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Long head of biceps tendon (LHBT) Testing
Overhead activities can cause anterior shoulder pain due to LHBT instability. A review of 3 physical exam maneuvers for bedside evaluation.
Speed test
Shoulder at 90° of flexion with arm fully supinated and elbow extended
Patient attempts to fwd. elevate arm against a downward force
Positive test is pain localized to bicipital groove.
Sensitivity 54% and specificity 81% for biceps pathology
Yergason test
Elbow at 90° of flexion with arm fully pronated and held against thoracic wall. Examiner grips patient’s hand and resists attempts at supination.
Positive test is pain localized to bicipital groove or LHBT subluxation.
Sensitivity 41% and specificity 79% for biceps pathology
Upper Cut test
Shoulder neutral with Elbow at 90° of flexion, arm fully supinated and hand in a fist. Patient moves hand toward chin in an uppercut motion like a boxer. Examiner places hand over patient’s fist and resists upward movement.
Positive test is pain localized to bicipital groove or LHBT subluxation.
Sensitivity 73%, specificity 78%, +LR 3.38 for biceps pathology
References
Comprehensive Examination of the Shoulder. Cotter et al., 2018. Sports Health