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Special Test

Scapular Retraction Test

The scapular retraction test, described by Kibler et al. in 2009, is often used in conjunction with the dynamic labral shear test or the Jobe test to evaluate the potential role of scapular dyskinesis on supraspinatus strength and labral injuries.

How do you perform the Scapular Retraction Test?

In this maneuver, the scapula is first positioned and stabilized in a fully retracted position. With the scapula in this position, the examiner performs the dynamic labral shear test to evaluate the glenoid labrum followed by the Jobe test to evaluate supraspinatus strength (empty can test or full can test; however, it is advisable to use the full can test position in the setting of a positive scapular assistance test to minimize symptoms of impingement which can decrease strength measurements).

See Also: Empty Can Test
Scapular Retraction Test 2
Scapular retraction test. With the patient standing, the examiner manipulates the involved scapula into a position of full retraction. The patient then actively abducts the arm within the scapular plane while the examiner continues to apply a stabilizing pressure to the scapula. This posterior stabilization is maintained while the examiner performs both the dynamic labral shear test and Jobe test to assess for pathology involving the labrum or the rotator cuff, respectively

What does a positive Scapular Retraction Test mean?

The test is considered positive when the above described scapular manipulation decreases the symptoms associated with labral injury or rotator cuff impingement. A similar test has been described for the evaluation of infraspinatus strength in overhead athletes with scapular dyskinesis.

See Also:  Scapular Dyskinesis

Scapular Reposition Test

The scapular reposition test was first described in 2008 by Tate et al. as a modification of the scapular retraction test. The investigators aimed to decrease the amount of retraction while also emphasizing increased posterior tilt and external rotation of the scapula.

In their study, the Neer sign, Hawkins–Kennedy test, and Jobe’s empty can test were performed in 142 collegiate-level asymptomatic athletes. If any of the above-mentioned tests were positive, each maneuver was repeated with the addition of manual scapular repositioning.

See Also: Hawkins Kennedy test

Manual scapular repositioning was performed by first manually grasping the top of the shoulder with the fingers over the AC joint and the thumb resting along the scapula spine. The examiner’s forearm was then obliquely positioned over the scapular body. The examiner then applied a moderate force to the scapula using both their hand and forearm to encourage increased posterior tilt and external rotation without achieving full retraction.

Following scapular manipulation, the Neer sign and Hawkins Kennedy test were repeated to assess for any change in shoulder symptoms and the Jobe test was repeated to assess for any change in rotator cuff strength. The intra-class correlation coefficients for the evaluation of rotator cuff strength (using Jobe’s empty can test) were above 0.95 when the scapula was in its original resting position and during manual repositioning. No other studies have evaluated the clinical utility of this test.

Scapular Reposition Test
Scapular reposition test. With the patient standing, the examiner positions their forearm obliquely across the scapular body such that the fingers rest over the anterior shoulder. The patient is then asked to abduct the humerus in the scapular plane. During humeral elevation, the examiner’s elbow is used to push the inferomedial angle anterolaterally while the fingers are used to pull the scapula posteriorly. This posterior stabilization is maintained while the examiner performs the rotator cuff impingement signs

References

  1. Ben Kibler W, Sciascia AD, Hester P, Dome D, Jacobs C. Clinical utility of traditional and new tests in the diagnosis of biceps tendon injuries and superior labrum anterior and posterior lesions in the shoulder. Am J Sports Med. 2009 Sep;37(9):1840-7. doi: 10.1177/0363546509332505. Epub 2009 Jun 9. PMID: 19509414.
  2. Merolla G, De Santis E, Campi F, Paladini P, Porcellini G. Infraspinatus scapular retraction test: a reliable and practical method to assess infraspinatus strength in overhead athletes with scapular dyskinesis. J Orthop Traumatol. 2010;11(2):105–10.
  3. Tate AR, McClure PW, Kareha S, Irwin D. Effect of the scapula reposition test on shoulder impingement symptoms and elevation strength in overhead athletes. J Orthop Sports Phys Ther. 2008;38(1):4–11.
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