eversion test
- Douglas sign
- Drehmann sign
- Dreyer test
- Drop arm sign
- Duchenne sign (waddling gait)
- Dynamic Labral Shear Test
- Eden test (military brace test for the costal-clavicular area)
- Elbow Flexion Test
- Elbow Valgus Stress Test
- Elvey test (brachial plexus tension test, upper limb tension test)
- Ely test
- Extension compression test
- Facet pressure pain
- FADDIR test
- FAIR Test (Flexion, Abduction, internal Rotation) for Piriformis
- Heel pressure test
- Heel compression test
- Filler sign
- Finger-floor distance
- Finkelstein test
- Fleche test
- Flexion compression test
- Flick Sign (hand shake test)
- Foramina intervertebralia compression test
- Freiberg sign
- Fründ sign
- Foot flexibility test
- Full can test, see Jobe-Test / empty can test
- Galeazzi (Allis) test
- Gänslen’s sign (ISG)
- Gänslen handle
- GIRD (Glenohumeral Internal Rotation Deficit) test
- Glide test
- Gowers maneuver
- Gravity-Sign (posterior sag test, Godfrey test)
- Grifka test
- Hamstring stretch test
- Hawkins test
- Heel Contralateral Knee Maneuver
- Hoffa test
- Hoffa sign (test)
- Hoffmann-Tinel sign
- Homan’s sign
- HOP test
- Hornblower sign
- Cervical spine distraction test
- Cervical spine rotation screening
- Infraspinatus test
- Jackson compression test
- JAGAS test
- Jerk (Posterior Apprehension) Test
- Jobe (Empty Can) Test
- Joint Line Tenderness Palpation
- Scaphoid drop test
- Kalchschmidt dysplasia test
- Kemp test
- Kendall test (Rectus femoris muscle stretch test)
- Kernig sign
- Kim Test (Posterior Labrum Test)
- Crunch test
- Head rotation test with maximum extension
- Coprotation test with maximum flexion
- Crepitation test
- Lachmann (Trillat / Ritchie) test
- Lance
- Lasegue sign (straight leg raise, SLR)
- Laslett cluster
- Lateral Rotation Lag Sign
- Lelli test
- Lhermite sign
- Lift-off test
- Linburg sign
- Load and Shift Test
- Lumbar Spine Stenosis Clinical Prediction Rule by Cook
- Maigne Test
- Marten-Test
- Maudsleys Tennisellbogen-Test(epicondylitis lateralis)
- McBurney-Punkt
- McCarthy-Test
- McConnell-Test
- McMurray-Test
- Medial Epicondylitis-Test
- Mediopatellar Plica Test (Hughston Plica Test)
- Mennell test
- Merke sign
- Meyer sign
- Mill test
- Miniaci test
- Metatarsal tap test
- Modified Milking Maneuver
- Muckard test
- Mulder click test (Morton test)
- Neck grip
- Neck stretcher endurance test
- Neer test
- Interdigital nerve stretch test
- Noble test
- Ober test
- O’Brien needle test
- O’Brien sign (Active Compression)
- O’Donoghue’s test
- Ortoani/Barlow
- Ott sign
- Pace maneuver
- Paff psoas test
- Painful Arc Test
- Palm-up test
- Passive Distraction Test
- Payr sign (meniscus)
- Payr sign (veins)
- Pectoralis shortening test
- Percussion test cervical spine
- Phalen test
- Piriformis test
- Brachial plexus stress test
- Popeye-Sign
- Posterior Labral Tear Test
- Posterior ankle impingement test
- Pratt warning veins
- Prone Instability Test
- Psoas sign 1
- Psoas sign 2
- Quadriceps stretch test
- Q-angle
- Ratschow storage sample
- Reagent test
- Renne test
- reverse Popeye-Sign
- reversed pivot shift test
- Rhomboid force test
- Rib compression test
- Roos test
- Rovsing sign
- Scapular-assistance test
- Schepelmann test
- Schober sign
- Drawer test
- Shoulder caudalization test
- Apron handle
- Scratch Collapse Test
- Seated Piriformis Stretch Test
- Segmental functional test of the cervical spine
- Serratus anterior strength test
- Shoulder Relocation Test
- Shuck test
- Simmond test
- Single Heel Rise Test
- SLAP Lesion Test Cluster (SLAP Lesion Cluster)
- Slump test
- Soto Hall test
- Speed test
- Spine test (reflux phenomenon)
- Spurling test
- Squeeze test
- Standing Bent Over Test (pre-run phenomenon)
- Compression test
- Steinmann II sign
- Steinmann I sign
- Stemmer sign
- Stenvers Tests Cluster
- Sternum compression test
- Stork test (one-legged stand test)
- Strunsky test
- Stutter Plica Test
- Subluxation suppression test
- Sulcus sign (bottom drawer)
- Talar tilt test 1 (inversion or varus stress test)
- Talar tilt test 2 (eversion or valgus stress test
- Dancing patella
- The Moving Valgus Stress Test
- Thessaly test
- Thomas handle
- Thompson test (calf pinch test)
- Thomson test
- Tiffeneau test
- Tilt test
- Tinel sign
- Tinel sign cubital tunnel
- Too-Many-Toes sign
- Trapeziusforce test
- Trendelenburg/
- Triple Compression Test (tarsal tunnel)
- reverse Cozen test
- inverted Lasegue
- Reverse Phalen test
- Valgus stress test
- Valsalva test
- van der Wurff Cluster
- Varus stress test
- Quad sign (Patrick test, Faber test)
- Front and rear drawer base
- Forefoot adduction correction test
- Weber-Barstow maneuver
- Windlass test
- Wright (hyperabduction) test
- Yergason test
- Toe shift test
- Zohlen sign
Further sources:
http://www.medizin-kompakt.de/untersuchungsmethoden
https://amboss.miamed.de/wissen/index
Physio-study: well-designed English-language site of Indian physiotherapists
Physiotutors: extensive English-language site with good video clips
Stemmer sign
Location: Foot
Test item: Lymphoedema
Procedure: An attempt is made to form and lift a fold of skin on the back of the foot.
Interpretation: The Stemmer’s sign is positive if no skin fold can be lifted from the back of the foot. A positive Stemmer’s sign indicates lymphoedema. In the case of lipoedema, the skin fold can still be lifted (to a lesser extent).
Payr sign (veins)
Location: Leg
Definition: Tests for tenderness of the sole of the foot as a sign of phlebothrombosis
Test item: Phlebothrombosis
Procedure: pressure is applied to the sole of the foot, especially the medial edge
Interpretation: pressure pain can be a sign of thrombosis, rather low specificity
Link 1:https://www.youtube.com/watch?v=SHT5eKaeppg
Homan’s sign
Location: Leg
Definition: Tests for pressure pain in the calf as a sign of phlebothrombosis
Test item: thrombosis
Procedure: with the leg extended, a sudden, rapid dorsiflexion is performed in the ankle joint
Interpretation: Pressure pain in the calf can indicate phlebothrombosis. High specificity, rather low sensitivity
Link 1:https://www.youtube.com/watch?v=1Qmv17zPGio
Meyer sign
Location: Leg
Definition: Tests for tenderness along the medial calf
Test item: thrombosis
Procedure: pressure is applied to Meyer’s pressure points in the distal course of the great saphenous vein along the medial calf
Interpretation: pressure pain may indicate phlebothrombosis
Too-Many-Toes sign
Location: Foot
Definition: The positive Too-Many-Toes sign is the result of a hindfoot valgus with abduction of the foot, as occurs in a flat foot. Due to the pathological foot position, the foot appears to have too many toes (on the lateral side) when viewed dorsally at the level of the foot. The big toe is then not visible.
Test item: Knuckle foot
Procedure: When standing, the foot is viewed from behind at approximately the height of the foot
Interpretation: If „too many“ toes appear laterally (compared to a healthy foot), this is usually the result of a flat foot with hindfootvalgus and abduction of the foot.
Link 1:https://www.youtube.com/watch?v=cLMgaj6QPa8
Single Heel Rise Tes
Location: foot
Definition: tests for sufficiency of the tibialis posterior as an important supinator of the ankle joint by plantar flexion.
Test item: tibialis posterior syndrome
Procedure: The heel is lifted slowly while standing on one leg.
Interpretation: If an existing sooty foot valgus is not relieved, this indicates tibialis posterior syndrome, i.e. an insufficiency of this muscle or its tendon, possibly also a tear.
Cluster of Wainner (Cervical Radiculopathy Provocation Tests)
Location: HWS
Definition: Test cluster
Test item: Neuroradicular pain cervical spine
Execution:
Link 1:https://www.youtube.com/watch?v=QKc1BV-BErs
Specificity: 22
Sensitivity: 97
Cervical spine rotation screening
Location: Cervical spine
Definition: Tests in slight reclination for rotational ability ofthe cervical spine
Test item: Cervical spine rotation ability
Procedure: the seated patient’s head is slightly reclined (grasped parietally on both sides) and rotated to the maximum on both sides in succession.
Interpretation: Pain indicates segmental dysfunction such as osteoarthritis, blockage, inflammation, muscular shortening. A hard stop indicates degenerative changes: spondylosis, spondylarthrosis, non-arthrosis.
Head rotation test with maximum extension
Location: Cervical spine
Definition: Tests for rotation in max. extension with locked upper cervical joint(Occiput-C1)
Test item: Rotation of the cervical spine in max. extension
Procedure: The seated patient’s head is held by the chin and occiput, maximally reclined and rotated to both sides
Interpretation: painful movement restrictions indicate segmental dysfunction such as spondylosis, spondylarthrosis, non-carthrosis; dizziness may indicate changes in the vertebral artery
Head rotation test with maximum flexion
Location: Cervical spine
Definition: Tests the ability to rotate in the atlantooccipital and atlantoaxial joints
Test item: Rotation of the cervical spine with maximum flexion
Procedure: the seated patient’s head is held by the chin and occiput, flexed to the maximum and rotated to both sides
Interpretation: painful movement restrictions indicate segmental dysfunction of a degenerative nature, inflammation, instability. Vegetative symptoms such as dizziness must be investigated further
Segmental functional test of the cervical spine
Location: Cervical spine
Test item: Variation in the cervical spine joints
Procedure: The examiner grasps the patient’s head with the whole arm from front to back with the ulnar edge of the hand and the little finger on the upper vertebra of the segment to be examined and places a palpating finger of the contralateral hand on the spinous process below. By moving the upper arm, the dorsal and lateral mobility of each segment is tested. To assess the cervicothoracic junction, three fingers are placed on three fingers on three adjacent thoracic spinal processes during traction of the upper arm
Soto Hall test
Location: Cervical spine
Definition: Tests the ability to flex the cervical spine actively and passively with a fixed sternum
Test item: ability to flex the cervical spine
Performance: the head is raised both actively and passively in the supine position with the sternum fixed.
Interpretation: neck pain may indicate bony or ligamentous disease, pulling pain may indicate shortened neck muscles
Link 1:https://www.youtube.com/watch?v=pjPu7Ayx2W8
Percussion test cervical spine
Location: Cervical spine
Definition: Tests for tapping pain in the spinous processes
Test item: Tapping pain of the spinous processes
Procedure: Test with percussion hammer in sitting position with slightly flexed cervical spine
Interpretation: localized, non-radicular pain indicates a fracture, muscular or ligamentous disorder; radicular symptoms indicate an intervertebral disc injury with nerve root compression
O’Donoghue’s test
Location: Cervical spine
Definition: Differentiation between ligamentous and muscular pain
Test item: pain during lateral flexion
Execution: the patient’s head is first passively and then actively bent sideways against resistance while seated
Interpretation: Pain during active movement indicates ipsi- or contralateral muscular disorders, pain during passive movement is more likely to be ligamentous or articular-degenerative
Link 1:https://www.youtube.com/watch?v=SZV5lMtHgxs
Valsalva test
Location: Cervical spine
Definition: tests for space-occupying processes that respond to intraspinal pressure
Test item: space-occupying processes
Procedure: while sitting, the patient tries to push the thumb out of the mouth with the lips closed and the cheeks inflated
Interpretation: herniated discs, tumors, osteophyte constrictions (stage 4 osteoarthritis)
Link 1:https://www.youtube.com/watch?v=k5o26XwpCt4
Specificity: 94
Sensitivity: 22
Spurling test
Location: Cervical spine
Test item: Assessment of facet painand nerve root irritation pain
Procedure: Perform carefully: the head is slightly flexed and rotated; the examiner places a hand on the head from the cranial side and taps on it, ipsi- and contralateral to the painful side. If tolerable, this is repeated with reclination of the cervical spine
Interpretation: The test is positive for pain radiating from the cervical spine towards the arm, dermatomal pain indicates nerve root compression syndrome. Under extension, the foramina are further narrowed, which increases the pain in the presence of cervical stenosis, spondylosis, osteophytes, atrophic facet joints or a herniated disc. Myalgias and cervical spine distortion trauma can lead to contralateral pain (reverse Spurling). Pain on the concave side indicates nerve root irritation or facet joint pathology, on the convex side muscle stretch pain
Contraindication: vertebralfractures, dislocations, cervical spine instabilities
Link 1:https://www.youtube.com/watch?v=3ZSNdv0o0yk
Specificity: 83
Sensitivity: 50
Cervical spine distraction test
Location: Cervical spine
Test item: differentiation between radicular and ligamentous/muscular neck/shoulder/arm pain
Performance: the head of the seated patient, grasped at the lower jaw and occiput, is pulled cranially in the axial direction in the middle position and rotational position
Interpretation: decrease in existing complaints under traction indicates radicular etiology, increase indicates muscular/ligamentous/articular etiology
Elvey test (brachial plexus tension test, upper limb tension test)
Location: Cervical spine
Definition: tests for radicular pain due to changes in position of the distal joints shoulder joint, elbow joint, wrist joint
Test item: radicular pain
Procedure: hand and arm are moved passively into various positions in supine position with shoulder fixed proximally-ventrally:
- Test 1: Upper arm abducted to 110° laterally, elbow joint extended, forearm supinated, wrist, fingers, thumb extended.
- Test 2: Upper arm abducted to 10° laterally, elbow joint extended, forearm supinated, wrist, fingers and thumb extended. The upper arm is exorotated from this position
- Test 3: Upper arm abducted to 10° laterally, elbow joint extended, forearm pronated, wristpalmarflexed and ulnar abducted, fingers and thumb flexed. The upper arm is endorotated from this position
- Test 4: upper arm is successively abductedlaterally from 10°-90°, hand is brought to the ear with maximum flexion of the elbow joint and supination of the forearm, the wrist is extended and radially abducted, fingers and thumb are extended, the upper arm is exorotated
Interpretation: This test gives an indication of the cause of the pain and can be used to evaluate treatment
- Test 1: median nerve and anterior interosseous nerve; spinal nerves C5-C7
- Test 2: Median nerve, musculocutaneous nerve and axillary nerve
- Test 3: Radial nerve
- Test 4: ulnar nerve; spinal nerve C8 and Th1
For videos see Plexus brachialis stress test
Link 1:https://www.youtube.com/watch?v=rir6x6Iiqc4
Specificity: 22
Sensitivity: 97
Brachial plexus stress test
Location: Cervical spine
Test item: Test for compression of the brachial plexus
Execution: sitting, the patient laterally abducts both exorotated arms until pain occurs. The arms are then lowered straight again until the pain stops. If they reappear with passive flexion of the elbow joints, the test is positive.
Interpretation: Modification of the Elvey test for ulnar nerve, C8 and Th1. An increase in pain with flexion of the cervical spine is to be expected
Link 1:https://www.youtube.com/watch?v=FqlKnFt_DOM
Link 2: https://www.youtube.com/watch?v=rir6x6Iiqc4
Link 3: https://www.youtube.com/watch?v=mVVJTXv3YnE
Birkele sign
Location: Cervical spine
Definition: Tests for a lesion of the brachial plexus by moving the arm
Test item: brachial plexus
Procedure: if radicular symptoms occur when the elbow joint of a previously 90° laterally abducted, exorotated and extended arm is extended, the test is positive
Interpretation: Variant of the brachial plexus stress test. A positive result suggests a lesion of the brachial plexus
Shoulder caudalization test
Location: Cervical spine
Definition: Tests for pain with caudalized/depressed shoulder blade and lateral flex ion of the cervical spine to the contralateral side
Test item: Pain during lateral flexion of the cervical spine
Procedure: One shoulder of the seated patient is pressed caudally and the cervical spine is laterally flexed to the contralateral side
Interpretation: The occurrence of radicular pain indicates nerve root compression, osteophytes constricting the foramen, dural sac changes or an ipsilateral contracture of the vertebral joint capsule. Contralateral muscle pain indicates shortening of the sternocleidomastoid or trapezius muscles
Bakody shoulder abduction test
Location: Cervical spine
Test item: irritation of the C4 or C5 nerve root
Procedure: sitting or lying down, the patient places the hand on the head in a transverse direction with the upper arm exorotated laterally and abducted
Interpretation: Improvement or disappearance of existing symptoms („Bakody sign“) indicate nerve root compression syndrome; the dermatome can be used to determine the nerve root, usually C4 – C6. However, if the symptoms worsen, it is more likely to be thoracic outlet syndrome(Mm. scaleni, cervical rib)
Link 1:https://www.youtube.com/watch?v=oXfOGkS8elE
Specificity: moderate – high
Sensitivity: low – moderate
Jackson compression test
Location: Cervical spine
Definition: Tests the facet joints by axial compression and for nerve root compression
Test item: facet joints and nerve root compression
Procedure: the patient’s cervical spine is flexed sideways and axial pressure is applied to the head from the cranial side
Interpretation: radicular pain indicates nerve root compression, localized pain results from stretching of the muscles
Link 1:https://www.youtube.com/watch?v=USonirX1-HQ
Foramina intervertebralia compression test
Location: Cervical spine
Definition: Tests for radicular symptoms by axial compression of the cervical spine
Test item: radicular symptoms
Procedure: the cervical spine is passively compressed axially from the cranial side
Interpretation: given radicular symptoms are intensified by the compression; diffuse, not strictly segmental pain indicates ligament disorders
Flexion compression test
Location: Cervical spine
Definition: Tests nerve root compression, facet joints and dorsal ligament structures by compression during flexion of the cervical spine
Test item: integrity of the intervertebral discs
Procedure: the cervical spine is passively flexed and axially compressed cranially from the vertex
Interpretation: In the case of a posterolateral disc event, the disc would be pressed dorsally and radicular symptoms would increase. On the other hand, pain due to degenerative changes in the facet joints would be reduced. However, if it increases, this indicates damage to the dorsal ligament structures.
Extension compression test
Location: Cervical spine
Definition: Tests nerve root compression and dorsal ligament structures by compressing the reclined cervical spine
Test item: Integrity of the intervertebral discs and ligament structures
Procedure: the cervical spine is passively reclined by 30° and axially compressed cranially from the vertex
Interpretation: In the case of a posterolateral disc event, the pressure on the disc would be shifted ventrally and the symptoms would be weaker. (Increased) non-radicular symptoms indicate degenerative changes in the facet joints with reduced gliding
Lhermite sign
Location: Cervical spine
Test item: Differentiation between spinal cord and peripheral nerve root irritation
Execution: In a long sitting position, an outstretched leg is raised and the cervical spine (and back) is flexed without flexion in the relevant knee joint
Interpretation: Severe pain radiating into the upper or lower extremities indicates dural or meningeal irritation, possibly cervical myelopathy. If the cervical spine is bent towards the chest, this corresponds to Soto-Hall. Pain may indicate cervical spinal stenosis caused by spondylosis or spondylarthrosis, in which a „sudden electric shock“ is felt. Early symptoms include abnormal sensations in the hands, gait disturbances, fine motor function disorders
Link 1:https://www.youtube.com/watch?v=WLT-EfocOys
Ott sign
Location: BWS
Definition: Tests for mobility of the thoracic spine in flexion and extension
Test item: Mobility of the thoracic spine
Procedure: Standing up straight, the C7 and a point 30 cm caudal to it are marked and the extent to which the distance increases with maximum spinal flexion and maximum extension is measured
Interpretation: 2-4 cm increase in flexion and 1-2 cm increase in extension are considered normal, less can be an indication of degenerative processes, e.g. ankylosing spondylitis
Link 1:https://www.youtube.com/watch?v=pOEovR_Vs9w
Sternum compression test
Location: Ribs
Definition: tests for fracture or blockage of ribs
Test item: rib fracture, blockage of sternocostal joints
Procedure: pressure is applied to the sternum in the supine position
Interpretation: localized pain may indicate rib fracture, parasternal pain may indicate blockage of a sternocostal joint
Rib compression test
Location: BWS
Definition: Tests for rib fractures and joint blockage by applying pressure to the ribs while sitting
Test item: Rib fractures and joint blockage
Execution: In a sitting position, the chest is grasped from behind with both hands, with the hands resting on top of each other. The rib cage is compressed in the transverse and saggital plane
Interpretation: localized pain may indicate rib fractures, joint blockages or intercostal neuralgia
Chest circumference test
Location: BWS
Definition: The difference in chest circumference between deep expiration and deep inspiration is measured
Test item: Breathing volume, indirect
Procedure: In women above the breast base, in men above the nipple, the difference in chest circumference between deep inspiration and expiration is measured.
Interpretation: 3.5 – 6 cm is considered normal. A painless restriction may be present, for example, in ankylosing spondylitis, painless obstructed exhalation in bronchial asthma and emphysema, painful restriction indicates rib and vertebral blockages, inflammatory and tumorous processes of the chest cavity and pericarditis.
Tiffeneau test
Location: Lungs
Definition: Measures the amount of air that can be exhaled in one second after previous maximum inspiration
Test item: one-second capacity of expiration
Procedure: the maximum forced expiration is measured with a connected spirometer.
Interpretation: the focussed expiratory volume FEV1 that can be exhaled in one second should be 70% of the forced vital capacity (VC), i.e. the maximum forced inhalable volume. The Tiffeneau index of FEV1 / FVC should therefore be at least 0.7. On average, the index is 0.75 (75%), in healthy older patients it is closer to 0.7 (or 70%). Bronchial asthma, COPD and emphysema are the main reasons for a reduced Tiffeneau index.
Bragard sign
Location: Lumbar spine
Definition: Tests for nerve root compression syndrome between L4 and S1
Test item: Lumbar spine nerve root compression syndrome
Procedure: Tests whether pain occurs in the supine position when the leg is lifted passively and the knee joint is bent at the same time. The foot is also dorsiflexed.
Interpretation: Pain indicates nerve stretching and a lesion in the L4 – S1 area, such as a herniated disc
Link 1:https://www.youtube.com/watch?v=_T7xQUKZGFA
Lasegue sign (straight leg raise, SLR)
Location: Lumbar spine
Definition: Tests for nerve root compression syndrome between L4 and S2
Test item: Lumbar spine nerve root compression syndrome
Procedure: Tests whether there is a sharp, locking pain in the hip joint when the extended leg is passively raised to 70-80° flexion in the supine position. Internal rotation of the leg and dorsiflexion can increase the pain
Interpretation: Smaller flexion angles can also be demanded in order to take account of the individually different muscle constitution in the hamstrings/spine area. Pain indicates inflammation of a nerve root, e.g. in the case of a slipped disc, but also meningitis or subarachnoid hemorrhage. If pain occurs in the contralateral leg, this is referred to as positive crossed Lasegue
Link 1:https://www.youtube.com/watch?v=LdAD9GNv8FI
Specificity: 26
Sensitivity: 91
inverted Lasegue
Location: Lumbar spine
Definition: Tests for L3/L4 nerve root compression syndrome
Test item: Lumbar spine nerve root compression syndrome
Procedure: Tests whether bending the knee joint dorsally in the prone position with the hip joint extended (not extended) causes pain. If the knee joint can be flexed by less than 90°, additional hip extension can be performed
Interpretation: Pain is interpreted as a sign of stretching of the femoral nerve (compression of the L3/L4 nerve roots ).
Link 1:https://www.youtube.com/watch?v=4VxKyPRq6HA
Prone Instability Test
Location: LWS
Test item: Instability
Procedure: the patient lies with the upper body on a couch, legs hanging down with feet on the floor. It is tested whether pressure sensitivity in the lumbar spine area improves when the legs are actively raised
Interpretation: if there is an improvement when the legs are raised, the test is positive. It can then be expected that muscular training will bring improvement
Link 1:https://www.youtube.com/watch?v=OrgoC3mKhXQ
Schober sign
Location: Lumbar spine
Definition: Tests the mobility of the lumbar spine during flexion and extension of the spine
Test item: Mobility of the lumbar spine
Procedure: The spinous process S1 and a point 10 cm cranial to it are marked and the increase with maximum flexion of the spine and decrease with maximum extension of the spine are measured.
Interpretation: Increase to approx. 15 cm and decrease to approx. 8-9 cm are considered normal. Smaller measurements can be an indication of ankylosing spondylitis, for example
Link 1:https://www.youtube.com/watch?v=eYOUA9asDu8
McBurney point
Location: Abdomen
Definition: Tests for pressure pain of the appendix
Test item: Appendicitis
Procedure: Tests for pain on pressure on the McBurney point (half between navel and SIAS right), start with gentle pressure, test can cause perforation !!! Perform other tests first
Interpretation: If pain is present, appendicitis is suspected. Hospital !
Lance
Location: Abdomen
Definition: Test for pressure pain of the appendix
Test item: Appendicitis
Procedure: Tests whether pain is felt when pressure is applied to the Lanz point on the first third on the right between the SIAS on the right and the SIAS on the left (approximately the lower tip of the appendix)
Interpretation: If pain is felt, appendicitis is suspected. Hospital !
Blumberg point
Location: Abdomen
Definition: Tests for pressure pain of the appendix
Test item: Appendicitis
Procedure: Tests for pain felt after abrupt release after previous pressure on Blumberg point (between SIAS left and right on first third left)
Interpretation: If pain is felt, appendicitis is suspected. Hospital !
Link 1:https://www.youtube.com/watch?v=wNuQfsmJHuY
Rovsing sign
Location: Abdomen
Definition: Tests for tenderness of the appendix
Test item: Appendicitis
Procedure: Tests whether stretching the colon against peristalsis causes pain
Interpretation: If pain is present, appendicitis is suspected. Hospital !
Douglas sign
Location: Abdomen
Definition: Tests for pressure pain from the side of the rectum
Test item: Appendicitis
Procedure: Tests for pain on digital rectal palpation in the direction of the appendix
Interpretation: If pain is present, appendicitis is suspected. Hospital !
Psoas sign 1
Location: Abdomen
Definition: Tests for tenderness of the appendix when pressure is applied through the psoas major
Test item: Appendicitis
Procedure: Tests for pain when dropping the leg previously raised from the supine position
Interpretation: If there is pain, appendicitis is suspected. Hospital !
Psoas sign 2
Location: Abdomen
Definition: Tests for tenderness of the appendix when pressure is applied by the greater psoas muscle
Test item: Appendicitis
Procedure: Tests whether pain occurs in the appendix area when the leg is raised against resistance in the supine position
Interpretation: If there is pain, appendicitis is suspected. Hospital !
Link 1:https://www.youtube.com/watch?v=n0a0PCwsVQ4
Finger-floor distance
Location: WS
Definition: Tests several mobilities together: WS + ischiocrural group + hip function + Lasegue
Test item: WS + ischiocruralgroup mobility
Procedure: While sitting or standing, attempt to reach the toes with the fingers, the remaining distance (if any) is measured
Interpretation: non-specific sign that summarizes several muscle areas, helpful for therapy control, test for Lasegue
Schepelmann test
Location: WS
Definition: Tests for pain during side bends
Test item: Side bend
Procedure: seated, the patient bends the trunk straight without rotation, first to one side and then to the other
Interpretation: Pain on the concave side indicates intercostal neuralgia, on the convex side pleurisy. Rib fractures are painful in both directions
Link 1:https://www.youtube.com/watch?v=3mofwhxUDYw
Ratschow storage sample
Location: Circulation
Definition: Tests for vascular occlusion or high-grade stenosis
Test item: paVK/cardiac insufficiency
Procedure: in supine position, raise arms and legs to maximum height and move or open and close feet and hands. If pain occurs or after one minute, let arms and legs hang and measure the time until the veins fill. Contraindicated in severe heart failure or severe paVK
Interpretation: more than 7 seconds is considered pathological (indication of occluded vessels). Physiologically, reactive hyperemia occurs within 5 s, after which the veins fill.
Link 1:https://www.youtube.com/watch?v=1mVFTV3ZM0Y
Kernig sign
Location: Back
Test item: Meningitis
Procedure: in supine position, bend the knee and hip 90 degrees on one side and then straighten the raised leg
Interpretation: if the head is raised to avoid pain when the raised leg is extended, the Kernig sign is positive and an indication of possible meningitis
Link 1:https://www.youtube.com/watch?v=Evx48zcKFDA
Fleche test
Location: Spine
Test item: Hyperkyphosis of the thoracic spine
Procedure: the patient stands upright with their head vertical and their back against a wall. The horizontal distance between the occiput and the wall is measured
Interpretation: the distance may not be present or may only be small. A larger distance is usually the result of a hyperkyphosis of the thoracic spine
Stork test (one-legged stand test)
Location: Lumbar spine
Definition: Assessment of vertebral joint dysfunctions
Procedure: the lumbar spine is extended while standing on one leg
Interpretation: if pain occurs in the lumbar spine, the test is positive, indicating stress fractures; if the pain intensifies with rotation: facet joint arthrosis:
Lumbar Spine Stenosis Clinical Prediction Rule by Cook
Location: Lumbar spine
Definition: Test cluster for lumbar spinal stenosis
Execution:
Link 1:https://www.youtube.com/watch?v=BCMY8LftLPw
Specificity: 98, if at least 4 of the 5 tests are positive
Sensitivity: 96 if none of the 5 are positive
Slump test
Location: Spine
Test item: Neuroradicular complaints
Execution: sitting at the end of the couch, the patient bends the back to the maximum, then the cervical spine is flexed, then one leg is extended and the corresponding foot is dorsiflexed
Interpretation: pain in one phase of the test may indicate neuroradicular complaints
Link 1:https://www.youtube.com/watch?v=HFGfP84uwEo
Specificity: 23-63
Sensitivity: 44-87
Kemp test
Location: LWS
Test item: spinal canal stenosis
Execution: with the spine extended, slowly rotate and laterally flex the spine
Interpretation: Occurrence or increase in symptoms indicate lumbar spinal canal al stenosis. If the symptoms are purely local, facet joint arthrosismay also be present
Link 1:https://www.youtube.com/watch?v=4GBjhAcwh90
Sensitivity: 70
Spine test (reflux phenomenon)
Location: ISG
Test item: Weakness of the ligaments in the ISG
Execution: The patient lifts one leg wide in standard anatomical position with the knee joint held loosely so that the lower leg hangs approximately vertically according to gravity.
Interpretation: Physiologically, the ipsilateral PSIS (posterior superior iliac spine, spinae iliacae posteriores superiores) moves in adorsal-caudal direction. If this is not the case, a functional disorder of the SI joint must be assumed, usually an SI joint blockage or an inflammatory change.
Maigne test
Location: ISG
Test item: general dysfunction of the SI joint
Execution: in supine position, the patient stands with one leg bent and then lets it fall sideways outwards
Interpretation: Limited possibility of abduction and pain indicate a disorder of the SI joint
Compression test
Location: ISG
Test item: general dysfunction of the SI joint
Execution: in prone position, the examiner holds the sacrum with one hand and lifts one thigh with the other hand
Interpretation: Pain during extension of the hip joint indicates a dysfunction of the SI joint
Standing Bent Over Test (pre-run phenomenon)
Location: ISG
Test item: ligament weakness in the ISG
Performance: the position of the PSIS(posterior superior iliac spine, spinae iliacae posteriores superiores) is observed during forward flexion from standard anatomical position
Interpretation: a lateral difference in behavior indicates a ligament insufficiency in one of the two SI joints
Link 1:https://www.youtube.com/watch?v=HBapDoZZ_T8
Laslett cluster
Location: ISG
Definition: Sequence of four ISG provocation tests
Performance: with the patient in the supine position:
- 1. press down on bothSIAS
- 2. the performer stands on the asymptomatic side, bends at the hip to 90°, places one hand under the sacrum and presses the femur vertically downwards with the other.
- 3. in lateral position on the asymptomatic side with 45° hip flexion and 90° bent knees press the lateral/posterior iliac crest downwards
- 4. in prone position press the sacrum downwards.
All tests are performed 3-6 times in immediate succession with increasing pressure
Interpretation: the scoring algorithm is given in the video
Link 1:https://www.youtube.com/watch?v=g8txpsqHYpQ
Specificity: 78
Sensitivity: 88
van der Wurff Cluster
Location: ISG
Implementation:
Link 1:https://www.youtube.com/watch?v=0fQYI5CVjvk
Specificity: 79
Sensitivity: 85
Gänslen’s sign (ISG)
Location: ISG
Definition: Tests for complaints in the ISG
Execution: in supine position with the leg of the side to be tested hanging down from a table, this leg and the other leg bent and pulled up to the chest are pressed away from each other in sagittal direction
Link 1:https://www.youtube.com/watch?v=ED_bYoQk9d4
Specificity: 71/77
Sensitivity: 53/50
Codman handle
Location: Shoulder
Definition: Tests the ROM in the glenohumeral joint by fixation of the scapula
Test item: ROM
Procedure: the examiner places the index and middle fingers ventrally on the coracoid process and the thumb dorsally on the scapular spine to ensure that the following test is performed without movement of the scapula and checks the mobility of the arm. The mobility test can then be performed with permitted movements of the scapula
Interpretation: if no movement of the scapula is allowed, the three-dimensional range of motion in the glenohumeral joint can be assessed.
Link 1:https://www.youtube.com/watch?v=YYwflXOwR64
Scapular-assistance test
Location: Shoulder
Execution: with the patient standing upright, the clavicle and spina scapulae are fixed with one hand. The other hand is used to support the dorsal movement of the scapula during lateral abduction of the arm.
Interpretation: If the pain is reduced under the assistant of the scapula movement, this indicates weakness of the serratus anterior or the lower trapezius.
Link 1:https://www.youtube.com/watch?v=pfXdmXL9ouM
O’Brien sign (Active Compression)
Location: Shoulder
Test item: SLAP lesion
Procedure: the 90° frontally abducted arms should be held in position against pressure from above, fully internally rotated the first time, fully externally rotated the second time
Interpretation: if the pain present in the internally rotated state disappears or is reduced by external rotation, there is an indication of a SLAP lesion
Link 1:https://www.youtube.com/watch?v=qkDvVBi0gg8
Specificity: 37
Sensitivity: 67
Biceps load test
Location: Shoulder
Test item: SLAP lesion
Performance: in supine position, the arm is abducted 90° laterally, flexed 90° at the elbow, the forearm is pronated and the patient is asked to flex the elbow against resistance
Interpretation: Pain when trying to flex the elbow indicates a SLAP lesion
Link 1:https://www.youtube.com/watch?v=ciseGTfrqZ4
Biceps Load 2 Test
Location: Shoulder
Test item: SLAP lesion
Execution: in supine position, the arm is abducted 90° laterally, flexed 90° at the elbow, the forearm is neutral. As in the biceps load test, the elbow should be flexed against resistance
Interpretation: Pain when trying to flex the elbow indicates a SLAP lesion
Link 1:https://www.youtube.com/watch?v=dPh5wQmKTfk
Dynamic Labral Shear Test
Location: Shoulder
Test item: SLAP lesion
Performance: with the exorotated upper arm raised 90° laterally and the forearm vertical, the examiner pushes the proximal humeral head ventrally and raises the arm to 150° at the wrist.
Interpretation: Pain or clicking sound or sensation between 90° and 120° indicates a SLAP lesion
Link 1:https://www.youtube.com/watch?v=Vo7YBDwZAbk
Specificity: 51
Sensitivity: 78
Kim Test (Posterior Labrum Test)
Location: Shoulder
Execution: the arm raised 90° laterally with the forearm pointing horizontally forwards is pressed from the lateral humerus into the glenoid. The arm is then moved forwards and backwards in the transverse plane under a force directed caudally and posteriorly on the proximal humerus
Interpretation: Pain or clicking sound or sensation indicates a lesion of the posterior inferior labrium
Link 1:https://www.youtube.com/watch?v=-knsALCdv_A
Specificity: 94
Sensitivity: 80
Roos test
Location: Shoulder
Test item: Thoracic outlet syndrome
Performance: with the upper arms exorotized at 90° laterally with supinated, vertical forearms, the fists are closed for three minutes and then opened again
Interpretation: Severity of the arms, ischemic pain, weakness of the arms, numbness, tingling, discoloration are considered a positive result, normal fatigue is not.
Link 1:https://www.youtube.com/watch?v=rM4fB-t_l9E
Specificity: 30
Sensitivity: 84
Stenvers Tests Cluster
Location: Shoulder
Test item: cervicothoracic dysfunction
Execution:
Link 1:https://www.youtube.com/watch?v=vPLFbNi-R5g
Adson test
Location: Shoulder
Test item: Thoracic outlet syndrome
Procedure: The radial pulse is felt on the 45° laterally abducted and slightly retrovertedexorotated arm. The head is reclined and rotated ipsilaterally, then breathing is stopped
Interpretation: Pain or failure of the radial pulse makes the test positive
Link 1:https://www.youtube.com/watch?v=-7346RaEGKU
Specificity: 76
Sensitivity: 79
SLAP Lesion Test Cluster (SLAP Lesion Cluster)
Location: Shoulder
Test item: SLAP lesion
Execution:
Link 1:https://www.youtube.com/watch?v=FRotc9Rx1Ak
Drop arm sign
Location: Shoulder
Definition: tests for supraspinatus or infraspinatus tendon rupture
Test item: supraspinatus rupture
Procedure: one arm is passively raised to 90° lateral abduction in external rotation and the support is suddenly released
Interpretation: if the patient is unable to hold the arm in position, the test is positive
Link 1:https://www.youtube.com/watch?v=JXgRBeqToik
Specificity: 77
Sensitivity: 73
GIRD (Glenohumeral Internal Rotation Deficit) test
Location: Shoulder
Test item: GIRD (glenohumeral internal rotational deficit)
Performance: in supine position with 90° laterally abducted upper arm with vertical forearm and one thumb of the examiner on the coracoid process turn in the arm up to the meximum and record any lateral difference
Interpretation: if the lateral difference is more than 10°, this test is considered positive. Normally, the TROM (total range of motion from internal rotation to external rotation) is 130° – 180° individually and the lateral difference is less than 10°
Link 1:https://www.youtube.com/watch?v=RtTa4dvZsYc
Load and Shift Test
Location: Shoulder
Test item: shoulder instability
Procedure: with the clavicle fixed with one hand and the scapula spina, an attempt is made with the other hand to move the humeral head forwards or backwards
Interpretation: the test is positive if there is pain or mobility of the humeral head in the glenoid of more than 25% of the humeral diameter anteriorly or 50% posteriorly. Three grades:
- 1. safe spontaneous repositioning
- 2. perceived borderline and questionable spontaneous repositioning
- 3. subluxation
Link 1:https://www.youtube.com/watch?v=txARar71h5E
Sulcus sign (bottom drawer)
Location: Shoulder
Test item: shoulder instability
Performance: in a standing position, the proximal forearm is pulled caudally
Interpretation: if there is a visible depression on the acromion, the test is positive, which means glenohumeral instability, especially if one side is more affected
Link 1:https://www.youtube.com/watch?v=vV7u2JtdYWI
Shoulder Relocation Test
Location: Shoulder
Test item: Instability
Performance: in supine position with the arm abducted laterally by 90° and the forearm pointing cranially, pressure is exerted on the proximal humerus in a dorsal direction.
Interpretation: if the pain disappears when pressure is applied posteriorly, the impingement is secondary, i.e. caused primarily by the anterior displacement of the humerus.
Link 1:https://www.youtube.com/watch?v=JkO8nnWFIwM
Specificity: 90
Sensitivity: 65
Jerk (Posterior Apprehension) Test
Location: Shoulder
Test item: posterior instability, rupture of the posterioinferior labrum
Performance: in a sitting position with the scapula fixed with one hand, the arm is laterally abducted to 90° and slightly endorotated, then the humerus is pressed axially from the lateral into the glenoid and the arm is adducted forwards to the maximum.
Interpretation: a palpable sudden painful displacement is a positive result and a predictor of failure of conservative treatment
Link 1:https://www.youtube.com/watch?v=j_qG1MNOws8
Specificity: 85
Sensitivity: 90
Trapezius force test
Location: Shoulder
Test item: Trapezius strength test
Execution:
- the 120° laterally abducted arms are pressed ventrally, which the subject should prevent, testing all parts of the trapezius
- With slightly laterally abducted arms, the shoulder blades are elevated, which should be held against cranial pressure. This tests the pars descendens
- With the arm laterally abducted by 90°, an external adducting force is exerted, at the same time the head should be moved against resistance to the ipsilateral arm, which also tests the upper part
- in the prone position with the arm laterallyabducted by 90°, the arm should be retroverted against resistance, which tests the middle section
Interpretation: the examiner estimates the force based on his counterpressure
Link 1:https://www.youtube.com/watch?v=9tfVeIhlY-o
Lateral Rotation Lag Sign
Location: Shoulder
Test item: Weakness of the infraspinatus
Execution: standing, one arm is laterally abducted to 90° with the forearm pointing vertically upwards. The arm is then maximally exorotated, which the patient should hold
Interpretation: the test is positive if it is impossible to hold the arm exorotated, which indicates weakness of the teres minor and infraspinatus.
Link 1:https://www.youtube.com/watch?v=iUTxEAOrEMY
Specificity: 93 (infraspinatus), 93 (teres minor)
Sensitivity: 97 (infraspinatus), 100 (teres minor)
Apley scratch test (Dawbarns test)
Location: Shoulder
Definition: Tests shoulder flexibility
Execution: corresponds to gokukhasana
Interpretation: pay attention to side discrepancies. Restrictions in mobility need not be solely due to the glenohumeral joint, but may also have to do with the movement of the scapula or clavicle
Link 1:https://www.youtube.com/watch?v=K2VWpuqDQjU
Specificity: 58
Wright (hyperabduction) test
Location: Shoulder
Test item: Thoracic outlet syndrome
Performance: seated with 1. 90° laterally abducted, maximally exorotated upper arm and 90° flexedelbow joint 2. fully abducted arm palpate the radial pulse
Interpretation: occurrence of symptoms or loss of pulse
Link 1:https://www.youtube.com/watch?v=L6BoVyE_vfE
Pectoralis shortening test
Location: Shoulder
Test item: shortening of the pectoralis minor and pectoralis major
Procedure: to test the pectoralis major, the elbows are passively pressed towards the floor in a supine position with the hands clasped behind the head. For the pectoralis minor, the hands are placed on the abdomen and pressure is applied to the coracoid process.
Interpretation: The test is positive for a shortened pectoralis major if the elbows do not reach the level of the couch. For the pectoralis minor, perceived stretching is the indicator
Link 1:https://www.youtube.com/watch?v=6WSybz0modY
Miniaci test
Location: Shoulder
Test item: instability
Performance: in a sitting position, one arm is abducted frontally by 70-80°, endorotated and adducted, then pressed posteriorly by the examiner with one hand while palpating the dorsal and ventral shoulder with the other hand. The arm is then abducted and exorotated transversely several times
Interpretation: a click or a displacement that can be felt indicates a reduction during abduction after the humerus in the glenoid was previously subluxated dorsally
Link 1:https://www.youtube.com/watch?v=rMAk8MnscBM
Hornblower sign
Location: Shoulder
Test item: Insufficiency of the teres minor and infraspinatus
Execution: in a sitting position, one arm is laterally abducted 90° with the forearm pointing 45° towards the transverse plane. The patient should now rotate the arm further against resistance
Interpretation: the inability to exert force from this position indicates a teres minoror infraspinatus tear
Link 1:https://www.youtube.com/watch?v=am5XZ1VnoLc
Specificity: 96 for infraspinatus tear
Sensitivity: 17 for infraspinatus tear
Serratus anterior strength test
Location: Shoulder
Test item: Strength of the serratus anterior
Execution: in a seated position, one arm is endorotated 90° frontally abducted with the forearm in a horizontal position. The examiner now presses the elbow dorsally and looks to see whether the shoulder blade lifts or can withstand the pressure.
Interpretation: A lifting scapula indicates a weakness of the serratus anterior. This would also be recognizable during push-ups against the wall or on the floor
Link 1:https://www.youtube.com/watch?v=jatVx3v7qDI
Neck stretcher endurance test
Location: Neck
Test item: Endurance test
Execution: in supine position, the chin is retracted and the head is lifted a hand’s breadth from the couch. Now measure how long the head can be held in this position without being put down for longer than one second
Interpretation: the average time for healthy men is approx. 40 s and approx. 30 s for women
Link 1:https://www.youtube.com/watch?v=0JEWM_McBmM
Eden test (military brace test for the costal-clavicular area)
Location: Shoulder
Test item: Thoracic outlet syndrome
Procedure: while seated, the radial pulse of one hand is palpated and pressure is applied to the area cranial to the clavicle next to the deltoid with the other hand.
Interpretation: if symptoms occur or the pulse fails, the test is positive
Link 1:https://www.youtube.com/watch?v=yV1V90ohpvM
Rhomboid force test
Location: Shoulder
Test item: Strength of the rhomboids
Procedure: in prone position, the patient places the hand ipsilateral to the test side with the back on the sacrum. While palpating the medial edge of the shoulder with the index finger, the patient should protract the shoulder against slight resistance and then raise the arm dorsally, with the rhomboids slightly pushing the index finger away.
Interpretation: if there is no pressure against the index finger, the test is positive
Link 1:https://www.youtube.com/watch?v=Gn3s7sVtyWo
Belly press test
Location: Shoulder
Definition: tests the functionality of the endorotators of the shoulder joint, in particular the subscapularis muscle in case of suspected rupture of the muscle or rupture of its tendon
Test item: endorotators of the shoulder joint
Procedure: The test determines whether the patient can press firmly on the abdomen with the hand without the elbow moving backwards. The hand and elbow should remain in a frontal plane
Interpretation: if the position of the elbow cannot be maintained, the endorotators are too weak
Link 1:https://www.youtube.com/watch?v=VV1C594xaeQ
Link 2: https://www.youtube.com/watch?v=RDfStbLsj6Q
Infraspinatus test
Location: Shoulder
Definition: tests for painless function of the infraspinatus
Test item: infraspinatus
Performance: Tests for pain during external rotation of the 90° flexed arm at different angles of lateral abduction against resistance
Interpretation: Pain indicates an injury to the infraspinatus
Link 1:https://www.youtube.com/watch?v=iUTxEAOrEMY
Palm-up test
Location: Shoulder
Test item: long biceps tendon
Performance: Tests for pain or inability to resist counterpressure at 90° frontal abduction and 30° lateral abduction of the exorotated arm with supinated forearm
Interpretation: Pain indicates
- Tendinitis of the long biceps tendonrunning through the sulcus intertuberlularis
- Subluxation
- subacromial impingement
- SLAP lesion
Link 1:https://www.youtube.com/watch?v=EhHrAtsexr8
Speed test
Location: Shoulder
Definition: The speed test largely corresponds to the palm-up test
Test item: SLAP lesion
Procedure: tests for pain when the arm is laterally abducted by 30°, exorotated by 45°, frontally abducted by 90° and flexed further against resistance
Interpretation: Pain indicates tendinitis or subluxation of the long biceps tendon. However, a lesion of the anterior labrum or subacromial impingement are also possible
Link 1:https://www.youtube.com/watch?v=fpkNuuuMD5o
Specificity: 78
Sensitivity: 20
Painful Arc Test
Location: Shoulder
Execution:
Interpretation: Pain between 60° and 120°: subacromial impingement; pain at > 120°: acromioclavicular impingement. Pain in the entire area may indicate frozen shoulder or other pathology in the glenohumeral joint
Link 1:https://www.youtube.com/watch?v=engHP9OA92U
Specificity: 76
Sensitivity: 53
Neer test
Location: Shoulder
Definition: Clinical sign to test for impingement
Test item: Impingement
Procedure: tests for pain when the shoulder blade is passively depressed and the arm is passively abducted frontally and endorotated.
Interpretation: subacromial impingement shows less pain when the arm is exorotated, if the pain remains about the same, it is more likely to indicate a problem in the acromioclavicular joint
Link 1:https://www.youtube.com/watch?v=IPLppop2g8
Lift-off test
Location: Shoulder
Definition: Tests for sufficiency and integrity of the subscapularis
Test item: Subscapularis
Performance: tests for impossibility or pain when lifting a hand placed with the back on the sacrum dorsally – with and without resistance. The hand and elbow should be in a frontal plane
Interpretation: Pain indicates insufficiency or injury of the subscapularis
Link 1:https://www.youtube.com/watch?v=QQvvX-kAZKo
Neck grip
Location: Shoulder
Test item: External rotation and lateral abduction of the shoulder
Execution: tests how low the palms can be placed behind the head/neck
Interpretation: The distance of the spread thumb from the prominence is measured
Link 1:https://www.youtube.com/watch?v=zYTK2pwjpBA
Apron handle
Location: Shoulder
Definition: Rather unspecific test to assess internal rotation and adduction deficits
Test item: internal rotation with adduction
Procedure: tests how high the thumb can be raised towards the prominence with the back of the hand resting on the back
Interpretation: The distance of the spread thumb from the prominence is measured, i.e. the normal range of motion is thumb on BW 7, but this is age-dependent.
Link 1:https://www.youtube.com/watch?v=zYTK2pwjpBA
Hawkins test
Location: Shoulder
Definition: Tests for impingement syndrome by twisting the frontally abducted arm
Test item: Test for impingement syndrome
Procedure: tests for pain when the 90° frontally abducted arm is rotated with the forearm flexed 90° horizontally
Interpretation: pain indicates impingement with a certain probability, no pain makes it very unlikely. Other pathologies that can be indicated by a positive test:>
- Tendinitis or (partial) rupture of the supraspinatus
- Tendinitis or (partial) rupture of the biceps brachii caput longum muscle
- Tendinitis or (partial) rupture of the infraspinatus muscle
- Tendinitis or (partial) rupture of the teres minor muscle
- Subacromial bursitis
- Bursitis subdeltoideae
A negative test makes shoulder pathology unlikely
Link 1:https://www.youtube.com/watch?v=6GkKB2oXi3o
Specificity: 56
Sensitivity: 80
Jobe (Empty Can) Test
Location: Shoulder
Definition: Tests for impingement syndrome/suprapinatus involvement in shoulder complaints
Test item: impingement/supraspinatus
Procedure: tests for pain when the endorotated arm is raised further from 90° lateral and 30° frontal abduction against resistance. There are two variants:
- Empty-can variant: with the upper arm endorotated and the forearm pronated, involvement of the biceps in the movement is largely excluded and the deltoid largely excluded, which allows a statement to be made about the supraspinatus
- Full-can variant: with exorotated upper arm and supinated forearm, the biceps (caput longum) is clearly involved, so that a statement is more likely to be made here
Interpretation: Empty-can positive: indication of impingement or tendinitis(supraspinatus tendon); full-can positive: indication of rupture or tendinitis of the long biceps tendon
Link 1:https://www.youtube.com/watch?v=QwUrNsvP2Bg
Link 2: https://www.youtube.com/watch?v=NuBOHdm20cc
Link 3: https://www.youtube.com/watch?v=DeO50UTxwoo
Specificity: 74
Sensitivity: 30
Hoffmann-Tinel sign
Location: Arm
Definition: Tests for carpal tunnel syndrome
Test item: Carpal tunnel syndrome
Procedure: tests for tapping pain over the carpal tunnel when the wrist is hyperextended
Interpretation: in the presence of carpal tunnel syndrome, even hyperextension without tapping is usually painful
Link 1:https://www.youtube.com/watch?v=U8cPjPeZgFw
Specificity: 68
Sensitivity: 67
Yergason test
Location: Shoulder
Definition: Tests the function of the biceps as the strongest supinator by attempting supination against resistance isolated from the brachialis
Test item: Function of the biceps, SLAP lesion
Procedure: Test for the ability to supinate the forearm against resistance at 90° flexion at the elbow
Interpretation: Inability or pain indicates a lesion of the biceps, subluxation, tendinitis or SLAP lesion
Link 1:https://www.youtube.com/watch?v=_Cjahul5yuI
Specificity: 88
Sensitivity: 32
Mill test
Location: Elbow
Definition: with pressure on the suspected lateral epicondyle, the arm is flexed 90°, the wristpalmar flexed, the forearm maximally pronated and the elbow extended again
Test item: tennis elbow (lateral epicondylitis)
Procedure: Pain indicates irritation at the origin of the extensor carpi radialis longus or extensor carpi radialis brevis
Link 1:https://www.youtube.com/watch?v=r_A84ox9JRM
The Moving Valgus Stress Test
Location: Ellbobgen
Test item: tear of the medial collateral ligament complex
Performance: With the arm abductedlaterally at 90° and maximally flexed in the elbow joint, the examiner applies pressure from ventral to dorsal on the forearm with a valgus moment and then suddenly extends the arm to 150° while maintaining the valgus moment,
Interpretation: already known sudden pain, especially between 70° and 120° in the elbow joint, indicates MCL damage
Link 1:https://www.youtube.com/watch?v=JIU_kv5VoQk
Specificity: 75
Sensitivity: 100
Maudsley’s tennis elbow test(lateral epicondylitis)
Location: Elbow
Test item: tennis elbow
Procedure: the lateral epicondyle is palpated while the patient is sitting with the pronated forearm resting on a table.
the patient should lift the middle finger of this hand off the table against the examiner’s pressure.
Interpretation: if tensing the extensor digitorum causes pain in the epicondyle, the test is positive and the patient probably has tennis elbow
Link 1:https://www.youtube.com/watch?v=BaxgmHT_2eQ
Modified Milking Maneuver
Location: Elbow
Test item: Medial/ulnar collateral ligament
Execution: in a seated position with the arm abducted frontally by 70°, bent 90° at the elbow joint and maximally turned out, the patient supports the upper arm with the other arm. The performer grasps the condyles of the upper arm with one hand and uses the abducted thumb to pull the arm further into external rotation
Interpretation: medial pain in the elbow joint or instability indicate collateral ligament damage, which is more common in connection with overhead sports
Link 1:https://www.youtube.com/watch?v=SwigwaZxBXE
Chair test
Location: Elbow
Definition: tests for irritation by lifting a chair with an overhand grip
Test item: tennis elbow (radial epicondylitis)
Procedure: The patient lifts a chair with an overhand grip while standing
Interpretation: Pain in the radial epicondyle indicates epicondylitis ( tennis elbow)
Bowden
Location: Elbow
Definition: tests for epicondylitis by contraction of the finger flexors
Test item: tennis elbow(lateral epicondylitis)
Procedure: The patient should squeeze a blood pressure cuff inflated to a certain pressure
Interpretation: Pain at the epicondyle when pressure is applied indicates epicondylitis/tennis elbow
Thomson test
Location: Elbow
Definition: tests by dorsiflexion of the wrist
Test item: tennis elbow (radial epicondylitis)
Execution: the patient should dorsiflex the wrist further against the resistance of the examiner with the elbow joint extended and the forearm in pronation with the wrist slightly in dorsiflexion at 30° frontal abduction.
Interpretation: If there is pain in the radial epicondyle, the test is positive
Elbow Valgus Stress Test
Location: Elbow
Test item: instability (inner ligament)
Performance: with the upper arm slightly frontally abducted and largely exrotated and held in place by one of the examiner’s hands, palpate the ulnar collateral ligament below the medial epicondyle with one finger of this hand. At 30° flexion in the elbow joint, the examiner exerts valgus stress in the elbow joint („abduction“ in the elbow joint)
Interpretation: Instability or pain indicate damage to the medial collateral ligament
Link 1:https://www.youtube.com/watch?v=3xF9_5fbJ8A
Cozen test
Location: Elbow
Definition: test for tennis elbow by dorsiflexing the wrist
Test item: tennis elbow
Procedure: the patient holds the pronated arm flexed with a closed fist and attempts to extend/dorsiflex the wrist against the resistance of the examiner, who holds the arm in place
Interpretation: Pain during extension/dorsiflexion is a sign of tennis elbow
Link 1:https://www.youtube.com/watch?v=8K7jzDIUpLI
reverse Cozen test
Location: Elbow
Test item: golfer’s elbow
Performance: the arm to be examined is supinated, the elbow joint is flexed 90°, the hand is clenched into a fist and the wrist is flexedpalmarwards
Interpretation: if there is pain in the medial epicondyle, the test is positive, suspected golfer’s elbow
Link 1:https://www.youtube.com/watch?v=5Si6hEdo9k4
Tinel sign cubital tunnel
Location: Elbow
Definition: Test for cubital tunnel syndrome by tapping
Test item: cubital tunnel syndrome
Procedure: the cubital tunnel is carefully tapped 4-6 times with a reflex hammer
Link 1:https://www.youtube.com/watch?v=ASRatLbu8i0
Specificity: 53
Sensitivity: 62
Elbow Flexion Test
Location: Elbow
Definition: Tests for cubital tunnel syndrome
Test item: Cubital tunnel syndrome
Execution: with the arms resting against the body, the elbow joints are maximally flexed, the forearms maximally supinated and the wrists maximally dorsiflexed, held for three minutes
Interpretation: Pain, tingling or numbness after three minutes indicate cubital tunnel syndrome
Link 1:https://www.youtube.com/watch?v=brN-VLUETVU
Specificity: 40-99
Sensitivity: 36-93
Scratch Collapse Test
Location: Elbow
Test item: Cubital tunnel syndrome
Execution: from neutral zero (or sitting), the elbow joints are flexed 90° with the palms facing each other. Pressure is exerted against the distal forearms on both sides, which the patient should withstand (no more!). In between, the area of the ulnar nerve above the sulcus ulnaris is quickly applied and then continued immediately.
Interpretation: A brief drop in force after application is considered a positive result and is an indication of cubital tunnel syndrome
Specificity: 99
Sensitivity: 69
Finkelstein test
Location: Wrist
Definition: tests for tendosynovitis of the thumb
Test item: De Quervain’s tendosynovitis
Procedure: the hand is supported with the ulnar side of the forearm
- gravity-induced descent (ulnar abduction)
- ulnar abduction with external force
- with external force, the thumb is adducted and flexed in the ulnar abducted wrist joint
Interpretation: Pain at the styloid process in 1) and 2) indicates acute tenosynovitis of the extensor pollicis brevis and abductor pollicis longis, in 3), but not 1) and 2), chronic tenosynovitis.
Link 1:https://www.youtube.com/watch?v=8WBVXBx34W0
Phalen test
Location: Wrist
Definition: Clinical test for carpal tunnel syndrome
Test item: Carpal tunnel syndrome
Procedure: Tests whether one minute of maximum flexion in the wrist (by compressing the median nerve) with the arms horizontal and the backs of the hands pressed together triggers distal paraesthesia. Also exists with flexion as a reverse Phalen test
Interpretation: Paresthesias indicate carpal tunnel syndrome
Link 1:https://www.youtube.com/watch?v=rQJNrkq7tIs
Specificity: 89
Sensitivity: 85
Brudzinski sign
Location: Head
Test item: Meningismus
Procedure: The head is raised in the supine position and it is observed whether the legs are pulled up reflexively due to pain
Interpretation: Tightening/bending of the legs as a result of the raised head indicates irritation of the meninges
Link 1:https://www.youtube.com/watch?v=rN-R7-hh5x4
Mennell test
Location: Hip
Definition: tests in 3 phases whether pain comes from the hip joint, the SI joint or the lumbar spine
Test item: tests whether pain comes from the hip joint, SI joint or lumbar spine
Execution: in prone position:
- with caudal-frontal pressure on the ischial tuberosity lift the ispilateral leg into extension with internal rotation on the inside
- with pressure on the sacrum at S2 lift the leg into extension on its inner side
- While holding Th12 in place, lift the leg on its inner side
Interpretation: Pain is indicative of 1. hip disorders, 2. SI joint disorders such as SI joint syndrome, 3. lumbar spine disorders
Link 1:https://www.youtube.com/watch?v=QOM4fKkmurA
Quad sign (Patrick test, Faber test)
Location: Hip
Execution: in supine position, one leg is exorotated, laterally abducted and bent widely at the knee joint so that the foot protrudes laterally beyond the other leg. Now the flexed knee is pressed down ( dorsally)
Interpretation: If the knee remains above the opposite, extended leg, this indicates a shortening of the iliopsoas or, particularly in the case of pain, a disorder of the SIJ or hip joint (e.g. in Perthes‘ disease and coxitis).
Link 1:https://www.youtube.com/watch?v=89Qiht82zmg
Trendelenburg
Location: Hip
Test item: lack of strength of the gluteus medius
Performance: the patient walks at moderate speed. The weakness can also be observed in a quiet one-legged stance
Interpretation: A sinking of the pelvis on the unsupported side indicates weakness of the gluteus medius
Link 1:https://www.youtube.com/watch?v=0rcczDEWDqU
Duchenne sign (waddling gait)
Location: Hip
Test item: lack of strength of the gluteus medius
Execution: the patient walks and his pelvis is observed from behind
Interpretation: a sinking of the hip contralateral to the diseased leg when walking indicates – as does the Trendelenburg sign when standing – a weakness of the abductors, in particular the gluteus medius
Derbolowsky
Location: Hip
Test item: Pelvic curl
Execution: from the supine position, the ankles are raised by 10 cm. The patient sits up and side discrepancies in the change in position of the medial malleoli are observed. Repeat several times!
Interpretation: a lateral difference may indicate pelvic curvature
Piriformis test
Location: Hip
Definition: Test for DGS
Test item: DGS(piriformis)
Execution: on the side edge of the couch in a lateral position, the upper hip joint is flexed 45° and the corresponding knee joint 90° and then the leg is maximally adducted
Interpretation: stretching pain indicates a shortening, radiating pain indicates compression of the sciatic nerve
Link 1:https://www.youtube.com/watch?v=zha5jIv4_44
FAIR Test (Flexion, Abduction, internal Rotation) for Piriformis
Location: Hip
Definition: Test for DGS by stretching in adduction and internal rotation
Test item: DGS (piriformis syndrome)
Performance: in the lateral position on the symptom-free side, the knee joint is flexed and the hip joint is flexed, endorotated and adducted
Interpretation: occurrence or intensification of DGS-relevant pain is considered a positive test result
Link 1:https://www.youtube.com/watch?v=QvsNjFYYrN0
Specificity: 83
Sensitivity: 88
Active Piriformis Test
Location: Hip
Definition: Test for DGS (piriformissyndrome) by simultaneous movement dimensions of the piriformis
Test item: DGS (piriformis syndrome)
Execution: with the patient lying on their side without pain, the hipjoint is flexed, the leg is moderately turned out and the knee joint is flexed so that the foot can be placed on the couch. The patient should press the foot onto the table and push the leg dorsally against the resistance of the examiner (abduction + external rotation)
Interpretation: Occurrence or intensification of DGS-relevant pain is considered a positive result
Link 1:https://www.youtube.com/watch?v=qZzjXIXZL88
Specificity: 80
Sensitivity: 78
Seated Piriformis Stretch Test
Location: Hip
Definition: Test for DGS by stretching in internal rotation and adduction
Test item: DGS (piriformis syndrome)
Execution: sitting on the couch with the legs hanging over the edge, the affected leg is stretched, endorotated and adducted
Link 1:https://www.youtube.com/watch?v=Q__4bTuma4A
Specificity: 90
Sensitivity: 52
Beatty Maneuver
Location: Hip
Definition: Test for DGS (pir iformis syndrome) by abduction
Test item: DGS (piriformis syndrome)
Performance: one leg is abducted, i.e. raised, in the lateral position with the hip and knee joints bent.
Interpretation: the test is positive if the pain is typical of DGS or if it increases. Disc hernias would cause pain further cranially in the back
Link 1:https://www.youtube.com/watch?v=pvEnryptz28
Freiberg sign
Location: Hip
Definition: Test for DSG by internal rotation
Test item: DGS (piriformis syndrome)
Execution: in supine position, the leg on the affected side is forcefully rotated in order to put the piriformis under stretching tension
Interpretation: Pain caused by the internal rotation indicates excessive piriformis tension
Link 1:https://www.youtube.com/watch?v=GEG3Mn9Ir6Q
Pace maneuver
Location: Hip
Definition: Test for DSG by abduction
Test item: DGS (piriformis syndrome)
Execution: sitting sideways on a couch with legs hanging down, the patient pushes the knees apart against the resistance of the examiner
Interpretation: Pain or during powerful abduction indicates DSG
Link 1:https://www.youtube.com/watch?v=WhuPgPx4GtM
Thomas handle
Location: Hip
Test item: shortening of the hip flexors
Execution: in supine position, one hip joint is flexed and moved towards the chest with the knee joint flexed, while the examiner holds a hand under the lumbar spine.
Interpretation: Physiologically, the lumbar lordosis is compensated at a certain point. If this does not occur, this is an indirect indication of a hip flexor contracture. If, on the other hand, the contralateral thigh rises, i.e. the relevant hip joint flexes, this is a direct indication of a hip flexion contracture. Due to the extended contralateral leg, the rectus femoris is hardly relevant; instead, a contracture of the iliopsoas located in the pelvis is detected.
Ely test
Location: Hip
Test item: shortening of the rectus femoris
Execution: one knee joint is flexed at a time in prone position
Interpretation: if the hip joint also flexes to a certain degree when the knee joint is flexed, the rectus femoris is shortened
Link 1:https://www.youtube.com/watch?v=0FgacndWb4Q
Paff psoas test
Location: Hip
Definition: Test for contracture/shortening of the iliopsoas
Test item: shortening of the iliopsoas
Execution: a stick or ruler is placed against the spine in the best possible normal zero position so that it rests against the sacrum and thoracic spine. In this position, the minimum achievable distance of the lumbar spine from the stick is assessed with the knees extended and flexed. Care must be taken to ensure that the thoracic spine is not flexed. Instead of using a stick, the test can also be performed with the back pressed against a wall, whereby the distance of the lumbar spine is assessed from the side.
Interpretation: If the subject is unable to reduce the maximum distance between the lumbar spine spinous processes to below the distance corresponding to physiological lordosis by reducing flexion or extending the hip joints with the knee joint strictly extended, criterion 1 is positive. If this is possible through an appropriate degree of flexion of the knee joints, criterion 2 is positive. Both criteria indicate a shortening of the iliopsoas. Criterion 2 rules out the possibility that the inability to achieve physiological lordosis is due to a pathological change in the lumbar spine.
Link 1:https://www.youtube.com/watch?v=0FgacndWb4Q
Posterior Labral Tear Test
Location: Hip
Test item: posterior cartilage lip (labium posterior)
Performance: with the hip joint maximally flexed and the knee joint maximally flexed, the leg is brought from slight internal rotation and adduction into external rotation and abduction
Interpretation: if there is pain or slight bouncing in the hip, the test is positive
Link 1:https://www.youtube.com/watch?v=TWhJpSt1lZg
Anterior Labral Tear Test
Location: Hip
Test item: anterior cartilage lip
Performance: with the hip joint maximally flexed and the leg exorotated and slightly abducted, the leg is adducted, endorotated and extended in the hip joint
Interpretation: Pain or jumping indicates a lesion of the labium anterior
Link 1:https://www.youtube.com/watch?v=wmK_PhkUbaM
FADDIR test
Location: Hip
Test item: hip labrum
Performance: in supine position with the hip joint and knee joint flexed at 90°, the thigh is adducted and endorotated at the same time
Interpretation: Pain, especially in lateral comparison, can be an indication of hip impingement
Link 1:https://www.youtube.com/watch?v=xyJUIhsL4lg
Specificity: 5
Sensitivity: 99
4-character test
Location: Hip
Definition: tests for hip pain typical of Perthes disease
Test item: hip pain
Procedure: tests for pain during abduction and rotation with the lower leg-foot joint transition placed on the thigh (like half lotus position)
Link 1:https://www.youtube.com/watch?v=89Qiht82zmg
Quadriceps stretch test
Location: Leg
Definition: Measures the flexibility of the quadriceps
Test item: ability to stretch the quadriceps
Execution: In prone position, attempt to bring the heel to the buttocks by bending the knee joint
Interpretation: a remaining distance or its extent is considered a restriction of mobility
Kendall test (rectus femoris muscle stretch test)
Location: Hip
Definition: Measures the mobility of the rectus femoris
Test item: Flexibility of the rectus femoris
Performance: In supine position, the patient holds one flexed knee joint against the chest, the other is passively brought to 0° in the hip joint and flexed in the knee joint while overhanging the couch
Interpretation: a maximum flexion of less than 90° is considered a restriction
Link 1:https://www.youtube.com/watch?v=n8zRF56N-U8
Hamstring stretch test
Location: Leg
Test item: Stretching ability of the hamstrings
Execution: One extended leg is lifted in supine position
Interpretation: the maximum achievable flexion angle is measured, below 90° is considered pathological
Joint Line Tenderness Palpation
Location: Knee
Test item: Meniscus tear
Performance: the medial joint space is palpated in the supine position with the hip joint flexed at 45° and the knee joint flexed at 90° with the foot upright. The fingernail can be used for palpation to enhance the test result. To palpate the lateral meniscus, the lower leg is exorotated
Interpretation: the test is positive if the patient has known meniscus pain on palpation
Link 1:https://www.youtube.com/watch?v=XBle4px05ck
Specificity: 83
Sensitivity: 83
Valgus stress test
Location: Knee
Test item: Inner ligament rupture
Performance: in supine position with the knee joint extended and flexed 20°, the lower leg is pulled laterally opposite the thigh
Interpretation: Pain or a clearly visible movement in the inner knee indicates damage to the medial collateral ligament
Link 1:https://www.youtube.com/watch?v=GSFbttpxCuQ
Sensitivity: 86
Lelli test
Location: Knee
Test item: rupture of the anterior cruciate ligament
Performance: in supine position, the examiner places one fist under the proximal third point of the tibia, which raises the knee, and presses down on the distal femur with the other hand
Interpretation: if the lower leg does not lift adequately when the tibia is pressed down, or if the heel remains completely on the table, the test is positive and the ACL (anterior cruciate ligament) is defective.
Link 1:https://www.youtube.com/watch?v=T9ujIYIctdw
Specificity: 100
Sensitivity: 100 (94.98)
Thessaly test
Location: Knee
Test item: meniscus lesion
Performance: with the knee joint flexed by 20° in a single-leg stance, the body is rotated with the pelvis opposite the standing foot in the knee joint, if necessary with stability support
Interpretation: pain, especially in lateral comparison, indicates a meniscus lesion, the quality of the test is similar to the Apley-Grinding test or MC Murray test
Link 1:https://www.youtube.com/watch?v=ebraZ4jM36A
Specificity: 53
Sensitivity: 64
Varus stress test
Location: Knee
Test item: Outer ligament
Performance: in supine position, the knee is subjected to varus stress in an extended and 30° flexed position by pressing the lower leg medially with the thigh fixed in place
Interpretation: pain or significant movement in the inner knee may indicate damage to the inner collateral l igament
Link 1:https://www.youtube.com/watch?v=sg1gk6QKARw
Sensitivity: 25
Renne test
Location: Knee
Test item: Ilitibial band syndrome (runners knee)
Procedure: while standing, one leg is lifted slightly off the ground and the knee of the remaining leg is flexed 30-40°.
Interpretation: If the known pain occurs during flexion, the test is positive
Link 1:https://www.youtube.com/watch?v=pKktA1bjQbc
Ober test
Location: Knee
Test item: shortening of the iliotibial tract
Performance: in a lateral position with the hip joints slightly flexed, the examiner lifts the leg to be tested slightly with one hand (in abduction) and extends it in the hip joint. The knee can be flexed (as in the original test) or, better, extended. While holding the pelvis in place with the other hand, he looks to see how far the leg sinks with the first hand as the support decreases.
Interpretation: if the leg does not reach the table, the test for shortening of the tensor fasciae latae is positive
Link 1:https://www.youtube.com/watch?v=Amjv6FzDeLE
Cross-Crichton test (modified Ober test)
Location: Knee
Test item: Shortening of the iliotibial tract
Execution: As in the Ober test, the examiner lifts the leg to be tested slightly with one hand (in abduction) in a lateral position with the hip joints slightly flexed and extends it in the hip joint. The knee can be flexed (as in the original test) or, better, extended. While holding the pelvis in place with the other hand, he checks how far the leg drops with the first hand as support decreases and then extends and flexes the knee joint in alternation.
Interpretation: If the change between extension and flexion causes pain in the lateral condyle of the femur, ITBS (runner’s knee) is suspected.
Noble test
Location: Knee
Definition: Tests by applying pressure to the lateral condyle of the femur during extension
Test item: Test for ITBS (Runners Knee)
Procedure: the examiner applies pressure to the lateral condyle of the femur while the knee joint is extended either sitting on the couch or standing.
Interpretation: if the known pain is reproduced at approx. 30° on the lateral condyle of the femur, the test is positive.
Link 1:https://www.youtube.com/watch?v=PmUGl7ryQOo
Clarke (Patella Grind) Test
Location: Knee
Definition: Tests for retropatellar cartilage damage by friction
Test item: Chondropathy patellae
Performance: in supine position, the patella is pressed caudally and dorsally with the space between the thumb and index finger while the patient tenses the quadriceps
Interpretation: retropatellar pain during contraction or unwillingness to increase the contraction beyond a certain level indicates a positive test result
Link 1:https://www.youtube.com/watch?v=pRqnODPqxFs
Apley Grinding Test
Location: Knee
Definition: Tests for meniscus damage
Test item: Meniscus
Procedure: Tests for pain in prone position when pressing down and rotating the lower leg/foot with the knee bent at 90°
Interpretation: medial pain during external rotation indicates damage to the medial meniscus, lateral pain during internal rotation indicates damage to the lateral meniscus
Link 1:https://www.youtube.com/watch?v=6Z_9lfX_Pc8
Specificity: 84
Sensitivity: 38
Steinmann I sign
Location: Knee
Definition: Tests for meniscus damage
Test item: Meniscus
Procedure: tests for pain in supine position when rotating the lower leg with counterpressure against a knee raised by approx. 45° and flexed by approx. 135°
Interpretation: Pain during internal rotation of the lower leg indicates damage to the outer meniscus, pain during external rotation indicates damage to the inner meniscus
Link 1:https://www.youtube.com/watch?v=80l5A-uEj9I
Steinmann II sign
Location: Knee
Definition: Tests for meniscus damage by moving the pressure sensation
Test item: Meniscus
Procedure: tests for pressure pain in supine position in the medial and lateral joint space
Interpretation: Movement of the pressure pain from front to back during passive flexion of the knee joint and from back to front during extension of the knee joint indicate meniscus damage
Link 1:https://www.youtube.com/watch?v=CCXh36ds_EU
(Lateral) Pivot Shift Test (MacIntosh)
Location: Knee
Definition: tests for displacement of the center of rotation of the knee joint due to lesion of the anterior cruciate ligament
Test item: anterior cruciate ligament
Procedure: tests for pain in the supine position during internal rotation of the extended, approx. 20° raised lower leg under valgus stress and cranial compression. The ankle joint can be tested in a similar way, the foot remains fixed and pressure is applied against the distal tibia
Interpretation: if the end rotation of the lower leg shifts the tibia (and the pivot point) ventrally due to a lesion of the anterior cruciate ligament, pain occurs here. Increasing the flexion of the knee joint to 40° causes the iliotibial tract to change from an extensor to a flexor and leads to a noticeable dorsal reduction of the tibia
Link 1:https://www.youtube.com/watch?v=qqy5IfkEvfw
Link 2: https://de.wikipedia.org/wiki/Pivot-Shift-Test
Specificity: 98
Sensitivity: 24
reversed pivot shift test
Location: Knee
Definition: tests for displacement of the center of rotation of the knee joint due to lesion of the anterior cruciate ligament
Test item: posterior cruciate ligament
Performance: tests in supine position with 90° flexion in the hip joint and knee joint, exorotated lower leg and valgus stress applied externally against the knee, whether the tibia slides ventrally in the direction of extension when exceeding 150° in the knee joint
Interpretation: a subluxation of the tibia anteriorly at approx. 30 degrees of flexion in the knee joint indicates a loose posterior cruciate ligament
Link 1:https://www.youtube.com/watch?v=IqGPhYDhLSs
Specificity: 95
Sensitivity: 26
Lachmann (Trillat / Ritchie) test
Location: Knee
Test item: anterior cruciate ligament
Performance: in supine position, the examiner grasps the distal thigh from the dorsal side and the proximal lower leg from the ventral side with the thumb on the tibial tuberosity, flexes the knee joint to about 20° and pulls the lower leg ventrally with a jerk.
Interpretation: if the stop of the pulled lower leg is not hard but soft, the anterior cruciate ligament is insufficient
Link 1:https://www.youtube.com/watch?v=JFkbKNNa7xQ
Link 2: https://de.wikipedia.org/wiki/Lachman-Test
Specificity: 94
Sensitivity: 85
Drawer test
Location: Knee
Definition: Tests the function of the cruciate ligaments
Test item: cruciate ligaments
Execution: in supine position, with the foot in a fixed position and the knee joint bent at 90°, the lower leg is moved forwards and backwards in relation to the thigh.
Interpretation: if the lower leg can be pushed backwards significantly – especially in a side-to-side comparison – this indicates a lesion of the posterior cruciate ligament; if it can be pushed forwards, this indicates a lesion of the anterior cruciate ligament. The drawer test is less specific than the Lachmann test; an additional gravity sign test confirms the result
Link 1:https://www.youtube.com/watch?v=IdnBKv38EEQ
Link 2: https://www.youtube.com/watch?v=wDIGll5wzZs
Specificity: 91
Sensitivity: 92
Payr sign (Menisuks)
Location: Knee
Definition: Tests for pain caused by damage to the medial meniscus
Test item: medial meniscus
Procedure: cranial pressure is applied to the knees in a cross-legged position
Interpretation: Pain in one knee indicates damage to the medial meniscus of the affected knee
Link 1:https://www.youtube.com/watch?v=XKL4Z6BhPgU
McMurray test
Location: Knee
Definition: Tests for pain on flexion/extension of the knee with the lower leg turned in and out
Test item: meniscus damage
Performance: in supine position, the leg is repeatedly fully flexed and largely extended with the lower leg endorotated or exorotated
Interpretation: Pain in the outer knee with the lower leg endorotated indicates damage to the outer meniscus, in the inner knee with the lower leg exorotated indicates damage to the inner meniscus
Link 1:https://www.youtube.com/watch?v=lwDFPAyGGgI
Specificity: 63
Gravity-Sign (posterior sag test, Godfrey test)
Location: Knee
Test item: posterior sacrum
Procedure: Tests whether the proximal tibia sinks dorsally towards the floor in the supine position with the thigh vertical and the lower leg horizontal, creating a larger dent between the patella and tibia. If the patient flexes the knee joint against the fixation of the foot by the examiner, i.e. tenses the hamstrings, the dent may increase further
Interpretation: A dent that goes beyond the natural shape and its enlargement when the knee joint is flexed against resistance indicates damage to the posterior cruciate ligament. Lateral comparison!
Link 1:https://www.youtube.com/watch?v=BVWD2V0RwRA
Link 2: https://www.youtube.com/watch?v=R8KYd-mZSHM
Fründ sign
Location: Knee
Definition: tests for tapping pain in the patella
Test item: patella
Procedure: tests whether the patella is tender at different flexion angles of the knee joint.
Interpretation: this test is not particularly specific or conclusive. A positive test may indicate chondropathia patellae or retropatellar arthrosis as well as an injury to the patella bone itself, e.g. fracture.
Böhler mark
Location: Knee
Definition: Varus stress and valgus stress are exerted on the extended knee joint.
Test item: meniscus
Procedure: Pain during varus stress indicates damage to the medial meniscus or medial collateral ligament, pain during valgus stress indicates damage to the lateral meniscus or medial collateral ligament.
Link 1:https://www.youtube.com/watch?v=sg1gk6QKARw
Brush test
Location: Knee
Definition: Tests for joint effusion by spreading
Test item: slight joint effusion
Procedure: In supine position with the leg relaxed, the test is performed medially from distal to proximal and then laterally from proximal to distal.
Interpretation: A „fluid wave“ is triggered even with a small amount of effusion
Link 1:https://www.youtube.com/watch?v=ySpqA-K5kjo
Dancing patella
Location: Knee
Definition: Test for pressure elasticity in joint effusion
Test item: joint effusion
Execution: the suprapatellar recess is spread out cranially in the supine position with the patella pressed against the femur or moved between medial and lateral, then tested for pressure elasticity when pressure is applied to the patella
Interpretation: palpable elasticity indicates joint effusion
Link 1:https://www.youtube.com/watch?v=CNlaAQl7AR4
Q-angle
Location: Knee
Definition: Measures the Q-angle between quadriceps forceand patellar tendon direction
Test item: Q-angle
Procedure: With the hip joint and knee joint in standard anatomical position, a line is drawn between the SIAS and the center of the patella and between the center of the patella and the tibial tuberosity.
Interpretation: Normal are M:13°, W:18°. Smaller angles tend to lead to patellar dysfunction or patella alta, larger angles to patellar subluxation or increased femoral anteversion, genu valgum or increased tibial torsion
Glide test
Location: Knee
Definition: Tests for displacement and crepitation by transverse displacement
Test item: Displacement, crepitation
Procedure: In supine position with the leg relaxed, the patella is displaced medially from the side with both thumbs and later laterally with both index fingers. The test can be repeated with the quadriceps tensed by attempting to lift the leg. Traction (lifting the patella ventrally) is also possible. The caudal displacement can also be tested
Interpretation: Lateral equal displacement of the patella without crepitation or a tendency to dislocateis physiological. Increased lateral or medial displacement indicates a loose ligamentous apparatus or a habitual dislocation or subluxation tendency. A hypomobile patella cannot be displaced by more than a quarter, a hypermobile patella by more than half. Retropatellar crepitation indicates a chondropathy patellae or retropatellar arthrosis. Reduced caudal displacement indicates shortened quadriceps or patella alta
Link 1:https://www.youtube.com/watch?v=jt3lUvfAX-c
Zohlen sign
Location: Knee
Test item: Patella
Procedure: Test in supine position for pain when the thigh is tensed with the patella previously pressed proximally medially and laterally against the femoropatellar gliding bearing by the examiner. In addition, the quadriceps is tensed first and then the patella is pressed into the gliding bearing(Clarke sign or patella grind test)
Interpretation: Pain often indicates retropatellar cartilage damage (chondropathia patellae), but there are also plenty of false positives. Therefore repeat the test in 30, 60, 90° flexion of the knee joint
Link 1:https://www.youtube.com/watch?v=DA3Y9spJptg
Facet pressure pain
Location: Knee
Test item: retropatellar facet pressure pain
Procedure: in supine position with the knee joint extended and the muscles relaxed, the patella is tilted open first with the thumbs from the medial side, then with the index fingers from the lateral side and an attempt is made to palpate the retropatellar cartilage
Interpretation: Pain, usually more medial, indicates retropatellar arthrosis, attachment tendinopathy or synovitis
Crepitation test
Location: Knee
Test item: Crepitation
Procedure: While bending the knee, try to hear noises with the ear close to the knee
Interpretation: Crepitations (snowball crunching) indicate a clear chondromalacia (grade II and III). Painless cracking noises during the first two squats are without findings. It is best to perform a few squats before the test. The absence of a retropatellar crunch makes retropatellar damage unlikely. False positives are not uncommon.
Apprehension test according to Fairbank (Smilie test)
Location: Knee
Procedure: in supine position with relaxed muscles, both thumbs are used to try to move the patella laterally, whereupon the patient is asked to flex the knee joint
Interpretation: After a dislocation, severe pain and avoidance behavior would be expected
Link 1:https://www.youtube.com/watch?v=aDkISYVmNyE
McConnell test
Location: Knee
Test item: Subluxation of the patella
Execution: With the lower leg hanging loosely down, the knee joint is attempted to be extended against resistance in 0,30,60,90,120° flexion
Interpretation: if pain or a „tight feeling“ is reduced by medializing the patella, the test is positive; side comparison! Then stretching of the iliotibial tract and rectus femoris is needed, strengthening of the vastus medialis
Link 1:https://www.youtube.com/watch?v=25gGcJS_Pec
Tilt test
Location: Knee
Definition: Tension of the lateral retinaculum patellae
Test item: lateral retinaculum
Execution: the patella is moved slowly and passively in a supine position with the leg relaxed . Another variant attempts to lift the lateral edge of the patella, see link1
Interpretation: if the outer edge of the patella moves towards the femur (pathological negative test), if the lateral retinaculum is too tight, it moves too loosely caudally; physiological would be a purely lateral movement of the entire patella
Link 1:https://www.youtube.com/watch?v=DlHoesKkvTM
Specificity: 92
Sensitivity: 43
Subluxation suppression test
Location: Knee
Definition: Test for lateral subluxation tendency
Test item: lateral or medial subluxation
Procedure: If a lateral subluxation tendency is known, a thumb is placed on the proximal lateral edge of the patella when the relaxed knee is flexed and the lateralization urge is perceived and the subluxation suppressed. Lateral comparison!
Interpretation: A medial subluxation tendencycould be tested analogously, but it is very rare.
Dreyer test
Location: Knee
Definition: Tests the functionality of the quadriceps tendon
Test item: Quadriceps tendon rupture
Performance: If the patient is unable to lift the extended leg in the supine position, but can do so with the kneecap passively fixed pxoximally, this suggests a quadriceps tendon ruptureor an old patella fracture
Mediopatellar Plica Test (Hughston Plica Test)
Location: Knee
Execution: in supine position, the knee is moved back and forth between 90 and 180° under pressure from lateral to medial against the patella
Link 1:https://www.youtube.com/watch?v=amfnTj2bTYE
Stutter Plica Test
Location: Knee
Definition: Palpated for uneven movement of the patella during extension of the knee joint
Test item: Plica
Execution: on the couch with the legs hanging down, the patella is palpated during extension of the knee joint
Interpretation: a palpable jerk between 30° and 45° indicates a plica, which can cause discomfort under load
Link 1:https://www.youtube.com/watch?v=8C2zPukyr5c
Link 2: https://www.youtube.com/watch?v=EeGMkjzaGws
Dial test
Location: Knee
Test item: posterolateral rotational instability
Performance: In prone position, the knees are flexed 30° and the maximum external rotation of both lower legs in the knee joint is measured, then this is repeated at 90° flexion.
Interpretation: side discrepancies of more than 10° are considered significant. PCLs (posterolateral corner) are often the result of knee trauma, hyperextension or varus stress and often occur together with cruciate ligament damage
Link 1:https://www.youtube.com/watch?v=3UGffd71KyI
Windlass test
Location: Foot
Test item: Plantar fasciitis
Procedure: the patient stands on the couch with the balls of the feet beyond the edge of the couch, then the hallux is dorsiflexed
Interpretation: Pain or increased pain indicates plantar fasciitis. A lack of extension in the metatarsophalangeal joint (MTP) indicates hallux rigidus
Link 1:https://www.youtube.com/watch?v=fg0PtnoAzSs
Specificity: 100
Sensitivity: 32
Thompson test (calf pinch test)
Location: Ankle
Definition: Tests the function of the Achilles tendon
Test item: Achilles tendon
Procedure: Tests whether the expected plantar flexion does not occur in the prone position with the feet projecting beyond the couch when the triceps surae is manually compressed from both sides. Inspection and paplator examination for dents, swelling and hematoma
Interpretation: Absence of plantar flexion of the foot indicates rupture of the Achilles tendon
Link 1:https://www.youtube.com/watch?v=z-7cJ7LpCqY
Specificity: 93
Sensitivity: 96
Weber-Barstow maneuver
Location: Leg
Test item: functional leg length difference
Performance: in supine position, the examiner palpates the medial malleoli, then the patient flexes 45° in the hip joint and 90° in the knee joint and then raises the pelvis. The patient then lowers the pelvis and the examiner passively extends the legs and hips again
Interpretation: a difference can be reduced or remain as a result of the maneuver described, but it provides the best conditions for the assessment. A measured difference can still be functional or anatomical, then measure:
- Iliac crest to greater trochanter
- Greater trochanter to lumbar joint space
- Medial joint space to medial malleolus
- the lower leg length can also be measured in the prone position with the lower legs vertical, the thigh length in the supine position with the hip joints bent at 90°
In the first measurement, hip jointsubluxations and the CCD angle play a role, the next two measure the lengths of the bone pieces independently of the joints. Functional differences with pelvic obliquity are usually adaptations to pathologies or shortening in the spine, pelvis (and hip muscles) or lower limbs. If the limbs are the same length, it can be determined whether there is a malleolus-xyphoid or malleolus-navellateral difference, although this is less accurate.
Link 1:https://www.youtube.com/watch?v=K2VWpuqDQjU
Cotton test
Location: Lower leg
Test item: syndesmosis lesion
Performance: on the couch with the foot hanging freely, the distal lower leg is supported dorsally and transverse translation is attempted in the ankle region
Interpretation: more than 3-5 mm translation and audible or palpable cracking are considered a positive test for an unstable syndesmosis
Link 1:https://www.youtube.com/watch?v=ivGqC0te6uA
Sensitivity: 25
Simmond test
Location: lower leg
Definition: corresponds approximately to the Thompson calf pinch test
Test item: Achilles tendon rupture
Performance: as Thompson test, but with leg flexed at 90° and compression of the triceps surae with both hands
Interpretation: Absence of reactive plantar flexion indicates rupture of the Achilles tendon
Link 1:https://www.youtube.com/watch?v=x2xTMvrmqz0
Hoffa sign (test)
Location: Lower leg
Definition: Tests for old Achilles tendon rupture with increased dorsiflexion
Test item: lesion of the Achilles tendon
Performance: maximum dorsiflexion is performed passively in prone position with feet hanging freely
Interpretation: reduced tension and a larger angle during dorsiflexion may indicate an old Achilles tendonrupture. In addition, the position of the ball of the foot can be tested, which is impossible in the case of a rupture
Link 1:https://www.youtube.com/watch?v=gn9O2gn_8F0
Achilles tendon tap test
Location: Lower leg
Definition: Tests the Achilles tendon reflex with a reflex hammer
Test item: Achilles tendon rupture
Execution: in a prone position with the leg bent at 90°, the distal third of the Achilles tendon is tapped with a reflex hammer. If there is no plantar flexion, i.e. no Achilles tendon reflex, there is probably a rupture. Follow up with further neurological tests.
Strunsky test
Location: Foot
Definition: Tests for damage to the metatarsophalangeal joints
Test item: metatarsophalangeal joints
Execution: in supine position with feet projecting beyond the couch, toes 2-5 are plantarflexed in the metatarsophalangeal joints
Interpretation: In the case of chronic complaints of the metatarsophalangeal joints, the pain increases significantly. The individual palpation determines the affected joint(s)
Link 1:https://www.youtube.com/watch?v=6nOkqpfQZiA
Grifka test
Location: Foot
Definition: Tests for splayfoot-typical tenderness of the metatarsal heads
Test item: splayfoot
Procedure: with the toes dorsally extended and the foot held loosely in the ankle joint, pressure is exerted from thedistal-plantar side on the metatarsal heads in the metatarsophalangeal joints.
Interpretation: Pressure pain indicates splayfoot
Link 1:https://www.youtube.com/watch?v=k_Czuv_qz9c
Toe shift test
Location: Foot
Test item: Repositionability of malalignments in the metatarsophalangeal joint in splayfoot
Execution: with the foot fixed medially with one hand, the other hand is used to successively shift each base of a metatarsophalangeal joint against the metatarsal head in a plantar and dorsal direction
Interpretation: Pain on movement with signs of instability indicate malalignment with claw toe formationunder stress. This is progressive and ends in dislocation with claw toe and callus formation that can no longer be repositioned in the toe displacement test
Crunch test
Location: Foot
Definition: Tests for metatarsophalangeal joints that are painful to move
Test item: Hallux rigidus
Procedure: One hand fixes the forefoot from the lateral side, the other grasps the big toe from the plantar and dorsal sides and performs plantar, flexion and rotation movements.
Interpretation: In the case of hallux rigidus, all directions of movement would be painful and dorsiflexion in particular would be painfully restricted. Audible and palpable crunching would then also be typical
Gänslen handle
Location: Foot
Definition: Compression of the metatarsal heads
Test item: clarification of forefoot pain
Procedure: One hand grasps the metatarsal heads, plantar side with the fingers, dorsal side with the thumb, the other hand presses the metatarsal head area together in a lateral direction 1-5
Interpretation: Pain between the metatarsal heads and possibly additional radiation into the toes indicate Morton’s neuralgia (pain-sensitive interdigital neuroma), which sometimes occurs with a significant splayfoot.
Metatarsal tap test
Location: Foot
Definition: Provocation test for metatarsalgia by tapping
Test item: Metatarsalgia
Execution: In supine position, the feet hang freely, one hand overstretches the toes dorsally, the other taps the metatarsal heads/metatarsophalangeal joints with a reflex hammer
Interpretation: if metatarsalgia is present due to chronic irritation, the test increases the symptoms. Painfulness especially of the 3rd and 4th indicate metatarsalgia due to Morton’s neuroma, see Mulder click test
Scaphoid drop test
Location: Foot
Test item: Overpronation
Performance: mark the scaphoid tuberosity and measure its distance to the ground in unloaded and loaded standing position
Interpretation: up to 1 cm is tolerable, more is a predisposition for overuse syndromes such as tibial tuberosity syndrome, plantar fasciitis, chondropathia patellae
Link 1:https://www.youtube.com/watch?v=BejuNMmD7-Y
Coleman side block test
Location: Ankle joint
Definition: Tests as a lateral test the compensation of a contracted forefoot valgus position by a flexible hindfootvarus and as a medial test the compensation of a contracted forefoot varus position by a flexible hindfootvalgus
Test item: Torsion in the foot
Performance: test blocks of different heights to determine up to which height the valgus/varus is compensated, in the lateral test the block lies under the lateral edge of the foot and the lateral heel so that the first metatarsal still reaches the ground, or in the medial test the lateral edge of the foot with support of the medial edge of the foot and the medial heel.
Link 1:https://www.youtube.com/watch?v=TCp25F0l7hc
Foot flexibility test
Location: Foot
Definition: Tests for flat foot, i.e. hindfoot valgus with a lowered medial longitudinal arch. This test corresponds to the single heel rise test when performed unilaterally
Test item: Knock-kneed foot
Performance: Tests for lifting of the heel valgus during dorsiflexion
Interpretation: If the heel valgus is lifted during active dorsiflexion (standing on the ball of the foot), the flexed flat foot is flexible, otherwise it is contracted.
Forefoot adduction correction test
Location: Foot
Definition: Tests for flexibility of a sickle foot
Test item: Sickle foot in infants
Execution: one hand grasps the heel, the other thumb attempts to lift the sickle foot
Interpretation: If the sickle can be lifted, i.e. is flexible, it will probably regress, otherwise traction and intervention with plaster casts is indicated
Talar tilt test 1 (inversion or varus stress test)
Location: Ankle
Definition: Tests the collateral ligaments through Everison
Test item: lesion of the outer ligaments
Execution: with the lower leg hanging freely, one hand grasps the ankle, the other hand grasps the heel and brings the foot from the middle position into inversion
Interpretation: if the ankle joint on one side is more mobile than the other and is also painful, a rupture of the lig. calcaneofibulare and lig. fibulotalare anterius is suspected
Link 1:https://www.youtube.com/watch?v=UHNbm6Z3XK4
Specificity: 88
Sensitivity: 50
Talar tilt test 2 (eversion or valgus stress test)
Location: Foot
Definition: Tests the medial ligaments by eversion
Test item: lesion of the medial ligaments
Execution: with the lower leg hanging freely, one hand grasps the ankle, the other hand grasps the heel and brings the foot from the middle position into eversion
Interpretation: if the ankle joint on one side is more mobile than the other and is also painful, a rupture of the deltoid ligament is suspected
Front and rear drawer base
Location: Ankle joint
Definition: Tests the collateral ligaments by inversion
Test item: lesion of the outer ligaments
Execution: in supine position with slightly bent knee and 15° plantar flexion, the heel is held dorsally with one hand and the tibia ventrally with the other and an attempt is made to push the heel ventrally against the tibia. To test the posterior drawer, the midfoot is held ventrally and the tibia dorsally and the foot is dorsiflexed
Interpretation: A rupture of the lig. fibulotalare anterius would result in a displacement with rotation of the talus around the intact outer ligaments laterally and ventrally in relation to the tibia. >If the talus moves dorsally and medially in the posterior drawer, a rupture of the dorsal and medial collateral ligaments is suspected
Link 1:https://www.youtube.com/watch?v=vAcBEYZKcto
Link 2: https://www.youtube.com/watch?v=4ameXWlUQb4
Specificity: 38/40
Sensitivity: 74/83
External rotation stress test Kleiger
Location: Leg
Definition: Tests the syndesmosis by forced external orotation
Test item: syndesmosis tibiofibularis
Execution: with the foot hanging freely at 0°, the proximal lower leg is fixed with one hand and the foot is forcefully exorotated with the other on the hindfoot (heel).
Interpretation: The forceful external rotation also externally rotates the talus and spreads the tibia and fibula. If pain occurs in the ventrolateral talocrural joint, the tibiofibular syndesmosis is suspected; if pain occurs in the medial OSG with additional plantar flexion, the deltoid ligament is suspected.
Link 1:https://www.youtube.com/watch?v=LnB1fta_rQA
Squeeze test
Location: Leg
Definition: Tests the syndesmosis by displacing the tibia and fibula against each other
Test item: syndesmosis tibiofibularis
Procedure: the free-hanging lower leg is grasped from ventral to dorsal with both hands and an attempt is made to compress it from the outside(laterally and medially)
Interpretation: Pain over the syndesmosis tibiofibularis indicates its injury
Link 1:https://www.youtube.com/watch?v=ANgWSz0UoDg
Specificity: 94
Sensitivity: 30
Dorsiflexion test
Location: Ankle joint
Definition: Tests the syndesmosis by forced dorsiflexion
Test item: syndesmosis tibiofibularis
Execution: with one hand grasping the exorotated lower leg ventrally, the foot is forced dorsiflexed with the other hand
Interpretation: Pain over the syndesmosis tibiofibularis indicates a lesion
Link 1:https://www.youtube.com/watch?v=s53uzyUv0bc
Specificity: 63
Sensitivity: 71
Heel pressure test
Location: Foot
Definition: Tests the syndesmosis by axial compression
Test item: syndesmosis tibiofibularis
Procedure: While one hand fixes the freely hanging lower leg, the other taps the heel from the caudal side
Interpretation: Pain over the syndesmosis tibiofibularis indicates a lesion. This test can also be used to test for a tibial stress fracture
Anterior ankle impingement test
Location: Ankle joint
Test item: Impingement of the ankle joint
Performance: the foot is dorsiflexed centrally, slightly endo- and slightly exorotated, with one hand holding the heel and the other moving the midfoot
Interpretation: pain medial or lateral to the tendon of the tibialis anterior indicates impingement
Link 1:https://www.youtube.com/watch?v=SrgSZOyRSPg
Link 2: https://www.youtube.com/watch?v=IbRCCIDa5-8
Specificity: 88
Sensitivity: 95
Posterior ankle impingement test
Location: Ankle joint
Test item: Impingement of the ankle joint
Execution: the foot is abruptly plantarflexed in the middle, slightly endo- and slightly exorotated, with one hand holding the heel and the other moving the midfoot
Interpretation: dorsolateral pain in the hindfoot in the area between the tibia and calcaneus indicates impingement, as sometimes occurs in dancers (dancer’s heel) and runners, especially when running downhill. Causes are: dislocated os trigonum, hypertrophic processus posterior tali, free joint body in the posterior joint area of the OSG, osteophytes on the posterior edge of the tibia, post-traumatic scarring and calcifications.
Link 1:https://www.youtube.com/watch?v=TqFWEtQNxYE
Interdigital nerve stretch test
Location: Foot
Definition: Test for Morton’s neuralgia by stretching the nerve
Test item: Morton’s neuralgia
Performance: in supine position with bilateral dorsiflexion, the 4th toes are passively dorsiflexed to the maximum
Interpretation: Burning pain in the sole of the foot and plantar at the level of the affected metatarsal heads with radiation to the corresponding toes indicates Morton’s neuralgia. An electrifying pain when standing and rolling the foot with radiation into the toes and possibly hypesthesia also often occurs.
Mulder click test (Morton test)
Location: Foot
Test item: Morton’s neuralgia
Performance: The forefoot is pressed together from the side, whereby the metatarsal heads move against each other
Interpretation: Pain possibly with paresthesia of the neighboring toes and possibly shifting palpable
Link 1:https://www.youtube.com/watch?v=pcA2fx_ovD0
Link 2: https://www.youtube.com/watch?v=Ar621njTSLU
Link 3: https://www.youtube.com/watch?v=P1pcvhLT6ig
Tinel sign
Location: Ankle
Definition: Tests for tarsal tunnel syndrome by tapping
Test item: Tarsal tunnel syndrome
Procedure: In prone position with knee bent at 90°, the tibial nerve behind the medial malleolus is tapped with a reflex hammer
Interpretation: Pain or discomfort in the sole of the foot indicates tarsal tunnel synd rome. The nerve would then be painful on pressure. In advanced damage, there were deficits in the area of the plantar nerve as well as paresis and atrophy of the plantar foot muscles
Link 1:https://www.youtube.com/watch?v=sAhEhWYmkEQ
Sensitivity: 58
Dorsiflexion eversion test
Location: Ankle
Definition: Tests for tarsal tunnel syndrome
Test item: Tarsal tunnel syndrome
Procedure:
Link 1:https://www.youtube.com/watch?v=XqA_WGjItXM
Specificity: 100
Sensitivity: 25 (numbness), 57 (pain), 98 (tenderness)
Triple Compression Test (tarsal tunnel)
Location: Ankle
Definition: Tests for tarsal tunnel syndrome
Test item: Tarsal tunnel syndrome
Procedure:
Link 1:https://www.youtube.com/watch?v=FBaonEgJHGs
Specificity: 100
Sensitivity: 86
Heel compression test
Location: Foot
Test item: stress fracture of the calcaneus
Execution: the heel is gripped from behind with interlaced fingers and compressed with the balls of the hands
Interpretation: Pain in the heel area usually indicates a stress fracture of the calcaneus, as occurs with significant osteoporosis; a pain-relieving gait would then also be observed, possibly swelling and tenderness.
Link 1:https://www.youtube.com/watch?v=guaPHJKmN_I
Gowers maneuver
Location: WS
Definition: Inability to stand up as a sign of muscular dystrophy
Test item: muscular dystrophy
Performance: the subject is unable to raise himself from a sitting position on the floor by clear, purposeful use of the muscles of the extremities arms and legs but brings his arms and legs closer together in order to raise his upper body from an improvised quadrupedal position with multiple support of the arms on his own legs
Link 1:https://www.youtube.com/watch?v=Ye8jYA08K60
Link 2: https://www.youtube.com/watch?v=sM7GiU06EWE
Flick Sign (hand shake test)
Location: Wrist
Test item: carpal tunnel syndrome
Procedure: the hands are shaken vigorously for a while
Interpretation: relief indicates a positive test and suspected carpal tunnel syndrome
Link 1:https://www.youtube.com/watch?v=7K1l_Onb-0I
Hoffa test
Location: Knee
Performance: in supine position, the knee joint is pressed on the caudal patellar pole in 45° flexion and extension
Interpretation: Pain due to the pressure indicates Hoffa syndrome(pain due to changes in the Hoffa fat body)
Link 1:https://www.youtube.com/watch?v=QdCJU7EQc3k
Bounce test
Location: Lower leg
Definition: Inflammation due to maximum extension or hyperextension of the knee joint due to inflammation of the Hoffa’s fat body
Test item: Inflammation of the Hoffa’s fat body
Procedure: The knee joint is passively maximally extended or, if possible, hyperextended by the examiner. Another description requires gravitational extension of the knee joint, which was previously flexed together with the hip joint in the supine position: if the support of the lower leg initially used for flexion is suddenly withdrawn and the hand supporting the foot is quickly pulled caudally, the knee joint falls into extension or hyperextension due to gravity.
Interpretation: Triggering of the typical pain indicates inflammation of the Hoffa’s fat body
Link 1:https://www.youtube.com/watch?v=P570wBELisU
Heel Contralateral Knee Maneuver
Location: Knee
Test item: DGS
Execution: in supine position, the hip and knee joints are flexed on one side and the leg is exorotated so that the heel can be placed on the contralateral thigh when the knee is bent. The same hip is then passively flexed
Interpretation: The position is held for up to one minute. If pain occurs, the test is positive and a DGS is suspected
Link 1:https://www.youtube.com/watch?v=4M8rCgcKjSg
Specificity: 60
Sensitivity: 100
Medial epicondylitis test
Location: Arm
Test item: Golferellobgen
Execution:
Link 1:https://www.youtube.com/watch?v=u5H9iG8QhYA
Muckard test
Location: Wrist
Test item: Tendosynovitis
Execution: with the forearm pronated, the thumb is placed (adducted) and the wrist abducted ulnarly
Linburg sign
Location: Wrist
Execution: with the thumb placed in the palm of the hand (opposed and flexed), the index finger is maximally extended
Interpretation: pain or limited extension is a positive sign for Linburg-Comstock syndrome, in which the tendons of the flexor pollicis longus and the flexor digitorum produndus of the index finger are fused together
Link 1:https://www.youtube.com/watch?v=ZiHv8Pxr9aI
Bunnell-Littler test
Location:
Implementation:
Link 1:https://www.youtube.com/watch?v=0ShL6QLEYMk
Reverse Phalen test
Location: Wrist
Test item: carpal tunnel syndrome
Procedure: the hands are folded in front of the sternum and lowered as far as the wrists can be held together. This is held for one minute
Interpretation: if symptoms typical of carpal tunnel syndrome are present, the test is positive
Link 1:https://www.youtube.com/watch?v=3oUSzEOD8IY
Reagent test
Location: Wrist
Test item: luno-triquetral instability
Execution:
Link 1:https://www.youtube.com/watch?v=gFM25GC-Llc
Shuck test
Location: Wrist
Test item: radiocarpal, intercarpal scaphoid instability
Procedure:
Link 1:https://www.youtube.com/watch?v=Dn8gNqbum8M
Galeazzi (Allis) test
Location: Leg
Test item: Leg length difference, hip dysplasia
Execution:
Link 1:https://www.youtube.com/watch?v=BerHU4Y6Gd4
Anvill test
Location: Hip
Test item: coxarthrosis, coxitis, TEP loosening
Execution: in supine position, one leg is raised by 20° and struck against its heel with the lateral fist
Link 1:https://www.youtube.com/watch?v=imUAnNQT3t4
Drehmann sign
Location: hip
Execution: the patient should flex the hip without any rotation. The Drehmann sign is also described as passive hip flexion.
Interpretation: if external rotation inevitably occurs during flexion and no voluntary internal rotation is possible at the same time or if it is performed passively it is painful, the test is positive and hints at a epiphyseolysis capitis femoris, Coxarthrosis or FAI.
McCarthy test
Location: Hip
Test item: hip impingement (FAI)/labrum damage
Procedure: both hips and both knees are flexed to the maximum in the supine position. While the patient holds the leg not to be examined in this position, the examiner stretches the hip and knee of the leg to be examined once with endo- and once in external rotation. This is then repeated on the asymptomatic side
Interpretation: Cracking and pain indicate hip impingement due to labrum damage
Link 1:https://www.youtube.com/watch?v=To4r0YQI6Nc
Ortoani/Barlow
Location: Hip
Test item: Hip dysplasia
Performance: In the Ortolani test, the hip joints are compressed in the dorsal direction from the typical supine position of the baby with the hipjoints flexed 90° and the knee joint also flexed 90° and then the thighs are abducted.
Interpretation: In the event of subxulation, the femoral head snaps audibly and palpably back into the acetabulum, in which case the test is considered positive. This is considered suspicious for hip dysplasia and may only be performed once, as it endangers the cartilage.
Link 1:https://www.youtube.com/watch?v=Qy3uSkDhMZs
Kalchschmidt dysplasia test
Location: Hip
Test item: Dysplasia
Performance: In the prone position, the thighs are forcibly exorotated with the hip joints extended
Interpretation: Pain in the groin area indicates symptomatic hip dysplasia
Marten test
Location: Knee
Performance: after a Lachmann test, the same maneuver is repeated with additional internal rotation of the lower leg and valgus stress
Interpretation: a noticeable subluxation during the maneuver indicates an ACL insufficiency
Link 1:https://www.youtube.com/watch?v=h-YR_DTTuHg
Allen test
Location: Circulation
Test item: Blood circulation in the hand
Procedure: one hand is clenched into a fist as quickly as possible several times in succession, then held firmly in a fist-clench. The examiner then squeezes the radial and ulnar arteries. The fist is then opened (which should then show a certain pallor), the compression of the arteries is released and it is observed how quickly the palm regains its normal color
Interpretation: If blood flow is slow to resume, a circulatory disorder of the supplying arteries must be assumed
Link 1:https://www.youtube.com/watch?v=D1tJO0RW9UM
Anterior apprehension test
Location: Shoulder
Test item: anterior instability
Execution: with the shoulder blade fixed, the arm is laterally abducted 90° and the elbow flexed 90°. Then the arm is exorotated 90°
Interpretation: palpable subluxation or defensive tension against external rotation indicate a lesion of the capsuloligamentous apparatus
Link 1:https://www.youtube.com/watch?v=hy7zgoEsbzQ
Active Compression Test
Location: Shoulder
Test item: SLAP lesion
Procedure: in a standing position, the arm is abducted 90° frontally and adducted 10-15°. The patient should now hold the arm in position against pressure from above, first in the endorotated position, then in the exorotated position
Interpretation: if the endorotated position provokes more than the exorotated position, the test is positive
Link 1:https://www.youtube.com/watch?v=FRotc9Rx1Ak
Passive Distraction Test
Location: Shoulder
Test item: SLAP lesion
Procedure: in supine position, the exorcised arm is brought into 150° lateral abduction with the forearm supinated. The upper arm is manually fixed in external rotation while the forearm is pronated.
Interpretation: If there is pain deep in the shoulder joint, the test is positive
Link 1:https://www.youtube.com/watch?v=FRotc9Rx1Ak
JAGAS test
Location: Hip
Test item: Piriformis syndrome (DGS)
Performance: in supine position, the patient adducts the affected leg in a scissor movement in the frontal plane maximally beyond the midline
Interpretation: the occurrence of pain after a while indicates DGS
Filler sign
Location: Hip
Definition: in supine position, active adduction is performed, e.g. to cross the leg over the midline against resistance
Test item: piriformis syndrome (DGS)
Execution: pain during sustained exercise indicates DGS
HOP test
Location: Leg
Test item: MTSS/fracture
Procedure: the patient attempts to jump standing on one leg at least 10 times
Interpretation: a fracture would prevent him from jumping or make him refuse to jump again after the first jump. If this is not the case and there is (possibly increasing and presumably known) pain in the medial lower leg when jumping, a tibial plateau syndrome is likely.
Link 1:https://www.youtube.com/watch?v=Etu8nhGQArk
Pratt warning veins
Location: Leg
Test item: Thrombosis
Procedure: the lower leg is inspected for filled superficial veins and palpated
Interpretation: pressure-painful veins filled in supine position indicate occlusion of the deep veins due to thrombosis
O’Brien needle test
Location: Ankle
Test item: Achilles tendon rupture
Procedure: a needle is inserted percutaneously into the Achilles tendon far distally and the foot is passively plantarflexed
Interpretation: if the needle moves during plantar flexion, the Achilles tendon is not completely torn
Popeye-sign
Location: Shoulder joint
Definition: The visible contraction of the long head of the biceps after rupture of the tendon of origin leads to an optical phenomenon reminiscent of the exaggerated biceps of the cartoon character, namely a muscle displaced towards the distal end.
Test item:
Execution: Bend the arm at the elbow joint to 90°, laterally abduct it 90° and contract the arm flexor muscles against the arm extensor muscles.
Interpretation: If the head of the biceps is displaced towards the distal end, this indicates a tear in the original tendon of the biceps.
biceps tendon.
Reverse Popeye-Sign
Location: Elbow joint
Definition: The visible contraction of both heads of the biceps after rupture of the insertion tendon at the radius leads to an optical phenomenon that shows a muscle displaced towards the proximal end, contrary to the overdrawn biceps of the cartoon character.
Test item:
Execution: Bend the arm at the elbow joint to 90°, laterally abduct it 90° and contract the arm flexor muscles against the arm extensor muscles.
Interpretation: A head of the biceps displaced towards the proximal end indicates a tear.
biceps indicates a tear of the insertion tendon of the biceps at the radius.
radius.
Ludington test
Location: Shoulder joint
Definition: During contraction of the biceps, it is felt whether the biceps behave
biceps behave the same on both sides.
Test item: Tear of the tendon of origin of the long head of the biceps brachii
Procedure: Fold the arms behind the head and relax the biceps. The examiner places a finger in the axial crease on the ventral biceps on both sides and allows the subject to contract the biceps.
Interpretation:
Childress test/Duck-walk test
Location: Knee joint
Definition: Tests for meniscus-related pain during duck gait
Test item: Meniscus lesion
Performance: The subject walks a few steps forwards, backwards, left and right in duck walk, whereby typical triggers of meniscus pain occur with internal rotation and external rotation in the knee joint under changing flexion.
Interpretation: The occurrence of typical meniscus pain indicates damage to the corresponding meniscus (l/r, front/back)
Specificity: 39
Sensitivity: 71
Link1: https://www.youtube.com/watch?v=C2D9OG1EpbA
Quadriceps Active Test / Active Drawer Test
Location: Knee joint
Definition: Tests for reduction of a dorsally subluxed tibia by tensing the quadriceps at a favorable flexion angle
Test item: tear of the posterior cruciate ligament (PCL)
Performance: in the supine position with the knee joint flexed 90°, hip joints flexed 45° and feet fixed by the examiner, the subject attempts to extend the knee joint. Dorsal subluxation is eliminated or at least visibly reduced by the traction of the patellar ligament on the tibial tuberosity.
Interpretation: A ventral movement of the tibia is a positive sign and indicates damage to the posterior cruciate ligament
Specificity: 98
Sensitivity: 53
Link1: https://www.youtube.com/watch?v=tQCacgQgC-s
Merke sign
Location: Knee joint
Definition: Tests for pain caused by rotation when the knee joint is slightly flexed.
Test item: Meniscus lesion
Execution: In a one-legged stance with the supporting leg flexed 10-20°, the thigh is rotated in and out as a punctum mobile in the knee joint relative to the lower leg as a punctum fixum.
Interpretation: The occurrence of pain in the region of the inner or outer joint space is considered a positive sign and an indication of a meniscus lesion.
Link1: https://www.youtube.com/watch?v=PFwwZApnkBg
Eges test
Location: Knee joint
Definition: Test for meniscus complaints caused by internal rotation and external rotation in the knee joint under changing flexion with a heavy load
Test item: Tests for meniscus-related complaints in a similar way to the McMurray test, but with the knee joint loaded with body weight
Procedure: The test subject first stands with the heels at a distance of approx. 40 and the legs externally rotated (turned out) as far as possible in the hip joints (i.e. with the feet turned out as far as possible). Then bend the knee joints as far as possible and straighten them again. In the second part, the feet are not turned out as far as possible, but only opened to an angle of 20°. The thighs are internally rotated (turned in) as far as possible, i.e. the knees are moved inwards. The subject then flexes and extends the knee joint again.
Interpretation: The Eges test is based on the fact that when the thighs are rotated externally (turned out) with increasing flexion in the knee joint, restrictions in the mobility of the adductors and the iliopsoas pull the knees forwards and thus the lower legs into external rotation. In the second case, the internal rotation is produced arbitrarily. In both cases, the collateral ligaments completely cancel out the rotation in the knee joint when it is extended, so that a situation is created in which the rotation changes with the degree of flexion under load. Pain or snapping in the knee joint is therefore considered a positive test and indicates a meniscus lesion.
Specificity: 90(lateral), 81(medial)
Sensitivity: 64(lateral), 67(medial)
Link1: https://www.youtube.com/watch?v=OUwzCKkGQjw
Pässler rotational compression test
Location: Knee joint
Definition:
Test item:
Procedure: The examiner fixes the subject’s knee with his thighs. While palpating the medial joint space, the examiner rotates the subject’s lower leg back and forth between internal and external rotation.
Interpretation: If there is discomfort during internal rotation, this indicates a lesion of the medial meniscus; if there is discomfort during external rotation, the lateral meniscus is affected.
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Jump-Sign / Finochietto test
Location: Knee joint
Definition: Tests for lesions of the posterior horn by translation in this direction
Test item:
Procedure: The subject lies in a supine position with the knee joint at 130-140° and the examiner holds the foot in place,
while the examiner pulls the tibia ventrally, similar to the anterior shear limb test, only more forcefully.
Interpretation: If the examiner perceives a jump, this indicates an injury to the posterior horn, due to which the detached area of the posterior horn of the meniscus is pulled up to the contact area between the tibia and femur. Pain or sound perception need not be present. In the case of known cruciate ligament tears, this test is not considered positive. In the case of a disc meniscus or free joint bodies, this test can also be a false positive. Its specificity, which has not yet been evaluated, is therefore certainly limited.
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Chaklin sign
Location: Knee joint
Definition:
Test item:
Performance: Inspection of the quadriceps and sartorius
Interpretation: Atrophy of the quadriceps due to an older meniscus lesion or isolated atrophy of the medial vastus with hypertonus of the sartorius for the same reason is considered a positive Tschaklin sign.
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Turner sign
Location: Knee joint
Definition:
Test item:
Performance: Palpation of the inner knee in the area of the inner meniscus
Interpretation: tenderness of the skin area around the medial joint space or an inadequate response to heat is considered a positive Turner sign and indicates a lesion of the medial meniscus.
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Chabot test
Location: Knee joint
Definition:
Test item:
Performance: In the supine position, the subject places one foot on the contralateral lower leg and attempts to extend the ipsilateral knee joint against moderate resistance from the examiner.
knee joint against moderate resistance from the examiner.
The examiner palpates the lateral joint space.
Interpretation: Pain occurs during extension, particularly if there is damage to the lateral meniscus.
joint space to the dorsal side.
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Hyperextension test
Location: Knee joint
Definition: Tests whether hyperextension occurs due to varus stress or valgus stress.
Test item:
Execution: while standing with legs extended, varus or valgus stress is applied to the knee joint and it is checked whether it hyperextends as a result.
Interpretation: A greater hyperextension than contralateral caused by varus stress or valgus stress indicates damage to the ACL.
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Shimpi Prone SI Joint Test
Location: ISG
Definition:
Test item: ISG blockade
Procedure: in prone position, the examiner fixes the sacrum with one hand
sacrum with one hand and lifts one thigh with the other hand.
Interpretation: Pain during extension of the hip joint indicates a disorder of the SI joint.
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Gilet test
Location: ISG
Definition:
Test item: ISG blockade
Procedure: With the subject standing upright and palpating one SIPS and the spinous process
SIPS and the spinous process S2, the subject raises the leg on the same side by 90°.
Interpretation: SIPS and S2 are at the same level. Physiologically, the PSIS lowers noticeably further in unloaded flexion in the hip joint. If this does not occur, this indicates a blocked or hypomobile SI joint.
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Yeoman test
Location: ISG
Definition:
Test item: sacroiliitis
Procedure: In the prone position, the examiner fixes the SIPS of the side to be examined with one hand by applying pressure cranioventrally, while pulling the thigh of the same side into extension with the other hand with the knee joint flexed
Interpretation: If pain occurs during extension, this indicates sacroiliitis.
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Watson-Test
Location: wrist
Definition: Test of scapholunar stability
Testitem: Skapholounar instability
Durchführung:
During fixation of the lower arm with pressure on the scaphoid in slight ulnar abduction and slight dorsiflexion,
it is observed whether the scaphoid physiologically presses more against the thumb during the transition to radial abduction.
Interpretation: The absence of increased pressure of the scaphoid against the thumb is indicative of ligament insufficiency. Triggered by impacts or falls.Verletzungen des lig. interosseum scapholunatum also frequently occur in distal radius fractures or carpal fractures.
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Silfverskjöld-Test
Location: ankle joint
Definition:
Test item: shortening in the triceps surae
Execution: In the supine position, the dosriflexion of the ankle joint is tested.
Interpretation: If dorsiflexion in the foot joint is not possible and plantarflexion remains, the gastrocnemius is significantly shortened (pointed foot). With flexion of the knee joint, the plantarflexion would be cancelled out if the gastrocnemius was shortened alone, not with an additional shortening of the soleus.
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definite yoga upper arm wall test
Location: Knee joint
Definition:
Test item:
Execution: With the back leaning against the wall and the feet at a distance of 30 cm from the wall to ensure a stable stance and sufficient contact pressure of the thoracic spine, the examiner tries to press the subject’s arms, which are stretched parallel upwards in frontal abduction, against the wall and observes visually and by feeling with one hand whether the middle thoracic spine can still be held against the wall or is at a distance from it.
Interpretation: The resulting distance indicates reduced frontal abduction in the shoulder joint. Hyperkyphosis and a limited possibility to extend the thoracic spine lead to the presence of clearly recognisable areas that are not supported above and below the support area of the thoracic spine.
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definite yoga held pullover
Location: shoulder joint
Definition:
Testitem: tests the maximum possible frontal abduction in the shoulder joint
Durchführung: Lie on your back on a weight bench, couch or similar object. Take a dumbbell in your hands and lower your arms, bent only minimally, over your head in maximum frontal abduction towards the floor. The elbows should be kept tight and thus the upper arms in wide external rotation. The stretching sensation that occurs then sets a soft-elastic limit to the movement and thus indicates the mobility of the shoulder joint in the direction of frontal abduction. If the dumbbell is held in the undergrip (in front of the abdomen, this corresponds to upward-facing palms), this results in even more external rotation than the lateral grip on the heads of the dumbbell. The possible internal rotation overhead, to which the overgrip in particular would be prone, must be avoided at all costs, especially if there is a tendency to shoulder dislocation.
Interpretation:
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definite yoga shoulder frontal abduction test in elevated back stretching
Location: shoulder joint
Definition:
Testitem: tests the maximum possible frontal abduction in the shoulder joint
Execution: Take the raised back stretching and lower your upper body to the maximum with your arms stretched out.
Interpretation: The possible frontal abduction can be seen well from the side when the body is in the correct position.
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Shoulder retroversion test in purvottanasana
Location: shoulder joint
Definition:
Testitem: Tests the possible retroversion of the shoulder joint
Execution: Take purvottanasana once with the hands pointing forwards and once with the hands pointing backwards and raise the pelvis and upper body to the maximum. For better differentiation, you can also perform the variation with the forearms up.
Interpretation: The resulting angle between the upper arm and upper body, viewed from the side, allows the degree of possible retroversion to be easily recognised. In quite mobile people, the angle is in the order of up to 90°, in less mobile people it is often barely greater than 20° or 30°. As the group of antagonists restricting retroversion, the anteverters (frontal abductors) consist of several muscles, of which the biceps brachii is biarticular and also a supinator of the forearm, further differentiation is necessary here to recognise who sets the soft-elastic movement limit. The other frontal abductors are the deltoid muscle with its pars clavicularis and the monoarticular coracobrachialis. If the biceps brachii in particular is shortened, the stretching sensation will extend from the two heads in the direction of the tendon at the radius and the variant with the forearms placed on the floor will provide relief in this respect and possibly also result in a better retroversion angle compared to those with the arm extended. In practice, however, it is often the case that the pars clavicularis of the deltoid muscle is also significantly shortened, which does not make the variant with the forearm raised any easier than that with the arm extended, but instead causes a significant stretching sensation in this muscle.
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definite yoga shoulder retroversion test in uttanasana
Location: shoulder joint
Definition:
Testitem: Tests the possible retroversion of the shoulder joint
Execution: Take uttanasana with the arms behind the back and lower them as far as possible towards the floor. If the arms do not exceed the vertical line clearly enough or do not reach it at all due to significant mobility restrictions in the hamstrings, bend the knee joints until this is achieved. This test can also be performed under load with a dumbbell of suitable weight held by the hands.
Interpretation: Both the loaded and unloaded test show the possible retroversion of the shoulder joint quite well if the arms clearly exceed the vertical. The knee joints may need to be flexed more or less significantly. In cases of extremely immobile hamstrings, the vertical may not be reached. However, the test is still meaningful enough.
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definite yoga shoulder rotation test
Location: shoulder joint
Definition:
Testitem: Testitem: Tests the internal rotations und external rotations of the shoulder joint in a 90° lateral abducted arm.
Execution: Tests the possible internal rotation and external rotation of the shoulder joint at 90° laterally abducted arm.
Durchführung: The test person lies on their back and has their arms 90° laterally abducted with their elbows on the floor, possibly on thin softness mediators. The elbows are bent at 90°. From this position, the upper arm is maximally internally rotated and then maximally externally rotated. To examine the internal rotation, the examiner holds the shoulder blades in depression.
Interpretation: As a rule, the arms cannot be rotated so far that the barbell reaches the floor. If an angle of more than 30° to the horizontal remains, this represents a restriction of internal rotation and hypertonicity of the limiting muscles such as the infraspinatus should be investigated. It is also important to look for lateral discrepancy. The external rotation should be possible to the extent that the dumbbell reaches the floor. Pay attention to lateral differences here too. If the horizontal position is easily reached, the elbow can be raised slightly so that more external rotation is possible.
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definite yoga shoulder internal rotation test in maricyasana
Location: shoulder joint
Definition:
Testitem:
Execution: versuche maricyasana 1 und danach maricyasana 3 einzunehmen und auf dem Rücken mit der das Bein umgreifenden Hand die andere Hand zu fassen.
Interpretation: The inability to grasp the other hand with the hand grasping the leg on the back can have various reasons, so that this test is not very specific. The two most important reasons, apart from a lack of ability to internally rotate the arm in the shoulder joint, are a lack of ability to rotate the spine and a lack of hip mobility, so that the knee of the raised leg remains well away from the armpit. If these two reasons do not apply, a lack of available external rotation of the arm must be assumed. In practice, however, there is often a combination of several limitations.
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dummy
Location: shoulder joint
Definition:
Testitem:
Execution: While sitting or standing, place the back of the hand on the side to be tested on the ipsilateral side of the back above the iliac crest. Now move the elbow as far as possible in a ventral direction.
Interpretation: The movement of the elbow with the hand on the back as a punctum fixum corresponds to an internal rotation of the less laterally abducted arm. With good mobility, the elbow can still be moved ventrally by at least 10 or 15 cm from a transverse path of the forearm (in a frontal plane). Lower values correspond to a limited possible internal rotation. The most important source of error could be a very limited possible dorsiflexion of the hand. Apart from this, the specificity is good and the sensitivity is very good.
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definite yoga latissimus dorsi flexibility test in elbow dog pose
Location: shoulder joint
Definition:
Testitem:
Execution: Take dog elbow pose and try to maximise the elevation of the shoulder blades and movement of the upper body towards the ribcage. If due to immobility of the hamstrings the pelvis cannot be tilted far enough to achieve the full possible frontal abduction in the shoulder joint, flex the knee joints sufficiently far. If the gastrocnemius reports too intense a stretching sensation, place the heels on a suitable elevation.
Interpretation: The latissimus dorsi originates in large areas of the lower medial upper body, extending into the thoracic spine and from there into the upper arm. It is therefore not only the frontal adductor and lateral adductor of the arm, but also the indirect shoulder blade depressor. Due to its attachment to the medioventral humerus, it is also an internal rotator. The dog elbow pose requires the opposite in all three movement dimensions, making it an excellent test of the flexibility of this muscle. After constructing the stance with parallel forearms, these are widely externally rotated in the shoulder joint, which is also unchangeable. An elevation of the shoulder blade is only possible with good mobility; before this, any degree of elevation would necessarily reduce frontal abduction. With increasing restriction of mobility, the possibility of elevation is therefore generally lost first, after which the angle of frontal abduction becomes increasingly smaller. This test is similar to the definite yoga latissimus flexibility test in shoulder opener at the chair, except that the desired movement here must be performed actively against gravity.
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Spezifity: good
Sensitivity: high
definite yoga Latissimusflexibilitätstest Schulteröffnung am Stuhl
Location: shoulder joint
Definition:
Testitem:
Execution: Take shoulder opener at the chair and try to maximise the elevation of the shoulder blades and movement of the upper body towards the ribcage. Keep the thighs vertical and drop the chest to the maximum. Be sure not to keep the trunk lifted by force of the hip extensors.
Interpretation: The latissimus dorsi originates in large areas of the lower medial upper body, extending into the thoracic spine and from there into the upper arm. It is therefore not only the frontal adductor and lateral adductor of the arm, but also the indirect shoulder blade depressor. Due to its attachment to the medioventral humerus, it is also an internal rotator. The dog elbow pose requires the opposite in all three exercise dimensions, making it an excellent test of the flexibility of this muscle. After constructing the stance with parallel forearms, these are widely externally rotated in the shoulder joint, which is also unchangeable. An elevation of the shoulder blade is only possible with good mobility; before this, any degree of elevation would necessarily reduce frontal abduction. With increasing restriction of mobility, the possibility of elevation is therefore generally lost first, after which the angle of frontal abduction becomes increasingly smaller. This test is similar to the definite yoga latissimus dorsi flexibility test in elbow dog pose, except that the desired movement here is gravity induced.
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definite yoga shoulder external rotation test at the wall
Location: shoulder joint
Definition:
Testitem:
Execution: Stand upright in front of a wall with your arms hanging down, place one hand on the wall at elbow level and rest the elbow on the wall against your body. Rotate the upper body in the sense of external rotation of the arm in the shoulder joint away from the hand on the wall to the limit of mobility.
Interpretation: it should be possible to turn the upper body away from the frontally placed hand by at least 60 or 70°, which corresponds to an angle between the forearm and the frontal plane of at least 150°.
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definite yoga shoulder external rotation test lying without abduction
Location: shoulder joint
Definition:
Testitem:
Execution: Lie on your back with your arms straight. Grasp an appropriate dumbbell and bring the elbow joint into a 90° flexion. The elbow remains on the floor next to the body. Rotate the wrist to a neutral position and lower the lower arm laterally towards the floor, which corresponds to an external rotation of the arm in the shoulder joint.
Interpretation: With good flexibility, the arm with the dumbbell should be able to sink to the floor.
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definite yoga shoulder external rotation test sitting with half frontal abduction
Location: shoulder joint
Definition:
Testitem:
Execution: Sit in front of an object such as a chair or weight bench whose seat or upper horizontal surface is approximately the same height as your shoulders. Pick up a suitable dumbbell, place your elbow on the object and let your forearm point vertically upwards. From this position, let the forearm with the dumbbell tilt as far as possible laterally into the external rotation of the arm. Two versions are possible: the upper arm points straight forwards (sagittal) or exactly laterally (in the frontal plane).
Interpretation: The two results usually differ only slightly. In front of the body, external rotation of the arm is possible to a minimally greater extent. In both cases, at least the vertical should be achieved.
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definite yoga Kurzhantel Supinations- und Pronationstest
Location: lower arm / elbow joint
Definition:
Testitem: Strength, mobility and pain of pronation and supination of the forearm
Execution: Place one forearm on a suitable object such as a bench, chair or table so that the hand with the wrist protrudes and can move freely. Take a dumbbell bar in this hand and grip it asymmetrically so that radially more of the bar protrudes. Rotate the forearm into maximum supination and maximum pronation. Reach around to extend the radial protrusion until the limit of the forearm’s strength for both movements is reached.
Interpretation: Pay attention to signs of discomfort: Pain at the medial epicondyle of the humerus with wide supination are usually triggered by the tendon of origin of the pronator teres and are highly likely to indicate a golferellbow, especially if its tendon tissue and the medial epicondyle itself are also painful. Pain at the lateral epicondyle with wide supination is also highly likely to originate from the tendon of origin of the M. supinator and indicate a tennis elbow, especially if the lateral epicondyle is also painful. The overhang of the dumbbell bar achieved in both movements may show a weakness that can become apparent in absolute terms or in a side-to-side comparison. Supination should be possible at least up to the horizontal (upward-facing) palm, pronation from this position at least 135°, i.e. 45° against the horizontal.
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definite yoga Trizeps-Kraft-Test über Kopf
Location: arm
Definition:
Testitem:
Execution: Pick up a dumbbell, take the same arm externally rotated at 180° or, if possible, in frontal abduction. With the other hand, maintain external rotation and frontal abduction of the upper arm and flex and extend the elbow joint over the entire ROM.
Interpretation: This test can be used to determine the strength of the triceps in absolute terms and in a side-by-side comparison. Furthermore, (rare) insertional tendopathies of the triceps due to exercise-painfulness in the tendon tissue on the extensor side of the elbow joint. In addition, supination can trigger the pain of an existing tennis elbow and pronation of a golferellbow. Disorders of the ulnar part of the ligament system of the wrist (the ulnar abductors) can be particularly noticeable in the midline position.
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definite yoga elevation test
Location: shoulder (sapulothoracal gliding bearing)
Definition:
Testitem:
Execution: Take one arm in 180° or, alternatively, maximum possible frontal abduction. Elevate the shoulder blade and place the forearm on the head from above. Depress the shoulder blade and observe the change in the inclination of the forearm.
Interpretation: In depressed shoulder blade, the forearm rises towards the hand in almost all people. In elevation, however, the forearm should fall. If it does not, it can be assumed that there is a low level of available elevation in the overhead movement of the arm, which is usually due to reduced mobility of the latissimus dorsi. With very good mobility, the forearm clearly drops and the angle difference between the two positions clearly exceeds 10°.
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definite yoga triceps caput longum shortening test
Location: shoulder joint
Definition:
Testitem:
Execution: With a depressed shoulder blade, take an outstretched arm in 180° or, alternatively, maximum possible frontal abduction, with the hand holding a light dumbbell. Flex the elbow joint maximally and then reduce the frontal abduction to determine the angle by which the flexion angle of the elbow joint increases. The test can also be performed in reverse by increasing the frontal abduction to the maximum beginning with 90°, with the elbow joint maximally flexed and observing the angle by which the flexion of the elbow joint is reduced with the proceeding frontal abduction.
Interpretation: The test utilises the biarticularity of the caput longum of the triceps by first bringing one covered joint into the final position and then attempting to do the same with the second covered joint, whereby the limit of flexibility of this muscle must be shown. Despite the depressed shoulder blade, the frontal abduction of the upper arm may be restricted to such an extent that the full effect is not seen.
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definite yoga – adductors-side discrepancy (external rotation-abduction) in baddha konasana
Location: hip joint
Definition:
Testitem:
Execution: Sit in baddha konasana and measure the height of both knees from the floor.
Interpretation: As both the outer edges of the foot and the hip joint represent a punctum fixum, abduction and external rotation always occur together. It is therefore not possible to say whether the aspect of abduction or external rotation is at the forefront of the restriction of mobility, apart from the sensation of stretching. lateral differences predispose to pelvic obliquity and the development of scoliosis. Pain in the medial joint space of the knee joint indicates a high probability of damage to the medial meniscus. This test corresponds to an interpretation of the Payr test with an assessment of any mobility restrictions and examination for lateral differences.
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definite yoga rotational side discrepancy in savasana
Location: hip joint
Definition:
Testitem:
Execution: Lie in savasana and observe whether both legs fall into the same degree of external rotation in the hip joint.
Interpretation: Side discrepancies in the resulting external rotation are due to differences in the tone of the internal rotators and external rotators of the hip joint.This phenomenon should be investigated in more detail as it can have damaging effects on the lower limb in particular.
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definite yoga Rotations-Seitendifferenz in savasana
Location: hip joint
Definition:
Testitem:
Execution: Lie in upavista konasana against the wall. Make sure that both sides of the pelvis are equally heavy on the floor and that both inner thighs report an equally intense stretch sensation. Measure the distance of both heels or external malleoli from the floor.
Interpretation:
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definite yoga Gracilis-Seitendifferenz in supta upavista konasana
Location: gracilis, knee joint
Definition:
Testitem: side discrepancy, meniscus damage, damage to the medial collateral ligament
Execution: Lie in upavista konasana against the wall. Make sure that both sides of the pelvis are equally heavy on the floor and that both inner thighs report an equally intense stretch sensation. Measure the distance of both heels or external malleoli from the floor.
Interpretation: This test can be used to determine both the mobility of the gracilis and whether there is a side difference, which basically predisposes to one.
If the foot is placed so high that there is hardly any stretching sensation in the gracilis or other adductors, a knee joint occurs due to the punctum fixum of the heel against the wall, which compresses the inner meniscus and can trigger the associated pain in the event of medial meniscus damage. In principle, a damaged lateral collateral ligament could also cause pain, although this occurs less frequently in practice.
If the foot is now placed so low that a maximum tolerable stretch sensation is achieved in the gracilis, the adductors, including the gracilis pull the thigh upwards (medially) and thus cause a valgus moment, which, given lateral meniscus damage, can trigger the associated pain by compressing the external meniscus. It is also possible to trigger a pain phenomenon at the site of an insertion of the medial collateral ligament, usually the distal one.
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two finger test
Location: acromioclavicular joint
Definition:
Testitem: acromioclavicular instability
Execution: The examiner places the index and middle fingers next to each other on the two joint partners of the acromioclavicular joint, acromion and clavicle and feels for clicking in the joint during frontal abduction and during lateral abduction.
Interpretation: A palpable snap, usually felt above 90° frontal abduction, is a sign of an unstable
acromioclavicular joint.
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definite yoga hip external rotation test in half lotus forward bend
Location: hip joint
Definition:
Testitem:
Execution: Adopt the forward bend of the half lotus, also perform the side comparison.
Interpretation: With the foot as the punctum fixum in this posture, hip joint, abduction and exorotation occur simultaneously. When bending forwards, the short hip extensors pull the leg towards the floor, thereby increasing exorotation. The measured variable should be the angle at which the thigh turnes out in the hip joint; alternatively, the distance of the knee from the ground can also be measured, especially for lateral comparison. Pronounced lateral differences predispose to a pelvic obliquity, especially with greater mobility restrictions.
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definite yoga hip external rotation test in hip opener 3
Location: hip joint
Definition:
Testitem:
Execution: Take hip opener 3, also carry out the side comparison.
Interpretation: The rotation of the pelvis around the thigh placed on the floor at the front is primarily an external orotation in the hip joint, which means that it can be assessed very well. If too much stretch is felt in the biceps femoris, the knee joint of the dropped leg should be flexed further until this stretching sensation no longer impairs the execution of the external rotation in the hip joint. Pronounced side discrepancies predispose to pelvic obliquity, especially with greater mobility restrictions.
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definite yoga small glutes shortening test in hip opener at the edge of the mat
Location: hip joint
Definition:
Testitem:
Execution: Take the hip opener at the edge of the mat, also perform the side comparison.
Interpretation: The small glutes, gluteus medius and gluteus minimus, are well stretched in this posture, especially their dorsal fibres, which extend the hip joint . Pronounced lateral differences predispose to a restriction of mobility, especially with greater pelvic obliquity.
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definite yoga strength test of finger extensors
Location: finger
Definition:
Testitem:
Execution: Determine the grip strength with an adjustable grip strength trainer (spring mechanism). If possible with the device, determine the maximum grip strength as well as the number of repetitions with 80% of the maximum grip strength. The forearm is in the centre position between pronation and supination. Pay attention to any discomfort that occurs. Also carry out the side comparison.
Interpretation: This test can be used to measure the strength of the finger flexors, also in side-by-side comparison. Depending on the device, the 1RM (single repetition maximum) can be measured directly or calculated approximately from a certain number of repetitions. The side comparison is also interesting, which usually shows more force on the dominant side. If this is the other way round, it is cause for investigation. In this test, also look out for discomfort caused by tendovaginitis, golferell elbow, tennis elbow or misalignment of wrist bones.
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definite yoga strenght test for finger extensors manually
Location: fingers
Definition:
Testitem:
Execution: The subject grips the examiner’s distal forearm as firmly as possible. Pay attention to any discomfort. Also carry out the side-by-side comparison.
Interpretation: Although this test does not make it possible to objectively measure grip strength and thus the strength of the finger flexors, it does offer a very simple way of roughly orientating and comparing sides. In addition to the pure perception of the force exerted by the test person, the test person may also experience discomfort caused by tendovaginitis, golferell elbow, tennis elbow or misalignment of wrist bones.
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definite yoga strength test for finger extensors
Location: finger
Definition:
Testitem:
Execution: The examiner grasps – depending on the size of the examined hand and his own – with one or two hands around the firmly closed fist of the subject, which the latter should open against the resistance. Pay attention to any discomfort. Also carry out the lateral comparison.
Interpretation: The test provides a rough indication of the available force, whereby it must be taken into account that the human finger extensors are generally significantly weaker than the finger flexors. As expected, the dominant hand would perform somewhat better. Also of interest are discomfort, especially due to tennis elbow or tendovaginitis as well as misalignment of carpal bones.
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definite yoga strength test for palmar flexors of the wrist
Location: wrist
Definition:
Testitem:
Execution: The subject places their forearm on a support, whereby the hand remains freely movable, i.e. protrudes. The upper arm is in a vertical position. They hold a dumbbell in their hand and move it from maximum palmarflexion to maximum dorsiflexion and back again. Several repetitions should be performed. The weight should be adapted to the available strength and, in the case of given disorders, also to the load capacity. Pay attention to any discomfort. Also carry out the side-by-side comparison.
Interpretation: On the one hand, the absolute weight that can be moved is interesting, but also the side comparison, whereby these muscles in particular should be more noticeable on the side of the dominant arm. Also pay attention to any discomfort in the tendon area (tendovaginitis) of the performing muscles, the insertions (in the area of origin at the medial epicondyle of the humerus they indicate a golferellbow) or dorsal or palmar discomfort in the hand, which may indicate malalignment of carpal bones. A tendency to cramp with wide palmarflexion indicates high muscle tone, the achievable dorsiflexion shows the flexibility of the finger flexors and wrist palmar flexors.
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definite yoga strength test for dorsiflexion of the wrist
Location: wrist
Definition:
Testitem:
Execution: The subject places their palmar forearm on a support, with the hand remaining freely movable, i.e. protruding. The upper arm is in a vertical position. They hold a dumbbell in their hand and move it from maximum palmarflexion to maximum dorsiflexion and back again. Several repetitions should be performed. The weight should be adapted to the available strength and, in the case of given disorders, also to the load capacity. Pay attention to any discomfort. Also carry out the side-by-side comparison.
Interpretation: The dorsiflexion is generally less powerful than the palmarflexion, so it should not be compared directly with it. The lateral comparison usually shows the dominant hand to be somewhat stronger. Also of interest are discomfort, especially due to tennis elbow or tendovaginitis as well as malposition of carpal bones.
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definite yoga strength test for radial abduction of the wrist
Location: wrist
Definition:
Testitem:
Execution: Take a dumbbell of an appropriate weight in your hand and place the corresponding forearm with the ulnar side on a support. Swivel the wrist into maximum radial abduction and then into maximum ulnar abduction. Perform several repetitions and also the side-by-side comparison. Pay attention to any discomfort.
Interpretation: The radial abduction can be somewhat more pronounced compared to ulnar abduction and is usually also somewhat stronger on the side of the dominant arm. Any discomfort that occurs is often associated with the extrinsic muscles of the thumb movement if it is not localised in the joint itself. In principle, a tennis elbow could also respond to the request.
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definite yoga strength test for ulnar abduction of the wrist
Location: wrist
Definition:
Testitem:
Execution: Take a dumbbell of an appropriate weight in your hand and place the corresponding forearm with the radial side approximately horizontally on your head. Keep your head stable and vertical. Swivel the wrist maximally in the direction of ulnar abduction and then in gravity in the direction of radial abduction. Repeat this a few times and pay attention to any discomfort. Also perform the lateral comparison.
Interpretation: By design of the movement spaces, this test is not as easy to realize on an object below head height as is the corresponding test for radial abduction. The radial abduction can be somewhat more pronounced compared to ulnar abduction and is usually also somewhat stronger on the side of the dominant arm. Sometimes a tennis elbow is noticeable with the typical pain in this test.
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definite yoga elbow extension test in 90° frontal abduction
Location: elbow joint
Definition:
Testitem:
Execution: The subject holds the arm to be examined at 90° frontal abduction with supinated forearm and loose hand in front of the body. The examiner supports the distal humerus with one hand from the extensor side of the elbow joint in order to examine the elbow joint with the other hand on the distal forearm elbow joint carefully and slowly until the hard-elastic limit of movement occurs or the subject reports too intense discomfort.
Interpretation: The elbow joint physiologically exhibits a hard-elastic limit-of-motion, where the joint surfaces of the humerus and olecranon meet. This movement limit is without significant discomfort when physiological force is applied and only gradually becomes clearer when moderate force is applied. If a clear intra-articular discomfort occurs without a clear application of force, the relevant joint structures must be examined. A soft-elastic limit-of-movement can be recognised in the significant degree of frontal abduction by the biarticular biceps brachii is not to be expected. The muscle that comes into question instead is the monoarticular biceps brachii, which still covers the elbow joint relatively broadly as a muscle, while the biceps brachii has long since merged into a thin tendon. This can also be used to differentiate between a stretch sensation that occurs. Stretching of the brachioradialis is just as unlikely due to the supination of the forearm as stretching of the elbow joint from medial epicondyle or from the lateral epicondyle. A stretching sensation or the symptoms of a golfer elbow would only occur in very contracted muscles.
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definite yoga Iliopsoas Flexibilitätstest in Hüftöffnung 1
Location: hip joint
Definition:
Testitem:
Execution: Take hip opener 1, extend the back leg correctly and lower the pelvis to the maximum. Also perform the side-by-side comparison. A visual impression is often sufficient for a rough assessment; the hip joint should be easily recognisable below the knee joint of the front leg. For a side-by-side comparison, a specific measurement must be made, which is most easily done using the vertical SIAS ground distance.
Interpretation: This pose has good specificity if the hip extensors are not too inflexible, otherwise they can limit the movement of the pelvis towards the floor, which is usually noticeable in a stretching sensation in the hamstrings of the front leg. In principle, a pronounced restriction of mobility in the short hip extensors such as the gluteus maximus, which also can limit this movement, would also be hindering. If these two factors are not present, the movement of the pelvis towards the floor depends only on the mobility of the hip flexors of the extended leg and, due to the extended knee joint, practically only on the iliopsoas. In this test, the side-by-side comparison is important because it often reveals differences in practice, which may then be responsible for known problems with the ISG, or at least partly responsible. Here, just 2 cm can lead to pelvic torsion and consecutive ISG complaints.
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definite yoga iliopsoas flexibility test in warrior 1 pose
Location: hip joint
Definition:
Testitem:
Execution: Take warrior 1 pose, extend the back leg correctly, turn it in at the hip joint and keep the pelvis pointing precisely forwards and exactly vertical. For an accurate result and comparability, the distance between the heels must be derived from the leg length with a factor of less than 1. Also carry out the side-by-side comparison.
Interpretation: The precise execution of the posture is important for a usable result. The hip joints must be exactly the same distance forwards and the pelvis exactly upright and the knee joint of the rear leg precisely extended, otherwise the measurement of the mobility of the iliopsoas is quickly falsified to the point of uselessness. If the pelvis can still be straightened when the heels are three-quarters of the way down the leg, the mobility of the iliopsoas should be sufficient for all everyday situations. However, if it is no longer possible to straighten the pelvis when the leg is only half the length, this is a shortening that can lead to a hollow back in everyday life. lateral differences of the iliopsoas can also have a serious effect, which can easily lead to pelvic torsion and consecutive ISG complaints.
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definite yoga hip flexor lying lift off test
Location: hip joint
Definition:
Testitem:
Execution: Lying on the back. The examiner holds the distal lower leg with one hand on the floor while the subject tries to lift the extended leg. Also carry out the side-by-side comparison.
Interpretation: Due to the long lever arm, the greater sarcomere length and the limited force arm of the two powerful hip flexors, of the two, the rectus femoris and the iliopsoas are not expected to exert any great force that the examiner could perceive. Nevertheless, a rough estimate can be made of how strong the muscles are. In addition, side discrepancies may be perceived, which must be investigated further because they predispose to pelvic torsion and ISG complaints. Less frequently, the performer feels discomfort in the knee joint, hip joint or the performing muscles or their tendons.
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definite yoga hip flexor lying 90 degree test
Location: hip joint
Definition:
Testitem:
Execution: From the supine position, the subject bends the
hip joint and knee joint 90° each on one side. The examiner holds the knee against the thigh while the subject tries to pull the leg towards the upper body.
Interpretation: In complete contrast to the definite yoga hip flexor lying lift off test, a large force is exerted here by the two hip flexors, the rectus femoris and the iliopsoas, which the examiner will find difficult to resist in reasonably trained individuals. This is due to the significantly more favourable force arm and also load arm and the more favourable average sarcomere length of both muscles. A side-by-side comparison can also be informative here.
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definite yoga Rectus femoris Beweglichkeitstest in supta virasana
Location: hip joint
Definition:
Testitem:
Execution: Take supta virasana and reduce the
flexion in the hip joints as much as possible. Make sure that the knees do not deviate outwards or upwards.
Interpretation: Due to the very wide flexion of the knee joints, the degree of remaining hip flexion very precisely indicates the restriction of mobility of the rectus femoris.
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definite yoga Rectus femoris Beweglichkeitstest in Quadrizepsdehnung 1
Location: hip joint
Definition:
Testitem:
Execution: Perform quadriceps stretch 1 against the wall. Keep the pelvis as correctly aligned as possible.
Interpretation: The three most important parameters that determine the effectiveness of this posture as a stretching exercise are the distance of the knee from the wall: the smaller, the more effective the distance of the pelvis from the wall: the smaller, the more effective the degree of straightening of the pelvis: the greater, the more effective Try to optimise at least one, preferably two, of these parameters as far as possible in order to draw a conclusion from the remaining parameter(s) about the degree of restriction of mobility in the rectus femoris. With very good mobility, both distances would be zero and the pelvis would be erect. Any reduction indicates a restriction in mobility, which manifests itself via the perceived stretching sensation.
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definite yoga liegender Rectus femoris Beweglichkeitstest (Hüftbeugerbeweglichkeitstest)
Location: hip joint
Definition:
Testitem:
Execution:
- The performer lies prone on the floor, bends the knees and grasps the restraints with the hands to pull the knees up from the floor with the strength of the arms.
- The supporter sits straddled on his buttocks behind the performer (at the foot of the performer) and presses the performer’s knees together with his thighs so that the performer cannot let them fall further than hip-width apart.
- When the maximum height of the knees is reached, the supporter measures with a centimetre ruler or, if not available, simply in hand thicknesses (thickness of the metacarpophalangeal joints, from palmar to dorsal) or hand width (width of the hand above the metacarpophalangeal joints 2-5, from radial to ulnar) or a combination of these how far the knees are vertically from the floor.
Interpretation: For the full discussion, see hip flexor mobility test. Small distances of the knees from the floor indicate a significant shortening of the rectus femoris. If the rectus femoris is shortened even more significantly, hip triangles may even occur.
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definite yoga flexibility test hamstrings in uttanasana
Location: hip joint
Definition:
Testitem:
Execution: Perform uttanasana with the knee joints extended and maximise the use of the hip flexors.
Interpretation: The angle of the pelvis to the femur shows the flexibility of the (predominantly biarticular) hamstrings.
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definite yoga flexibility test hamstrings in trikonasana
Location: hip joint
Definition:
Testitem:
Execution: Perform trikonasana precisely, but turn the pelvis 10 degrees less away from the 90° turned leg than the maximum.
Interpretation: The submaximal rotation of the pelvis relieves the gracilis to such an extent, so that the (exorotated abducted) flexion in the hip joint of the 90° exorotated leg is only limited by the hamstrings. A soft-elastic movement limit by short hip extensors such as the gluteus maximus almost never occurs in practice. Very rarely, the stretching sensation is not felt in the inner hamstrings but in the outer group, which then indicates a significantly shortened hamstrings compared to the inner biceps femoris. Because of its ability to turn out the lower leg in the knee joint , among other things, this needs to be examined more closely.
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definite yoga flexibility test hamstrings in parivrtta trikonasana
Location: hip joint
Definition:
Testitem:
Execution: Take parivrtta trikonasana precisely and turn the pelvis forwards with the front leg precisely extended.
Interpretation: This posture stretches the outer hamstrings slightly more than the inner one. If, on the other hand, more stretching is felt in the inner hamstrings, it must be assumed that it has excessive tension. As it also endorotates the lower leg, this should be clarified. However, this characteristic is not quite as critical as overstretching the biceps femoris because it at least does not predispose to patellar dislocation.
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definite yoga flexibility test of biceps femoris in hip opener 3
Location: hip joint
Definition:
Testitem:
Execution: Perform hip opener 3 with the usual parameters, i.e. the front lower leg parallel to the short edge of the mat. Then reduce the flexion angle of the knee joint (i.e. move the lower leg further forwards) and 10 degrees at a time and observe the effect on the stretch sensation in the biceps femoris or its tendon on the outer rear back of the knee joint.
Interpretation: Even a very clear stretch sensation with the lower leg parallel to the short edge of the mat can be an indication of a relative shortening of the biceps femoris in relation to the inner hamstrings. If this stretch sensation then increases rapidly with a reduced flexion angle, this confirms the suspicion. This must be investigated more closely, partly because of the ability of the biceps femoris to rotate the lower leg in the knee joint .
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definite yoga flexibility test of bizeps femoris in hip opener at the edge of the mat
Location: hip joint
Definition:
Testitem:
Execution: Perform the hip opening at the edge of the mat with the usual parameters, i.e. with the first lower leg parallel to the short edge of the mat and the second lower leg crossing over it. Then reduce the flexion angle of the knee joint of the second leg (i.e. move the lower leg further forwards) by 10 degrees at a time and observe the effect on the stretch sensation in the biceps femoris or its tendon on the outer back of the knee joint.
Interpretation: Even a very clear stretch sensation in the biceps femoris of the second leg can be an indication of a relavive shortening of the biceps femoris in relation to the inner hamstrings. If this stretch sensation then increases rapidly with a reduced flexion angle, this confirms the suspicion. Because of the property of the biceps femoris to rotate the lower leg in the knee joint this must be investigated in more detail.
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definite yoga strength test of the hamstrings in purvottanasana
Location: hip joint
Definition:
Testitem:
Execution: Perform purvottanasana in the version with arms straight and legs straight, raising the pelvis to the maximum. Then lift one of the heels off the floor. Also perform the side-by-side comparison.
Interpretation: This variation of purvottanasana is the most suitable of all variations because the long lever arm and the single leg remaining on the floor particularly challenge the strength of the hip extensors. Synergistic to the hamstrings extends above all the gluteus maximus the hip joint of the standing leg, however, in this test, subjects quite regularly report a large effort in the hamstrings. side discrepancies should be investigated, because the musculature moving in the sagittal plane can cause side discrepancies in the case of pelvic torsion and ISG problems.
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definite yoga strength test of the hamstrings in deadlifts
Location: wrist
Definition:
Testitem:
Execution: Perform dead lifts with increasingly heavy weights as long as the knee joints are stretched and the back can also remain precisely stretched in order to maintain the physiological lordosis.
Interpretation: Of course, the autochthonous back muscles must keep the back stretched for healthy execution and for a useful test result. This is no small requirement. If this is successful, the hamstrings can be regarded as the main agonist for lifting the upper body and dumbbells, although the gluteus maximus acts synergistically, the limit of the force is almost without exception clearly felt in the hamstrings. This test works less well for people with very limited mobility than for those who are mobile, as the former will not reach the horizontal position of the upper body with the knee joints extended, meaning that the maximum gravity effect of the upper body and dumbbells is correspondingly lower. If the knee joints are bent in order for the upper body to reach a horizontal position, this results in different leverage ratios, which falsify the result. Nevertheless, a reasonable assessment can also be obtained for these people.
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definite yoga shape abnormalities of the spine in uttanasana and karnapidasana
Location: spine
Definition:
Testitem:
Execution: Take uttanasana and karnapidasana one after the other and inspect and palpate the course of the spinal processes in both postures.
Interpretation: As postures that reflect the spine, these two are very well suited to detecting different types of spinal anomalies. On the one hand, sagittal anomalies are found, in particular:
- Reduced flexibility of the lumbar spine: despite the bending moments, the area of the lumbar spine remains largely straight or falls far away from the expected curvature.
- Reduced flexibility of the thoracic spine: despite the bending moments, the area of the thoracic spine remains largely straight or falls far away from the expected curvature.
- Spondylolisthesis: a part of the spine offset in the sagittal plane in relation to the neighbouring cranial or caudal area.
- Individual vertebrae protrude dorsally from the interpolation of the neighbouring vertebrae
- individual vertebrae remain too far ventral compared to the interpolation of the neighbouring vertebrae
- The degree of curvature deviates in part or completely from the physiological form, in which the curvature increases from the lumbar spine to the thoracic spine and decreases again from there.
and then also anomalies in the frontal plane:
- Displacement of one or more vertebrae in relation to their cranial and caudal neighbours. If larger areas are affected, this corresponds to scoliosis, but sometimes only individual vertebrae are rotated in the transverse plane. In the case of scoliosis, the possible causes such as posture and movement behaviour, but also a possible pelvic obliquity must be investigated. If individual vertebrae are rotated, the muscles inserting there must be examined.
Interpretation:
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definite yoga rotational ability of the spine
Location: spine
Definition:
Testitem:
Execution: This test is carried out in three stages:
- Sit cross-legged and rotate your upper body to the maximum using your own strength.
- Rotate the upper body as much as possible using the arms as described in the sitting twist.
- Rotate the upper body in the sitting twist with the help of the arms, with the examiner additionally supporting the rotation at the shoulders as described in the sitting twist with support.
Interpretation: This test checks the active and passive rotational ability of the spine without any major prerequisites. With good mobility, angles of over 60° between the shoulder line and the transverse pelvic axis are achieved using only the patient’s own arms.
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definite yoga rotational strength in jathara parivartanasana
Location: trunk
Definition:
Testitem:
Execution: Take jathara parivartanasana and lower your legs as far as your strength allows, but no further than 30 cm above your hand.
Interpretation: The reason for not being able to lower the legs far may also lie in the limited rotational ability of the upper body or in the limited strength for retroversion or transversal abduction. In the first case, the subject should not perceive the position of the upper body as particularly strenuous and perhaps also feel a little stretch in the oblique abdominal muscles, while in the second case the work of the arm or the muscles at the back of the shoulder is clearly perceived as particularly strenuous. If both cases are not present, the rotatory muscles of the upper body should set the limit. This usually lies less in the autochthonous back muscles and more in the oblique abdominal muscles.
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definite yoga transversal adduction test
Location: shoulder
Definition:
Testitem:
Execution: retract one shoulder blade to the maximum, laterally abduct the arm to 90° and then palpate the inferior angulus with one finger. Now try to maintain contact for as long as possible while increasing transverse adduction.
Interpretation: This procedure tests the transverse adduction ability in the glenohumeral joint. The further the arm can be moved medially without the finger detaching from the inferior angulus, the better it is. From the point at which the finger detaches, further movement comes from the protraction of the shoulder blade.
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definite yoga pronatory flexibility of the ankle
Location: ankle
Definition:
Testitem:
Execution: Place one foot as far as possible to the side over the other so that both inner feet can still press completely on the floor. The feet are offset as little as possible in the anterior-posterior direction.
Interpretation: The distance between the two heels in relation to your own leg length is an accurate indicator of the pronation ability of the ankle joints.
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definite yoga lateral flexibilty test of the spine
Location: spine
Definition:
Testitem:
Execution: Perform the sitting sidebend as fas as possible on both sides.
Interpretation: This test checks the lateral flexion ability of the spine without any major prerequisites. With good mobility, angles of 45° can easily be achieved between the pelvic axis and the upper thoracic spine. It is also important to test for
side discrepancies.
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definite yoga abduction capability of the hip joint in vasisthasana
Location: hip joint
Definition:
Testitem:
Execution:
- Take ardha vasisthasana, but do not hold the pelvis exactly in the line between the feet and the sternum as described there, but allow it to sink to the maximum without rotating it.
- Flex hip joints slightly in this pelvic position and observe whether the abduction in the lower hip joint increases.
Interpretation: This test records the abductors in their entirety without being able to differentiate between them exactly, but provides a good orientation. The extent to which the pelvis can sink, more precisely the abduction in the lower hip joint, is above all a good indication of the flexibility of the small glutes. In the first phase, the iliotibial tract and small gluteae are recorded together. If the hip joints are then slightly flexed, the tension in the iliotibial tract or the tensor fasciae latae that tensions it decreases slightly. If this results in an increasingly greater abduction, it can be assumed that the tensor fasciae latae already set the soft-elastic limit of movement even when the hip joint is extended, and not the small glutes.
In addition to mobility, the strength can also be roughly measured by how easy it is for the subject to bring the pelvis from the lowered position back into the line connecting the feet and thigh with and without the upper leg slightly raised. Without the upper leg raised, this should be possible without any problems; with the upper leg raised, it can usually only be managed by the more trained. If lifting without the upper leg raised is subjectively strenuous, limited strength can be assumed. If lifting is only possible at low speed,this also indicates limited muscle performance.
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definite yoga pronation test ankle joint in malasana
Location: ankle
Definition:
Testitem:
Execution: Take malasana as a forward bend with closed feet. The upper body moves between the thighs and tilts the lower legs opposite the feet into the pronation of the ankles. Make sure to keep your inner feet on the ground.
Interpretation: Due to a lack of dorsiflexion ability of the ankle joints, i.e. usually due to a less flexible soleus, not everyone can tilt the lower legs far enough forwards without tipping backwards or lifting the heels. In these cases, it is necessary to hold on with the arms in front of the body. The inability to keep the inner feet on the ground indicates a lack of pronation ability of the ankle joints. The further the lower legs tilt outwards with the inner feet still pressed to the ground, the better the pronation ability.
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definite yoga plantar flexion test in baddha padasana
Location: ankle
Definition:
Testitem:
Execution: Take baddha padasana and pull the belt so tight that the medial malleoli are no more than 3 mm apart when the knees fall apart for a test.
Interpretation: With a large partial body weight, this posture causes the feet to be pushed into plantar flexion. At the same time, pronation is prevented, which always occurs simultaneously with adduction in the subtalar joints because the contralateral foot blocks movement in this direction. The amount of distance from the ground that remains below the distal tibia indicates the extent of restricted mobility, which is usually caused by shortened footlifts. The contour of the lower leg should not be analysed but, which is particularly important in test subjects with a large amount of subcutaneous fatty tissue, the tibia itself.
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definite yoga plantar flexion test in hip opener 5
Location: ankle
Definition:
Testitem:
Execution:Take hip opening 5 with a large distance between the feet, stretching the front leg precisely and pressing the inner foot onto the floor.
Interpretation: Any restriction of the plantarflexion capability of the ankle joint is reflected here in a clear to excessive stretching sensation in the dorsiflexirs, especially the tibialis anterior and the extensor hallucis longus. Which of the two muscles is more severely affected can be determined by the exact extent of the stretch sensation that occurs. In the case of the tibialis anterior, the stretching sensation extends to the plantar side of the medial sphenoid bone or the dorsal base of the Os metatarsale 1, in the case of the extensor hallucis longus to the dorsal side of the distal phalange of the hallux. In addition to the intense stretching sensation, it is often not possible to press the inner foot to the ground in the area of the metatarsophalangeal joint, so that a visible distance and a visible supination of the foot remains there. This is also a consequence of the restricted mobility of the two muscles mentioned, as they both attach medially to the foot and therefore cause supination. Compression-like discomfort in the area of the Achilles tendon interacts with these events only slightly at best, its occurrence is very variable from person to person and is not an indication of a restriction of mobility in the direction of plantar flexion.
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definite yoga iliopsoas flexibility test in warrior 1 pose
Location: hip joint
Definition:
Testitem:
Execution: Nimm die 1. Kriegerstellung ein, drehe das Becken präzise nach vorne und strecke das hintere Bein exakt durch. Es gibt zwei Möglichkeiten zu testen:
- bei einem festen, sinnvoll gewählten Abstand der beiden Fersen, zum Beispiel einer eigenen Beinlänge, versuche das Becken maximal aufzurichten
- halte das Becken genau senkrecht und ermittle, bis zu welchen Abstand der Fersen das möglich ist
Interpretation: In the first case, the sagittal angle in the
hip joint of the rear leg provides information about the flexibility of the iliopsoas: if there still remains a flexion in the hip joint, the hip flexion is clearly restricted for everyday use. Even if the extended angle is reached, this is still a restriction of mobility relevant to everyday life, which predisposes to a hollow back. In the second case, the extension angle, which increases with the distance between the heels, indicates mobility, while the possibility of extension, even when the heels are next to each other, is a mobility restriction relevant to everyday life. In principle, both procedures should lead to the same result.
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definite yoga extension test of the spine lying on the roller
Location: spine
Definition:
Testitem:
Execution: lie on the roll across the spine directly below the shoulder blade. Independently lower your head and crossed arms to the floor. Rollers of different diameters can be used for this test.
Interpretation: This test shows the extensibility of the thoracic spine on the one hand and the flexibility of the ventral neck muscles via the distance of the head from the floor and the adductors of the shoulder joint via the distance of the elbows from the floor on the other, especially the latissimus dorsi, because the shoulder blades are elevated.
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definite yoga extension test of the spine in hyperbola
Location: spine
Definition:
Testitem:
Execution: Lie in the hyperbel, starting in a flat prone position with the head a hand’s thickness away from the wall. Allow the back of the body from the calves up to and including the back to remain passive and the upper body to sink as far as possible towards the floor. The hands are held as high as possible and are together with the thumbs overlapping.
Interpretation: Two main flexibilities can be observed in this posture:
- the extensibility of the thoracic spine: if this is too low, a steep position of the thoracic spine may remain or even a recognisable kyphosis.
- the frontal abduction capacity of the shoulder joints: if this is low, the frontal abduction remains less than 180°.
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definite yoga extension test of the spine in raised back stretching
Location: spine
Definition:
Testitem:
Execution: Stand in the raised back extension, with the wrist joints at the height at which the eyes were when standing upright.
Interpretation: Similar to the mobility test in hyperbola, the rib cage should be able to sink according to gravity. Only if the hamstrings is extremely immobile does this affect the movement of the upper body towards the floor via a more erect pelvis. The flexibility of the thoracic spine and the frontal abduction ability of the shoulder joints can be assessed in the same way.
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definite yoga supination test of the ankle in warrior 2 pose
Location: ankle
Definition:
Testitem:
Execution: Assume the 2nd warrior position by slowly bending the 90° extended knee joint and carefully press the outer foot of the extended leg onto the floor.
Interpretation: The angle of the extended leg to the ground, from which the outer foot can no longer be kept on the ground, indicates the limit of the supination ability of the ankle. If the strength of the quadriceps of the bent leg is not sufficient for sufficient flexion to reach the limit of the supination ability, the arm on the side of the bent knee can rest on the thigh as in the theke. If the adductors of the straight leg are too limited to reach the limit of the supination ability with the pelvis vertical, the pelvis can be tilted slightly sideways towards the bent leg to relieve the strain.
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definite yoga Gastrocnemius flexibility test in uttanasana on a block
Location: ankle
Definition:
Testitem:
Execution: Do uttanasana with the balls of your feet on a block and move your pelvis forwards as far as possible.
Interpretation: The inability to keep the heels on the ground or to move the pelvis to the limit of the physical limit given by the gravity-perpendicular indicates a shortening of the gastrocnemius. Of course, this statement is dependent on the elevation used, such as the block: the higher the elevation, the greater the flexibility requirement for the gastrocnemius. For this test, the knee joints must be correctly extended, as the gastrocnemius is also a knee flexor.
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definite yoga gastrocnemius flexibility test in downface dog with one leg lifted
Location: ankle
Definition:
Testitem:
Execution: Take dog pose head down and lift one leg slightly. The foot can be hooked behind the knee of the leg that remains on the floor; for greater intensity, it is also possible to extend the raised leg backwards and upwards.
Interpretation: Lifting one leg more than doubles the load in the gastrocnemius of the standing leg, so that a good statement can be made about its mobility. If the leg is extended backwards and upwards, the effect increases even more. If the foot joint of the standing leg has no recognisable or only slight dorsiflexion, the gastrocnemius is shortened, which poses a risk to the lower limb, particularly in terms of a clear predisposition to events such as achillodynia and plantar fasciitis.
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definite yoga soleus flexibility test in malasana
Location: wrist
Definition:
Testitem:
Execution: Take malasana as a forward bend so that the lower legs tilt forwards into dorsiflexion as best as possible.
Interpretation: The posture is designed in such a way that the lower legs are maximally tilted into dorsiflexion in relation to the foot, but there are some possible limitations in the execution of the posture. On the one hand, there are disorders of the knee joint, which prohibit such a wide flexion, and on the other hand, above all, restrictions in the mobility of the short hip extensors, which may cause the pelvis to tilt so significantly backwards. tilt the pelvis so significantly backwards that the heavy plumb line moves behind the heels and the posture is not statically stable. Secondarily, inadequate flexion of the spine can impair the statics of the posture. If these difficulties do not occur, this posture is very suitable for demonstrating the flexibility of the soleus.
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definite yoga Golferellbogen Test-Cluster
Location: wrist
Definition:
Testitem:
Execution: The Golferellbogen test cluster consists of 5 individual tests:
- Palpation of the medial epicondyle of the humerus on pressure pain: Pressure is exerted directly perpendicular to the medial epicondyle of the humerus, in addition to 180° of its proximal edge.
- palpation of the tendons extending proximally from the medial epicondyle. Again, all tendons extending distally are palpated at an angle of up to 180° over a length (corresponding to a distance from the medial epicondyle) of at least 2 cm.
- Pronation test: a dumbbell bar is used to determine whether supination from maximum pronation to the vertical of the dumbbell bar is painful when the dorsal forearm is placed on the bar. The dumbbell bar is gripped in such a way that the available pronatory force is fully utilised. For strong people, an appropriate weight plate may need to be attached to the moving end of the bar. Any sensation near the medial epicondyle at and near the starting angle that differs from physiological muscle effort and stretch sensation is considered a positive result.
- Grip strength test: if available, an adjustable grip strength trainer is used to determine whether a quality of sensation other than exertion occurs within the available grip strength. If no grip strength trainer is available, the subject grips the examiner’s distal forearm as firmly as possible so that the subject’s subjective perception of pressure enables a side-by-side comparison of grip strength. Any sensation near the medial epicondyle that is different from exertion is considered a positive result.
- Palmar flexion test: with the forearm placed dorsally, the subject alternates between maximum dorsiflexion and maximum palmarflexion of the fist gripping a dumbbell. In addition, the fist should be opened further and further in the direction of dorsiflexion of the wrist so that the dumbbell ends up resting almost exclusively on the distal phalanx. The weight of the dumbbell must be increased so that the available strength is essentially utilised. Any sensation other than exertion near the medial epicondyle is considered a positive result.
Interpretation: Even a single positive test can confirm an anamnestic and clinical suspicion of Golferell’s elbow. Only in rare cases are more than four tests positive, but in practice it is not uncommon for mixed types to occur that affect more than one functional group/movement dimension. A pressure-painfulness at the medial epicondyle and somewhere just distally behind it is then also found quite regularly. Sometimes only pressure-painfulness occurs at the medial epicondyle without a further test showing a positive result, which indicates that the condition is not yet very pronounced. However, in order to prevent this from manifesting further, appropriate therapeutic intervention with rest and strength training should be undertaken.
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definite yoga tennis elbow test cluster
Location: wrist
Definition:
Testitem:
Execution: The tennis elbow test cluster consists of 5 individual tests:
- palpation of the lateral epicondyle of the humerus on pressure-painfulness: Pressure is applied directly perpendicular to the lateral epicondyle of the humerus, additionally 180° of its proximal edge palpated
- palpation of the tendons extending proximally from the lateral epicondyle. Here, too, all tendons extending distally are palpated at an angle of up to 180° over a length (corresponding to a distance of at least 2 cm from the lateral epicondyle).
- Pronation test: a dumbbell bar is used to determine whether the pronation is painful when the dorsal forearm is raised from maximum supination to the vertical of the dumbbell bar. The dumbbell bar is gripped in such a way that the available supinatory force is fully utilised. For strong people, an appropriate weight plate may need to be attached to the moving end of the bar. Any sensation near the lateral epicondyle at and near the starting angle that differs from physiological muscle effort and stretch sensation is considered a positive result.
- Fist opening test: the examiner grips the subject’s tightly closed fist firmly with one or two hands and the subject then attempts to open the fist against the examiner’s resistance. The subject’s subjective perception of pressure enables a side-by-side comparison of the finger extensors. Any sensation near the lateral epicondyle other than exertion is considered a positive result.
- Dorsiflexion test: with the forearm resting on the palmar side, the subject alternates between maximum palmar flexion and maximum dorsiflexion of the fist gripping a dumbbell. The weight of the dumbbell must be increased so that the available strength is essentially utilised. Any sensation near the lateral epicondyle other than exertion is considered a positive result.
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0°-Abduktionstest
Location: Shoulder joint
Definition:
Test item: supraspinatus ruptures, –insertional tendopathies, paralysis and strength deficit
Performance: The examiner fixes the arm to be examined while the patient abducts laterally.
Interpretation: If pain or a strength deficit occurs in the lateral comparison, the test is positive and indicates damage to the
supraspinatus.
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Patte-Test
Location: shoulder joint
Definition:
Testitem:
Durchführung: At 90° lateral abduction and 90° flexed elbow joint with the forearm pointing upwards, the examiner limits the movement of the elbow forwards and pushes the hand forwards from behind, which the patient should resist.
Interpretation: If pain or a strength deficit occurs in a lateral comparison, the test is positive and indicates damage to the exorotation of the shoulder joint: infraspinatus, teres minor.
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External rotation lag sign (lateral rotation lag sign / infraspinatus spring back test)
Location: shoulder joint
Definition:
Testitem: Weakness or tears in infraspinatus or teres minor
Execution: With the upper arm resting against the body or laterally abducted by 90°, the elbow joint is flexed by 90° and the arm is passively maximally turned out by the examiner. If the patient cannot actively maintain this position, the sign is positive.
Interpretation:
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Spezifity: 93 (Teres minor full tear), 93 (Infraspinatus full tear)
Sensitivity: 100 (Teres minor full tear), 97 (Infraspinatus full tear)
Internal rotation lag sign
Location: shoulder joint
Definition:
Testitem: Subscapularis tendon full tear
Execution: The arm is maximally retroverted and endorotated by the examiner. If the patient cannot actively maintain this position, the sign is positive.
Interpretation:
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Spezifity: 84
Sensitivity: 100
Bear hug test
Location: shoulder joint
Definition:
Testitem: Subscapularis: tear, weakness
Execution: The subject places the hand of the side to be tested on the contralateral shoulder. The examiner tries to lift the hand from the shoulder against the resistance of the subject. If the subject is unable to keep the hand on the shoulder or if this is painful, the test is positive.
Interpretation: The bear hug test activates the pectoralis major, latissimus dorsi and teres major less than the belly press test and lift-off test and is therefore more specific. If the test is positive, this indicates damage to the subscapularis.
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Spezifity: 65-99
Sensitivity: 19-75
Gagey Test
Location: shoulder joint
Definition:
Testitem: Insuffizienz of the Lig. glenohumerale inferius
Execution: With the shoulder blade fixed, the upper arm is maximally laterally abducted.
Interpretation: More than 105° lateral abduction without movement of the shoulder blade is considered evidence of insufficient lig. glenohumerale inferius, as this limits the movement.
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Supine Flexion Resistance (Habermeyer)
Location: wrist
Definition:
Testitem:
Execution: In the supine position, the arms are stretched overhead and attempted to abduct frontally against the resistance of an examiner, as in a throwing movement.
Interpretation: Pain deep in the shoulder, also localised more dorsally, is considered a sign of a SLAP lesion. The test is more specific than O’Brien’s test and Speed’s test and has a higher sensitivity if there is only a SLAP lesion and no rotator cuff damage.
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Spezifity: 69
Sensitivity: 80
Anterior slide test
Location: shoulder joint
Definition:
Testitem: SLAP-lesion
Execution: The examiner places a hand on the shoulder of the seated or standing subject from behind so that the index finger grasps the tip of the acromion. The subject places the hands on the hips with the thumb pointing backwards. The examiner then pushes the upper arm craniomedially and the subject tries to resist force.
Interpretation: Pain in the ventral shoulder at the upper edge of the glenoid when pushing the arm indicates an SLAP-lesion.
Link 1: https://www.youtube.com/watch?v=nLRNIiJfPIg
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Passive Axial Compression Test (Sesamoiditis)
Location: foot
Definition:
Testitem: Sesamoiditis of the sesamoid bones of the hallux or Os metatarsale 1 resp.
Execution: Passively dorsiflex the hallux to be tested, apply pressure to the sole of the foot proximal to the sesamoid bones with one thumb and then plantarflex the hallux.
Interpretation: Pain on plantarflexion of the hallux hints to a sesamoiditis of one of the sesamoid bones.
Link 1: https://www.youtube.com/shorts/_kD4fNISpdw
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dummy
Location: wrist
Definition:
Testitem:
Execution:
Interpretation:
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