Shoulder Lock Test

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 Shoulder Lock Test


What is the Shoulder Lock Test?

The Shoulder Lock test is used to help differentiate the cause of symptoms when the patient complains of localized catching shoulder pain, and pain or restricted movement, when attempting to place the hand behind the back.

The lock position compresses the subacromial space and reproduces pain with shoulder impingement syndrome.

This test is done along with quadrant position of shoulder.

How do you perform the lock test of the shoulder?

It is assumed that the techniques are performed on the patient’s right side:

Shoulder Lock Test
Shoulder Lock Test

What is a positive lock test?

Positive findings for this test include reproduction of the patient’s symptoms and a decrease in ROM compared with the uninvolved shoulder.

Sensitivity & Specificity

Since the clinician controls the motion, this test can be a very sensitive test to help confirm the presence of an impingement of the supraspinatus tendon.

Quadrant Position of Shoulder

The quadrant position of shoulder stresses the anterior and inferior part of the shoulder capsule and indicates capsular tightening.

Quadrant’ Position is reached from the ‘locked’ position:

A small arc of movement may be detected in this maneuver which resembles a ‘hill’ in the coronal plane.

shoulder quadrant position
Shoulder Quadrant Position

Notes

The results of this a study suggest that a number of pain sensitive structures may be involved, namely:

During ‘locking test’:

  1. the supraspinatus tendon,
  2. coracoacromial ligament
  3. glenoid labrum,
  4. acromioclavicula joint,
  5. subacromial bursa.

Where there is anteroinferior capsular tightness, movement may be restricted.

During ‘quadrant position’:

The supraspinatus tendon, coracoacromial ligament, glenoid labrum, acromioclavicular joint and subacromial bursa are implicated.

The tendon of long head of biceps, the superior, anterior and inferior fibres of the capsule, and, to a lesser extent, tendons of infraspinatus and subscapularis may also be involved.

References

  1. Mullen F, Slade S, Briggs C. Bony and capsular determinants of glenohumeral ‘locking’ and ‘quadrant’ positions. Aust J Physiother. 1989;35(4):202-8. doi: 10.1016/S0004-9514(14)60508-0. PMID: 25025618.
  2. Maitland G: Peripheral Manipulation, 3rd ed. London: Butterworth, 1991.
  3. Dutton’s Orthopaedic Examination, Evaluation, And Intervention 3rd Edition.



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