By Chris L. Wells Frances E. Huber
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Extra resources for Therapeutic Exercise. Treatment Planning for Progression
Passive cross-chest adduction. can also lightly palpate the patients acromioclavicular joint with one or two fingers of the examiner's other hand. The detection of localized crepitus in the acromioclavicular joint further implicates it as the site of injury or degeneration. SLAP LESIONS The O'Brien test or active compression test was originally conceived as a test for acromioclavicular joint injury, although it may indicate tears of the glenoid labrum, also known as SLAP lesions, as well. The term SLAP lesion is an acronym (Superior Labrum Anterior to Posterior) coined by Snyder to indicate tears of the superior glenoid labrum extending anteriorly and/or posteriorly.
The examiner then identifies the biceps tendon distally and palpates along it proximally until the point of maximal tenderness is reached. Sometimes, an actual divot can be felt at the musculotendinous junction, although this is usually obscured by hematoma and edema if the injury is in a subacute phase. Shoulder and Upper Arm 39 myositis ossificans in the arm is usually presaged by a feeling of warmth and firmness in the affected muscle. Pectoralis Major. Palpation can be helpful in the presence of a suspected pectoralis major rupture.
Another phenomenon that may be detected while testing active abduction is painful arc syndrome. In painful arc syndrome, the patient experiences no pain during the initial portion of abduction but begins to report pain as the abducted limb approaches shoulder level (Fig. 2-25). If the patient is able to continue abducting through the pain, he or she may actually report a decrease or resolution of the pain as the arm approaches full abduction. Sometimes the pain continues unabated to 180° of abduction.