- Home
- Featured Articles
-
Special Tests
-
Cervical Spine
>
- Alar Ligament Test
- Bakody's Sign
- Cervical Distraction Test
- Cervical Rotation Lateral Flexion Test
- Craniocervical Flexion Test (CCFT)
- Deep Neck Flexor Endurance Test
- Posterior-Anterior Segmental Mobility
- Segmental Mobility
- Sharp-Purser Test
- Spurling's Maneuver
- Transverse Ligament Test
- ULNT - Median
- ULNT - Radial
- ULNT - Ulnar
- Vertebral Artery Test
- Thoracic Spine >
-
Lumbar Spine/Sacroiliac Joint
>
- Active Sit-Up Test
- Alternate Gillet Test
- Crossed Straight Leg Raise Test
- Extensor Endurance Test
- FABER Test
- Fortin's Sign
- Gaenslen Test
- Gillet Test
- Gower's Sign
- Lumbar Quadrant Test
- POSH Test
- Posteroanterior Mobility
- Prone Knee Bend Test
- Prone Instability Test
- Resisted Abduction Test
- Sacral Clearing Test
- Seated Forward Flexion Test
- SIJ Compression/Distraction Test
- Slump Test
- Sphinx Test
- Spine Rotators & Multifidus Test
- Squish Test
- Standing Forward Flexion Test
- Straight Leg Raise Test
- Supine to Long Sit Test
-
Shoulder
>
- Active Compression Test
- Anterior Apprehension
- Biceps Load Test II
- Drop Arm Sign
- External Rotation Lag Sign
- Hawkins-Kennedy Impingement Sign
- Horizontal Adduction Test
- Internal Rotation Lag Sign
- Jobe Test
- Ludington's Test
- Neer Test
- Painful Arc Sign
- Pronated Load Test
- Resisted Supination External Rotation Test
- Speed's Test
- Posterior Apprehension
- Sulcus Sign
- Thoracic Outlet Tests >
- Yergason's Test
- Elbow >
- Wrist/Hand >
- Hip >
- Knee >
- Foot/Ankle >
-
HEP
>
-
Neck and Shoulder
>
- Supine Chin Tuck
- Supine DNF with Towel Assist
- Supine DNF
- Standing Chin Tuck Against Wall
- Standing Chin Tuck Against Wall with Scaption
- Seated Cervical Retraction Repeated
- Seated Cervical Retraction with Extension Repeated
- Seated Cervical Retraction with Sidebend Repeated
- Seated Cervical Retraction with Rotation Repeated
- Standing Wall Shrugs at 90 Degrees Flex
- Seated Thoracic Whips
- Standing Ballistic Shoulder Extensions
- Standing Repeated Shoulder Extension with Squat
- Standing Repetead Shoulder Horiz. Abd. with Ext. CKC
- Seated with Arms on Pillows Cervical AROM (Flex/Ext/Rot/SB)
- Seated with Arms on Pillows Shrugs
- Seated with Arms on Pillows Shrug with Scapular Retraction
- Supine Shoulder IR with GH Centralization
- Supine Shoulder ER with GH Centralization
- Holding Dumbbell at 180 Degrees Flexion for Time
- Cat Camel
- Prone T's
- Prone Y's
- Quad Chin Tuck w/ Shoulder Flexion
-
Low Back
>
- Supine TA Isometric
- Standing TA Isometric Agains Wall with Squat
- Supine BKFO
- Quad Rock Back
- Standing Hip Hinge
- Sit to Stand with Hip Hinge
- Repeated Lumbar Sideglides
- Repeated Standing Lumbar Extension
- Repeated Standing Lumbar Flexion
- Repeated Prone Press-Ups
- Repeated Supine DKC
- Slump Sciatic Nerve Glides
- Birddog Progression
- Hip and Knee >
- Foot and Ankle >
- Examination Templates
-
Neck and Shoulder
>
-
Cervical Spine
>
- Insider Access
- Store
External Rotation Lag Sign (ERLS)
Purpose of Test: To test for the presence of isolated full thickness rotator cuff tears.
Test Position: Seated
Performing the Test: The examiner passively flexes the patient’s elbow to 90 degrees and brings the shoulder into a position of 20 degrees of scaption. Next, the examiner passively takes the patient’s shoulder into a position of maximal lateral rotation. The patient in then instructed to hold that position. A positive test is if the patient cannot maintain the position and the shoulder rotates internally.
Diagnostic Accuracy: Sensitivity: 56; Specificity: 98 (To test for full thickness tear of the Supraspinatus, Sensitivity of this test substantially improves performing this test to assess infraspinatus and teres minor.)
Importance of Test: When the shoulder is abducted and externally rotated, the supraspinatus muscle acts as a shoulder external rotator. By placing the arm in this position during the ERLS test, we are testing the ability of the supraspinatus (along with other rotator cuff muscles) to hold that position. Castoldi et al states “The ERLS is a useful sign for the diagnosis of isolated full thickness rotator cuff tears of the supraspinatus tendon. It is highly specific and offers a good sensitivity.” The authors also wrote that there is a strong correlation between the extension of the tear and the amount of lag present. “The lag increased from 7 degrees for an isolated rupture of the supraspinatus tendon to 26 degrees in case of extension into the teres minor.” Because the amount of lag can vary based off the size of the tear, it is a good idea to test the contralateral side for comparison. The authors make a point to use this test is conjunction with other rotator cuff examination measures as the novice clinician might not pick up on a small external rotation lag.
Note: these tests should only be performed by properly trained health care practitioners.
Test Position: Seated
Performing the Test: The examiner passively flexes the patient’s elbow to 90 degrees and brings the shoulder into a position of 20 degrees of scaption. Next, the examiner passively takes the patient’s shoulder into a position of maximal lateral rotation. The patient in then instructed to hold that position. A positive test is if the patient cannot maintain the position and the shoulder rotates internally.
Diagnostic Accuracy: Sensitivity: 56; Specificity: 98 (To test for full thickness tear of the Supraspinatus, Sensitivity of this test substantially improves performing this test to assess infraspinatus and teres minor.)
Importance of Test: When the shoulder is abducted and externally rotated, the supraspinatus muscle acts as a shoulder external rotator. By placing the arm in this position during the ERLS test, we are testing the ability of the supraspinatus (along with other rotator cuff muscles) to hold that position. Castoldi et al states “The ERLS is a useful sign for the diagnosis of isolated full thickness rotator cuff tears of the supraspinatus tendon. It is highly specific and offers a good sensitivity.” The authors also wrote that there is a strong correlation between the extension of the tear and the amount of lag present. “The lag increased from 7 degrees for an isolated rupture of the supraspinatus tendon to 26 degrees in case of extension into the teres minor.” Because the amount of lag can vary based off the size of the tear, it is a good idea to test the contralateral side for comparison. The authors make a point to use this test is conjunction with other rotator cuff examination measures as the novice clinician might not pick up on a small external rotation lag.
Note: these tests should only be performed by properly trained health care practitioners.
Reference: "External rotation lag sign revisited: Accuracy for
diagnosis of full thickness Supraspinatus tear"
Copyright © The Student Physical Therapist LLC 2018