Special Test of the Week: The O'Briens Active Compression Test

O’Briens Active Compression Test: Distinguishes between superior labral and acromioclavicular abnormalities in the shoulder.
Test: The patient flexes the affected arm to 90 degrees with the elbow in full extension.  The patient adducts the arm to 10-15 degrees medial to the sagittal plane of the body.  The arm is then internally rotated so the thumb is downward.  The examiner then applies a downward force to the arm.
Interpretation: A + test is pain with this and then reduced pain with the arm in the same position, but with the arm supinated.  Sensativity: 100%, Specificity: 99%, for labral pathology.
Tennent TD, Beach WR, Meyers JF.  Clinical Sports Medicine Update. A Review of the Special Tests Associated with Shoulder Examination: Part II: Laxity, Instability and Superior Labral Anterior and Posterior (SLAP) Lesions. Am J Sports Med. 2003:31;301-07.

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