Complete List of SOTs PDF

**Complete List of SOTs** Lower Body SOT's Hip **Supine to Sit (Rattray pg. 1097)** Indication: Anterior innominate rotation, Posterior innominate rotation Positive Sign: Affected Limb longer when supine and shorter when seated, Affected limb shorter when supine and longer when seated Supine;...

**Complete List of SOTs** Lower Body SOT's Hip **Supine to Sit (Rattray pg. 1097)** Indication: Anterior innominate rotation, Posterior innominate rotation Positive Sign: Affected Limb longer when supine and shorter when seated, Affected limb shorter when supine and longer when seated Supine; RMT is at the end of table where the clients' feet are using both hands to both legs by the ankle. RMT uses both thumbs to check the level of medial malleolus and aligns their thumb with them. RMT instructs client to sit up whilst holding their ankles. **Gillet** Indication: Sacroiliac Hypermobility Positive Sign: Thumb on affected side PSIS moving superiorly as the knee lifts Standing straight, hand on something for stability; Thumb on S2 Lumbar spine and PSIS of affected side. Ask client to lift up affected side knee **[SI LIGAMENT SPRAIN INDICATIONS]** **Gapping** Indication: Sacroiliac Ligament sprain (Anterior) Positive Sign: Reports gluteal or posterior leg pain Supine; Apply cross arm pressure to medial aspects of ASIS, to push spines lateral and inferior simultaneously. **Squish** Indication: Sacroiliac Ligament sprain (Posterior) Positive Sign: Reports pain local to sacroiliac joint Supine; Hand on either side of ASIS and apply pressure lateral to medial then posteriorly to sacroiliac joints 45-degree angle **Yeoman** Indication: Nerve root compression/facet joint irritation Positive Sign: Localized pain SI region Prone; Client is face down. RMT places one hand on contralateral L/S and other under ipsilateral knee/thigh of client. Then proceeds to do hip extension. **Rocking** Indication: Integrity of Sacro-tuberous ligament Positive Sign: Pain in Sacroiliac Joint Supine; RMT bend client's knee towards contralateral shoulder. **Hip Quadrant "Scouring"** Indication: Capsular tightness, Osteophyte formation Positive Sign: Early leathery feel, bumpiness or crepitus in the movement, **Pain** Supine; Bend knee, flex hip towards client's contralateral shoulder and adduct, then abduction, then place the leg back straight and repeat. **[SI Joint Dysfunction INDICATIONS]** **Faber Test "Patrick Test" "Figure 4"** Indication: Sacroiliac Joint dysfunction, Hip joint pathology or shortened or spasmed psoas muscle Positive Sign: Pain local to sacroiliac joint, Affected leg higher than unaffected leg level Supine; Place clients affected foot on the unaffected knee to form a 4 shape of the legs. Press down on the unaffected hip with one hand and on the inner knee of the affected leg down slowly towards table. **Gaenslen's Test** Indication: Sacroiliac joint or hip dysfunction Positive Sign: Pain in lower back or SI joint Supine; Client is on edge of table. Lifts both knees towards chest, then lets affected leg closest to edge of table fall towards ground. Stabilize pelvis with one hand, while the other hand hyper-extends the affected leg at the hip. **Thomas Test** Indication: Iliopsoas -- shortening, Rectus Femoris-shortening, L/S - hyper lordosis Positive Sign: 1. Hand goes under back = hyper lordosis 2. Hand goes under thigh = rectus femoris 3. Leg does not touch table = iliopsoas Prone; Client seated at the edge of end of table. Hugs both knees and goes supine on back. Let go of one leg and let must lay down flat. 1. Slide hand under back 2. Slide hand under thigh (hamstring) 3. Let leg fall and assess position **Ely's Test** Indication: Rectus Femoris Shortening or Contracture Positive Sign: Ipsilateral hip rises at or after 90-degrees Prone; Bend knee, pull heel towards gluteal. **Nachlas** Indication: 1. Rectus Femoris Shortening 2. SI Joint Problem 3. SI joint hypomobility Positive Sign: 1. Pain @ front thigh 2. Hip Rise at 90-degrees 3. Lower back Pain Prone; Bend knee, pull heel towards gluteal. **[PIRIFORMIS INDICATIONS]** **Pace Abduction** Indication: Piriformis weakness Positive Sign: **PAIN** indicates piriformis trigger point Seated; Client has knees together; RMT in kneeling placing hands on lateral of knees, with client then pushing against resisted hands. **Piriformis Length Test** Indication: Shortened piriformis muscle Positive Sign: Reduced ROM of affected femur with affected leg closer to midline Side lying; Side lying on the edge of the table with GT towards ceiling. Unaffected leg slight knee flexion, place hand on client's side stomach for stability, bring top/affected leg toward self and slowly let drop **Piriformis Test** Indication: Positive Sign: **PAIN** Side Lying; Client is 60-90-degree hip flexed. 90-degree knee flexion, top leg moves in-front of lower, unaffected leg and push it down into table from knee whilst holding hip. **Trendelenburg's Sign** Indication: Weak glute Medius Positive Sign: Pelvis on unsupported side stays level or drops Standing; Same as Gillet **Ober's Test** Indication: IT band contracture Positive Sign: Sidelying; Client is side-lying on the edge of the table with the affected leg as the uppermost. RMT slightly flexes the unaffected leg while **Ober's Modified** Indication: Positive Sign: Side-lying; Low Back **Straight Leg Raise** Indication: 70-degree flexion pain (sciatic) down leg, **PAIN** posterior thigh Positive Sign: Sacroiliac Joint Dysfunction, Hamstring contracture Supine; RMT is at the side of the table holding the Achilles and patella of the client as they bring their leg to 90-degree hip flexion. RMT flexes their hip till range of motion is restricted. **Well-Leg Raise "Fajerztajn's Test"** Indication: Disc Herniation Positive Sign: **PAIN** Supine; RMT is at the side of the table holding the Achilles and patella of the client as they bring their leg to 90-degree hip flexion. RMT flexes their hip till range of motion is restricted. **Rebound Tenderness** Indication: Appendicitis Positive Sign: severe **PAIN** Supine; RMT flexes hip to 45-degrees and knees flexed with feet on the table. Place fingers in the middle of the umbilicus and the right ASIS (McBurney's Point.) Slowly apply downward pressure then quickly release pressure. **Valsalva** Indication: Disc Herniation Positive Sign: **PAIN** Seated; **Kemps Test** Indication: Face Joint Irritation Positive Sign: Radiating **PAIN** **Quadrant** Indication: Positive Sign: **Kernigs "Soto Hall" "Burdinski"** Indication: Meningeal/Dural Irritation Positive Sign: **PAIN** **Slump** Indication: Positive Sign: **90-90** Indication: Positive Sign: Knee SOTs **[Noble:]** Indication: Iliotibial Band Friction Syndrome Positive Sign: **PAIN** on Lateral thigh Supine; Press 2cm Proximal to the Lateral condyle of the Femur. Client start position is hip and knee flexion with foot flat on the table. Press down with thumb, as you slide the client's foot into full extension. **[PATELLA FEMORAL SYNDROME INDICATIONS]** **[Waldron Test:]** Indication: Patella Femoral Syndrome Positive Sign: **PAIN**, crepitus, or patellar tracking, grinding. Standing; Client is standing straight with hands on hips. RMT is knelt down in front them with either hand completely encompassing both knees. Client is then instructed to do a squat with knees leading forward for a few repetitions. RMT observes. **[McConnel's Test:]** Indication: Patella Femoral Syndrome Positive Sign: **PAIN** leaves when RMT pushes against patella Seated; Client affected foot starts at 120-degree flexion (backwards) with RMT placing pressure/resistance against their shin. RMT tests strength by resistance at 120, 90, 60, and 30 degrees. At the points they feel **PAIN**, RMT then pushes their own palm against client's patella and resists again through 120, 90, 60, 20 degrees. IF they feel no **PAIN** at the points where they previously felt **PAIN**, it will be a positive sign. **[Clarke's Test:]** Indication: Patella Femoral Syndrome Positive Sign: **PAIN** or Crepitus, grinding, inability to hold contraction Supine; Clients leg is in full extension with RMT placing hand on base of patella and pushes down on leg. RMT then asks client to flex their quadricep. **[PATELLA DISLOCATION]** **[Patellar Apprehension Test]** Indication: Patella Dislocation lateral Positive Sign: **PAIN** or client face apprehension Supine; client slightly flexes knee at 30-degrees. RMT holds around knee with both hands and uses both thumbs to push patella lateral. RMT is on other side of table from the knee. **[MCL & LCL INDICATION]** **[Apley's Distraction:]** Indication: Knee Ligament Injury, MCL & LCL General Positive Sign: **PAIN** at Knee with movement Prone; Knee 90 degree up. RMT places knee on clients hamstring, then pulls their knee up by with one hand on plantar of foot and other hand on the calcaneus tendon. Then RMT rotates the ankle during the pulling action. **[Varus Stress Test]** Indication: Integrity of Lateral Ligaments (LCL) Sprain Positive Sign: **PAIN** on ligaments Supine; Client knee is flex at 20-30 degrees. RMT places one hand on lateral malleolus and other hand on the medial side of the knee. RMT then pushes the malleolus medially and pull the knee laterally. **[Valgus Stress Test]** Indication: Integrity of Medial Ligaments (MCL) Sprain Positive Sign: **PAIN** on ligaments Supine; Client knee is flex at 20-30 degrees. RMT places one hand on medial malleolus and other hand on the lateral side of the knee. RMT then pushes the malleolus laterally and pushes the knee medially. **[Meniscus Injury INDICATIONS]** **[Braggards:]** Indication: Medial Meniscus Injury Positive Sign: **PAIN** at medial Supine; Knee slightly flexed to 30 degrees, internal rotate knee and bring to full extension. Then **[McMurray's:]** Indication: Medial or Lateral Menisci Positive Sign: **PAIN** at Lateral or Medial Supine; External Rotation and Abduction while the knee is initially fully flexed to full extension. Medial rotation + Adduction to full extension **[Apley's Compression:]** Indication: Meniscus Damage Positive Sign: **PAIN** on medial lateral ligaments Prone; Knee 90 degree up. RMT places knee on client's hamstring, then pushes their knee down by having one hand on plantar of foot and other hand on the calcaneus tendon. Then RMT rotates the ankle during the pulling action. **[POSTERIOR CRUCIATE LIGAMENT INDICATION]** **[Posterior Drawer Test]** **[Posterior "SAG" Sign (Gravity Drawer)]** Indication: Posterior Cruciate Ligament laxity or rupture. Positive Sign: Dent between femur and tibia Supine; Client 90-degree knee flexion with foot flat on table. RMT looks for dent between femur and tibia from the lateral view. **[ANTERIOR CRUCIATE LIGAMENT INDICATION]** **[Anterior Drawer Test:]** Indication: ACL Sprain Positive Sign: Excessive movement Supine; Client has 90 degree knee flexion and 45 degree hip flexion with foot flat on table. RMT sits on client's foot and wraps hands around knees with thumbs on the tibial plateau and other fingers on gastrocnemius. RMT pulls leg towards own body. **[Lachmans Test:]** Indication: Damage to ACL Positive Sign: Excessive movement or laxity Supine; Knee external rotation with 30-degreee knee flexion. RMT places one hand on anterior side of femur near patella to stabilize. The other hand on posterior tibia (on gastrocnemius) pulling upwards. Ankle/Foot Tests **[DEEP VEIN THROMBOPHLEBTIS]** **[Homan's Sign:]** Indication: Deep Vein Thrombophlebitis Positive Sign: **PAIN** deep in calf Supine; Grab clients heel and place in dorsiflexion by using forearm to push in and slightly lunging. **[Ramirez:] QUIZ/FINAL EXAM ONLY** Indication: Deep Vein Thrombophlebitis Positive Sign: **PAIN** in calf Supine; Place clients foot in full in flexion with foot placed flat on the table. Use blood pressure pump and place clients thigh, then pump to 40mmg. Maintain pressure for two minutes **[Functional/Structural Pes Planus:] FINAL** Indication: Positive Sign: Standing (Functional) Seated (Structural); Observe for flat foot in both positions **[Thompson's Test:]** Indication: Achilles tendon Rupture Positive Sign: Absence of Plantarflexion during squeeze. Prone; Client is prone with feet and half of shin off the edge of table. Flex foot to 90 degrees and squeeze the calf muscle (gastrocnemius) and observe any movement of the foot. **[Babinski:]** **pg. 1113** Indication: Central Nervous System Lesion Positive Sign: (Adults) Extension of toes (Babies) Flexion of toes Supine; Lift the foot up by the heel 30 degrees and use the hammer tool, metal side (or pointed edge tool) and slide it up from the heel to the top of foot. **[Anterior Drawer Test:] pg. 1114** Indication: Rupture of talofibular ligament Positive Sign: Excessive movement of talus Supine; Clients foot is and half of shin is off the edge of table. RMT holds anterior side of lower shin and other hand holds the heel. Pull the heel down and pull the anterior shin upwards. **[Anterior Talofibular Ligamentous Stress Test:]** **pg. 1114** Indication: Talofibular Ligamentous Sprain Positive Sign: Local **PAIN**, excessive movement Seated; Client sits on edge of table with feet hanging off. One hand holds posterior inferior side of leg (on calcaneus tendon) and other hand on dorsal (top) of foot. Grab the foot and plantarflex, inversion and adduction. **[Deltoid Ligamentous Stress Test:] pg. 1115** Indication: Deltoid Ligament Sprain Positive Sign: **PAIN**, or Excessive movement Seated; Medial side of foot 1. Plantar + Eversion w/ pressure (Anterior Deltoid) Hold Dorsal of foot with other hand on calcaneus tendon. 2. Eversion w/ pressure (Middle Deltoid) Hold Plantar of foot and other hand on calcaneus tendon. 3. Dorsi + Eversion (Posterior Deltoid) Hold Plantar of foot and other hand on calcaneus tendon. **[Talar Tilt Test (Inversion Stress Test):] pg.** Indication: Ligament Sprain Positive Sign: **PAIN**, or excessive movement Supine or Side-lying; Foot in anatomical position (neutral or flat position). Then pull foot from abduction to adduction. Place hand on Dorsal of foot and other hand on calcaneus tendon. **[Tinel's Sign:] pg. 1120** Indication: Nerve Compression Positive Sign: Paresthesia Supine; Use index finger to tap on the Head of Fibula (Common Peroneal) Use index finger to tap on the lateral side of malleolus (Deep Peroneal) I think its actually anterior of foot Use index finger to tap in between medial malleolus and Achilles tendon (Posterior Tibial Nerve) **[Morton's Neuroma Test:] pg. 1115** Indication: Neuroma Nerve Positive Sign: Sharp **PAIN** at location of neuroma Seated; One hand on dorsal of foot and other hand holding calcaneus tendon. Neuroma = Tumor Squeeze foot placing palm on dorsal foot and wrap fingers around plantar. **[Head & Neck]** **[Vertebral Artery Tension Test (Cervical Quadrant)]** Indication: Vertebral Artery Compression (Circulation deficiency) Positive Sign: Eyes flutter, Dizziness, Nystagmus, Vertigo Supine; Client head is floating off table. Place head in extension (drop head) then rotate. Check for the positive sign for a few seconds then bring back to neutral. Repeat on the other side. **[Three Knuckle Test:]** Indication: TMJ Dysfunction Positive Sign: Pain or unable to do action. Seated; Ask client to place their own three knuckles into their mouth. **[Swallowing (no op)]** Indication: Sternocleidomastoid muscle trigger point. Positive Sign: Pain in Trigger point patterns. Seated; Pinch their SCM and ask them to swallow. **[Scalene Cramp Test]** Indication: Anterior Scalene muscle trigger point Positive Sign: Pain in trigger point patterns of Scalene muscle Seated; Ask client to bring their ear to their shoulder and look down. Lateral shoulder, Lateral arm, Lateral forearm, Index finger are trigger points. **[Scalene Relief]** Indication: Anterior Scalene muscle trigger point Positive Sign: Reduction of pain/numbness Seated; Ask client to bring elbow to forehead, elevate, protract shoulders. (Client brings forearm to head as if its hot outside and their wiping off sweat, then shrugs shoulder up) **[Nerve Root/Facet Irritation]** **[Spurlings Test]** Indication: Facet Joint Irritation & Nerve Root Compression. Positive Sign: Pain in area (C/S), numbness to arms Seated; Client extends, side bends, rotates, push their head down. (Kemps for C/S) **[Cervical Compression]** Indication: Facet Joint Irritation & Nerve root compression Positive Sign: Pain in local area, numbness in arms Seated; RMT laces fingers together and places on top of head, then adds pressure (downwards). Stretch the neck back up after. **[Cervical Distraction:]** Indication: Facet Joint Irritation, Nerve root compression Positive Sign: Relief of Pain and Neurological Symptoms Seated; RMT puts one hand under chin and other hand under occiput. If client has TMJ problem then move hand from chin to temporal area then lift the head up. **[Jackson's]** Indication: Nerve Root Compression Positive Sign: Pain or Numbness on same side arm. Seated; RMT is behind client. Rotate head and RMT applies downward pressure. Stretch the neck back up after. **[GH Group]** **[Apley's Scratch]** Indication: G/H Joint Pathology Positive Sign: Unable to touch two hands. Standing; RMT instructs client to touch hands together behind their back by reaching one hand from upper back and the other reaching from lower back. **[Sulcus Sign]** Indication: Inferior instability of GH Positive Sign: Dent/Sulcus in Shoulder (between Acromion and head of humerus) Seated; RMT uses both hands to grab onto the distal humerus and pulls down. **[Clunk Test (Labral Test)]** Indication: Glenoid Labrum Tear Positive Sign: Grinding, clunk sound. Supine; Clients shoulder is fully abducted, RMT grabs proximal humerus with the other hand clenched in a fist, under the clients shoulder. The clenched hand is moved anteriorly, while the other hand external rotates the humerus. **[A/C Shear (General Test) Acromioclavicular]** Indication: G/H Joint Pathology Positive Sign: Pain or Excessive movement on joint Seated; RMT is standing at the side of the client and laces hands together then wraps around shoulder. Then RMT slowly compress hands together. **[Anterior Apprehension Test]** Indication: Dislocation or Sublocation of GH Joint (Anterior Shoulder Stability) Positive Sign: Apprehension, Pain Supine; RMT passively abducts shoulder to 90-degrees with elbow flexed at 90. RMT stabilizes shoulder with one hand and uses other hand to slowly lateral rotate shoulder. Client will respond in pain/apprehensive facial expression. **[Jerk Test (Palmer 116)]** Indication: Posterior Shoulder instability Positive Sign: Client \**Jerks*\* due to PAIN Seated; Client shoulders flexed 90-degrees with elbow flexed 90-degrees. Then RMT holds the client by the wrist and stabilizes by holding onto shoulder, then pushes elbow into the direction of client while adducting shoulder towards contralateral side of body. **[Supraspinatus Group]** **[Painful Arc Test]** Indication: Supraspinatus Tendonitis, Subacromial Bursa Positive Sign: **PAIN** at 70-degrees abduction, Ease off at 130-degrees Standing; Instruct client to abduct fully. 60-120 **PAIN.** 130-180 **NO PAIN.** **[Supraspinatus Test]** Indication: Tear/Lesion of Supraspinatus, Scapular Nerve Dysfunction Positive Sign: **PAIN,** weakness Standing; RMT abducts client shoulder to 90-degrees with thumbs pointing up in neutral position. RMT then resists abduct by placing hands on the humerus. Then client does thumbs down **[Hawkins -- Kennedy]** Indication: Supraspinatus Tendonitis? Positive Sign: **PAIN** during Internal Rotation Seated; Flex client's shoulder to 90-degrees, flex elbow 90-degrees. Stabilize elbow with one hand and with the other grab the wrist of the client and internally rotate the clients shoulder inward (towards the body.) Pain should be felt during internal rotation of the shoulder. **[Drop Arm Test]** Indication: Supraspinatus Integrity, Rotator Cuff dysfunction Positive Sign: Pain or Arm drops, unable to adduct slowly Seated; RMT places client arms in 90 abductions. Then instructs client to adduct slowly back to body. **[Neer Impingement ]** Indication: Supraspinatus Tendonitis (Overuse) Positive Sign: Pain in Acromion area Seated; RMT is behind client brings arm slightly past 180-degree shoulder flexion. Stabilize shoulder by placing hand on upper traps. **[Bicep Group]** **[Yeargason's ]** Indication: Bicep Tendonitis, Integrity of Bicipital Groove Positive Sign: Pain, Tendon popping out. Seated; Flex client's elbow to 90-degrees with elbows pronated. Stabilize clients elbow with the thorax (side of body) and other hand shaking the hand of the client. Stabilize the shoulder with the other hand, with the thumb on the bicipital groove. Extend the elbow forward (straightening the arm) while the client supinates the forearm as you resist this action. **[Ludington's Test ]** Indication: Bicep Tendon Rupture Positive Sign: Unable to contract Bicep. Seated; Client places both hands at the back of their own head (as if being arrested.) RMT is behind client and palpates the bicep tendon (on shoulder), while they are contracting/flexing their biceps. **[Speed's Test]** Indication: Bicep Tendonitis Positive Sign: Pain on tendons (on Biceps origin) Seated; Ask client to completely extends arm while supinating. RMT has one hand elbow or forearm (to resist) and other on shoulder (to stabilize). RMT resists client's action and asks for any PAIN. Then ask client to completely extend arm while pronation. RMT asks for any PAIN. **[Transverse Humeral Ligament Test (Booth or Marvel Test) -- Palmer 109]** Indication: Transverse Humeral Ligament Rupture Positive Sign: Popping, Ligament moves out of groove *\*Ligament is on bicipital groove* Seated; RMT places clients arm in 90-degree abduction, 90-degree elbow flexion, and external rotation 90 degrees. RMT palpates ligament with thumb while taking clients arm from neutral/0-degree rotation to 90-degree rotation. **[Lipman Test]** Indication: Bicipital Tendonitis Positive Sign: Pain Seated; RMT finds bicipital groove with thumb. Then RMT presses into tendon, tracking its movement while external and internally rotating the shoulder by holding onto the client's wrist. Elbow is flexed at 90-degrees. **[ULTT Group]** **[Upper Limb Tension Test \#3 (ULTT)]** Indication: Radial Nerve Positive Sign: Paresthesia of Thumb, Ring Supine; Depress the shoulder, then abduct 110-degrees. Fully pronate the forearm. Flex the wrist. Ulnar deviation. Flex Wrist. Contralateral side bending of the neck. **[Upper Limb Tension Test \#4 (ULTT) ]** Indication: Ulnar Nerve Positive Sign: Paresthesia of Pinky Supine; Depress the shoulder. Adduct between 90-degrees. Flex the elbow 90-degrees. Pronate the forearm. Extend the wrist and radial deviation. Then extend the fingers. Laterally rotate the shoulder (upwards.) Contralateral side bending of the neck. **[Upper Limb Tension Test \#1]** Indication: Median Nerve Compression (C5 C6) Positive Sign: Numbness, Tingling in fingers (middle Supine; RMT is at the side of the client. Depress and bring into shoulder 110 abduction, 10-degree extension, 60 external rotations, extend wrist then extend fingers, ask for any feeling, then supination shoulder. No symptoms, then contralateral side bend neck **[Upper Limb Tension Test \#2]** Indication: Checking Median, Mucocutaneous, Axillary Nerve Compression Positive Sign: Numbness, Tingling in Fingers Supine: Client starts with hands at the side of body with hands in neutral position. Depress client's shoulder and abduction 10-degrees, slowly extend wrist, fingers and elbow, supination. If still no symptoms, then contralateral side bending of neck. **[Collateral Ligaments]** **[Valgus Test]** Indication: Medial Collateral Ligament Instability Positive Sign: **PAIN** MCL Supine; RMT places clients arm in slight flexion with forearm supinated. RMT places one hand on the lateral side of the elbow and the other hand holding the medial forearm. **[Varus Test]** Indication: Lateral Collateral Ligament Positive Sign: **PAIN** in LCL Supine; RMT hand on the medial side of the elbow while the other hand is holding the lateral forearm. RMT then pushes **[Forearm & Wrist]** **[Mills]** Indication: Tendonitis of Common Extensor Tendon Positive Sign: **PAIN** local to the Common Extensor Tendon Seated; RMT flexes clients shoulder to 90-degrees with elbow fully flexed, then flexes their wrist to 90-degrees (fingers pointing downward.) RMT hold elbow to stabilize. **[Reverse Mills]** Indication: Tendonitis of the Common Flexor Tendon Positive Sign: **PAIN** local to the Common Flexor Tendon Seated; Seated; RMT flexes client's shoulder to 90-degrees with elbow fully flexed, then flexes their wrist to 90-degrees (fingers pointing upward.) RMT hold elbow to stabilize. **[Extensor Tendinosis Test (Cozen's)]** Indication: Common Extensor Tendinosis Positive Sign: **PAIN** at the common extensor tendon Seated; Client's arm is flexed 90-degrees with full elbow extension. Wrist is pronated. RMT stabilizes by holding the elbow with thumb on the lateral epicondyle of humerus. RMT then resists wrist extension while their hand is clenched. **[Flexor Tendinosis Test]** Indication: Common Flexor Tendinosis Positive Sign: **PAIN,** weakness in Common Flexor Tendon Seated; Client's arm is flexed 90-degrees with full elbow extension. Wrist is supinated. RMT stabilizes by holding the elbow with thumb on the medial epicondyle of humerus. RMT then resists wrist extension while their hand is clenched. **[Finkelstein]** Indication: Quervain's Tenosynovitis Positive Sign: **PAIN** by lateral of wrist Seated; Client's arm is in 90-degree flexion while forearm is in neutral position. Client's hand is clenched with thumb in between palm and fingers. Then client performs radial deviation, resisted by RMT. **[Tinel's Sign]** Indication: Neuroma, Nerve Compression Positive Sign: Paresthesia Seated; RMT finds the ulnar nerve which is in between the olecranon and the medial epicondyle. RMT taps at that point. The 2^nd^ spot is in the middle of the anterior wrist beside the styloid process of radius. **[Rockwood]** Indication: Anterior shoulder instability Positive Sign: Pain in Posterior and Anterior Shoulder Seated; 0, 45, 90, 120 shoulder abduction. At every degree do full internal rotation. **[Allen Test (Wrist)]** Indication: Integrity of the Ulnar and Radial arteries of the hand Positive Sign: Diminish/Slow blood flow. Seated; Client quickly open and clenches hand a couple of times. Then RMT tells them to stop with hand clenched tight. RMT checks both ulnar and radial pulse then when found instructs them to open while releasing ulnar pulse and checking radial. **[Froments]** Indication: Ulnar Nerve Lesion Positive Sign: Client cannot hold paper. Seated; Client holds piece of paper with thumb in neutral position. Assessment Upper Body & Quiz \#2 1. Wrist Extension Ligament Stress Test 2. Wrist Flexor Ligament Stress Test 3. Radial Ligament Stress Test 4. Ulnar Ligament Stress Test **[TOS Group]** **[Roos]** Indication: Thoracic Outlet Syndrome (TOS-General) Positive Sign: **PAIN,** paresthesia, unable to open/close hands. Standing; Client shoulder is abducted 90-degrees with elbow flexion at 90-degrees. Shoulder is also external rotated fully. RMT then instructs client to open & close fists for **3 minutes**. **[Halstead's Maneuver]** Indication: Thoracic Outlet Syndrome (TOS) Positive Sign: Diminish/Disappear Pulse Seated; Palpate Radial pulse. Client hyperextends neck and rotates to the unaffected side. RMT checks radial pulse. **[Eden]** Indication: Thoracic Outlet Syndrome (TOS) Rib Positive Sign: Disappear/Diminish of Pulse Seated; RMT behind client. Check the pulse of client after does depression and retraction of scapula. Same as costoclavicular, except client does it themselves (AROM). **[Travell's Variation of Adson's]** Indication: Thoracic Outlet Syndrome of Middle Scalene Positive Sign: Diminish/Disappear Pulse Seated; The same as Adson's except take a breath and don't hold. Extend and externally rotate the arm then palpate the pulse. Client rotates head to the opposite side and takes breath. **[Wright's Hyperabduction]** Indication: Thoracic Outlet Syndrome (TOS) of Pectoralis Minor Positive Sign: Diminish/Disappear Pulse Seated; RMT checks clients pulse then abducts client shoulder to 180-degrees, and slightly extend the shoulder (backwards.) **[Adson's Test (TOS -- Thoracic Outlet Syndrome)]** Indication: TOS -- Thoracic Outlet Syndrome Positive Sign: Pulse disappears after head rotation Seated; RMT stands behind client as they extend and externally rotates (GH) joint then palpates radial pulse (@ the styloid process of radius) Then instruct client to rotate head to same side, elevate the chin, take a deep breath and hold for 30 seconds. **[Costoclavicular Syndrome]** Indication: TOS -- Thoracic Outlet Syndrome Positive Sign: Diminish/Disappear Pulse Seated; RMT stands behind client and palpates the radial pulse, then depress and retract scapula. **[Allen's Test (Palmer 118)]** Indication: TOS -- Thoracic Outlet Syndrome Positive Sign: Diminish/Disappear Pulse Seated; RMT is behind client. Client shoulder is abduction 90 degrees, elbow flexion 90 degrees and externally rotated up. RMT palpates pulse then client rotates head to contralateral shoulder. **[Carpal Tunnel Syndromes]** **[Phalen's]** Indication: Carpal Tunnel Syndrome Positive Sign: **PAIN**, numbness in fingers (Palmar surface of thumb, index, middle, and lateral half of the ring finger) Seated; Client puts back of hands together, so fingers are downward. Client strongly compresses back of hands together for **one minute**. **[Reverse Phalen's:]** Indication: Carpal Tunnel Syndrome Positive Sign: **PAIN**, numbness in fingers (Palmar surface of thumb, index, middle, and lateral half of the ring finger) Seated; Client does prayer hands. **[Cyriax Phalen's]** Indication: Carpal Tunnel Syndrome Positive Sign: Reduction of **PAIN**, numbness in fingers (Palmar surface of thumb, index, middle, and lateral half of the ring finger) Seated; Client does Phalen's then suddenly does wrist extension with hands and arms open.