We all spent hours during our clinical education agonizing over the specifics of orthopedic ‘special tests’. But, are they really that ‘special’? Numerous orthopedic testing procedures (otherwise known as ‘special tests’) have been developed in an effort to establish a tissue-specific diagnoses for rotator cuff-related shoulder pain (RCRSP). Clinical conditions that are placed in this category include rotator cuff-related shoulder pain, subacromial impingement syndrome, rotator cuff tendinopathy, bursa pathology and atraumatic partial/full thickness rotator cuff tears. These authors sought to outline and critique the current use and validity of RCRSP orthopedic tests and provide specific recommendations for how clinicians might consider using these special tests in practice…LOG IN OR SUBSCRIBE TO ACCESS THIS REVIEW!
THIS WEEK'S RESEARCH REVIEW: “Special Tests for Rotator Cuff-Related Shoulder Pain – A Critique”
This paper was published in the Journal of Orthopaedic and Sports Physical Therapy (2020) and this Review is posted in Recent Reviews, Shoulder and the 2020 Archive.
The authors argue that use and teaching of RCRSP special tests be discontinued until a valid reference standard associated with the patient’s pain experience can be identified. Special tests should no longer be used to inform patients of the source of their symptoms in surgical and non-surgical practice. The authors posit that if these tests are used, interpretation should only be related to symptom reproduction, without definitive emphasis on a specific pathological structure.